Uses

Metoprolol (Lopressor) is a selective beta -1 antagonist also known as a beta blocker. This drug works by decreasing the activity of the beta -1 receptors which are found in the heart and smooth muscle cells. Metoprolol (Lopressor) is used to reduce blood pressure and heart rate and is used to treat conditions such as hypertension, chest pain, migraines, and heart attacks.

How to Use

Take this medication by mouth with water. Take this medication right after a meal.

Take it exactly as directed, do not take it more often than directed.

Do not suddenly stop taking this medication, this can cause a risk of serious adverse events.

If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.

Important Information

Contact your healthcare provider if your symptoms worsen.

Do not operate heavy machinery, drive a car, or engage in other activity that requires fine motor skills until you are sure of how this medication affects you.

Check your blood pressure and meet with your doctor regularly while on this medication.

Do not suddenly stop taking this medication, this can cause a risk of serious adverse events.

Stand and sit slowly when first starting this medication to avoid dizziness.

Avoid alcohol consumption, alcohol can increase the chances of dizziness or drowsiness occurring.

Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication

Diabetes, heart or blood vessel conditions, heart failure, slowed heart rate, Reynaud’s Disease, kidney or liver disease, lung or breathing conditions such as asthma, pheochromocytoma, thyroid disease, allergy history, pregnancy, breastfeeding, trying to become pregnant.

Side effects that should be immediately reported to your healthcare provider

Allergic reactions(hives, itching, swelling of the face or mouth), trouble breathing, depression, lightheadedness or fainting, chest pain or heartbeat changes, weight gain, swelling of the legs or ankles, coldness or numbness of the hands or feet.

Other Side Effects

Dry skin, headache, sleep changes, short term memory losses, anxiety, fatigue, stomach upset, diarrhea.

Adult Dose

Myocardial Infarction

Metoprolol Tartrate: 25-50 mg by mouth every 6-12 hours. In 2 or 3 days the patient is switched to Metoprolol Succinate, the dose is then titrated to 200 mg once daily.

Angina

Metoprolol Succinate Extended Release Tablet: 100 mg by mouth once daily as a starting dose. The dose can then be increased at intervals of no less than 1 week based on response.

Immediate Release Tablets: 50 mg by mouth twice per day. The dose may then be titrated at intervals of no less than 1 week according to response.

Hypertension

Regular Release Tablets: 100 mg by mouth daily, given in single or divided doses. The dose may then be titrated at intervals of no less than 1 week according to response.

Extended Release(Toprol XL): 25-100 mg by mouth once daily. The dose may then be titrated at intervals of no less than 1 week according to response.

Congestive Heart Failure

Extended Release: 25 mg by mouth once daily for 2 weeks if the patient is in NYHA class two. 12.5 mg by mouth once daily for patients with more severe heart failure. The dose is typically doubled every 2 weeks to a target dose of 200 mg by mouth once daily. These are general dosing guidelines and doses can be increased and decreased based on patient specific factors.

Sources

1. Lopressor (metoprolol tartrate) tablet [package insert]. Parsippany, NJ: Validus Pharmaceuticals; 2013.

2. Rosendorff C, Black HR, Cannon CP, et al. Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation 2007;115:2761-88.

3. Toprol-XL (metoprolol succinate) [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2014.

4. Antman EM, Hand M, et al. 2007 Focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction. Circulation 2008;117:296-329