Metoprolol

Metoprolol is a prescription beta-blocker used to treat high blood pressure, heart failure, angina, and to prevent heart attacks. By blocking beta-1 adrenergic receptors, this medication slows the heart rate, reduces the heart’s workload, and improves blood circulation.

Metoprolol is FDA-approved and comes in various forms. Its immediate-release tablet is available under the brand name Lopressor (Metoprolol Tartrate), while the extended-release version is marketed as Toprol-XL (Metoprolol Succinate). It is widely prescribed for adults and sometimes used off-label for migraines.

Quick Facts About Metoprolol

Immediate Release (Metoprolol Tartrate)

Tablets:

• 25 mg
• 37.5 mg
• 50 mg
• 75 mg
• 100 mg

Extended Release (Metoprolol Succinate)

Tablets/Capsules:

• 25 mg
• 50 mg
• 100 mg
• 200 mg

Injectable Solution for Intravenous Use

• 1 mg/mL for hospital use, especially in acute conditions like a heart attack

Before you buy Metoprolol online, consult a doctor, as the dosage should be personalized by your healthcare provider based on your condition. The Metoprolol dose for adults and children may vary based on FDA prescribing information.

Metoprolol Dose for Adults (Immediate‑Release)

• Immediate‑release (Metoprolol Tartrate) tablets are usually taken twice daily due to their shorter duration of action.
• The maximum total daily dose is up to 400 mg.

Metoprolol Dosage for Adults (Extended‑Release)

• Extended‑release (Metoprolol Succinate) tablets are designed for once‑daily use.
• The maximum studied doses are generally ≤400 mg/day.

Metoprolol Dose for Children (Immediate‑Release)

• In children, the immediate-release form is mainly used for hypertension under specialist guidance.
• Use in children ≥1 year only under specialist guidance.
• Safety for <6 years is not established.

Metoprolol Dose for Children (Extended‑Release)

Whether you take Metoprolol for hypertension or other approved uses, you must know the correct steps of administration:

• Take with or immediately after a meal.
• Swallow whole tablets with a glass of water.
• Do not crush or chew the medicine.
• Do not skip doses; take them at the same time every day.
• Some tablets have a score line and can be broken in half if you are having difficulty swallowing them.
• Monitor your heart rate and blood pressure regularly during treatment.
• The IR form is good for short-term control or titration.
• The ER form is better for once-daily long-term management of hypertension, angina, or heart failure.
• Store the tablets at room temperature, away from moisture and heat.
• Always consult your doctor to know which Metoprolol form is better for you.

Metoprolol is a β₁-selective beta-blocker that works by blocking adrenaline’s effects on the heart and kidneys. When you take Metoprolol for angina, hypertension, or other approved uses, it slows the heart rate, reduces the workload on the heart, and lowers AV nodal conduction, which decreases the heart’s oxygen demand. In the kidneys, it reduces renin release, helping to lower blood pressure.

• These side effects may not be a complete list. If you notice any other side effects that are not mentioned here, talk to your medical provider.

Abrupt Discontinuation Risk:

• Do not stop treatment with Metoprolol suddenly, as this may cause worsened chest pain, heart attack, or arrhythmias.
• The risk is higher in patients with ischemic heart disease.
• Abrupt withdrawal may cause a sudden spike in blood pressure and heart rate.
• Sudden discontinuation is not recommended. If it is necessary, consult a healthcare professional. Dosage should be gradually decreased under medical supervision.

Is Metoprolol a High-Risk Drug: Metoprolol Warnings

Metoprolol, a beta-blocker, is not considered a high-risk drug, but like any medication, it carries certain warnings.

• This medication may cause a slow heart rate. Use cautiously in patients with severe bradycardia.
• People with decompensated heart failure should only start treatment under medical supervision.
• This beta-blocker can significantly lower blood pressure. If you are taking Metoprolol for hypertension, watch out for adverse symptoms, such as dizziness, fainting, or fatigue.
• Use cautiously in people with asthma or COPD, as the medication may worsen respiratory conditions.
• Cardioselective beta-blockers like Metoprolol can mask symptoms of hypoglycemia in diabetic patients. If you have low blood sugar, monitor for adverse effects.
• Metoprolol is a category C pregnancy drug. There are no controlled studies on the medication's safety in such situations. If you are pregnant or planning to have a baby, talk to your doctor to rule out any complications. Use only if clearly needed under medical supervision.
• Consult a medical expert before using this medication while nursing.

What to Avoid When Taking Metoprolol?

• Before taking Metoprolol for angina or other heart-related conditions, tell your doctor if you have:
  • Diabetes
  • Congestive heart failure
  • Breathing issues like asthma, COPD, or sleep apnea
  • Liver problems
  • Raynaud’s syndrome
  • Thyroid disorder
• Avoid alcohol, as it may increase dizziness, drowsiness, and low blood pressure.
• Do not take other heart-rate-lowering medicines unless prescribed by your doctor.
• Avoid taking too much medication due to the risk of a Metoprolol overdose. Symptoms may include heart rhythm changes, nausea, vomiting, or severe low blood pressure.

Metoprolol Contraindications

Do not take if you have:

• 2nd- or 3rd-degree AV block without a pacemaker.
• Overt cardiogenic shock.
• Allergic reactions to any of the medication’s ingredients.

Cardioselective and non-cardioselective beta-blockers differ in how they act on heart and lung receptors. Metoprolol is a cardioselective beta-blocker. Depending on a patient’s condition, such as asthma or diabetes, doctors may choose a cardioselective or non-cardioselective beta-blocker as an alternative to Metoprolol.

Do not take if you have:

• 2nd- or 3rd-degree AV block without a pacemaker.
• Overt cardiogenic shock.
• Allergic reactions to any of the medication’s ingredients.

Metoprolol has several drug interactions, some of which are as follows:

• Other blood pressure or heart-rate–lowering drugs:
  • Verapamil
  • Diltiazem
  • Digoxin
• Antiarrhythmics like Amiodarone
• CYP2D6 inhibitors:
  • Fluoxetine
  • Paroxetine
  • Quinidine
  • Bupropion
• NSAIDs:
  • Ibuprofen
  • Naproxen

Before using Metoprolol for hypertension or other heart-related conditions, you must be aware of the following important safety information as per the FDA official prescribing data:

Metoprolol comes in two forms: Tartrate and Succinate. Both formulations are beta-blockers used to treat heart conditions, but they differ in dosing, duration, and specific uses. Here’s a clear comparison table for Metoprolol Tartrate vs. Metoprolol Succinate:

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