Metoprolol Tartrate

Metoprolol Tartrate is a prescription drug that comes as immediate-release oral tablets. This medication is used to treat conditions like high blood pressure (hypertension) & angina (chest pain). It can be used in combination with other drugs prescribed by a medical professional. Besides, it helps prevent the risk of strokes, kidney problems, and heart attacks. There are two brand-name forms of Metoprolol, which are quite similar but differ in salt forms. Metoprolol Tartrate is known by the brand name Lopressor, and Metoprolol succinate is known by the brand Toprol-XL. While both have different salt forms, they treat the same condition. However, ensure that you are following your medical practitioner’s guidance to avoid any problems.

Metoprolol Tartrate is a prescription medication approved by the FDA for managing hypertension, angina pectoris, and early intervention in myocardial infarction. It contains the active ingredient metoprolol tartrate, a beta-blocker that effectively reduces blood pressure, alleviates chest pain, and improves survival after a heart attack. People might get confused between its two forms, Metoprolol Tartrate and Metoprolol Succinate. While both are almost similar, they differ in their salt formations. The first form is an immediate-release version of the medication, and the latter comes as an extended-release version of Metoprolol, which stays in the bloodstream for a longer period of time.

Metoprolol Tartrate is available in tablet form and intravenous injections. Tablet strengths include 25 mg, 50 mg, and 100 mg, while the intravenous form is administered in 5 mg doses. It should be taken with or followed by meals for optimal absorption. Moreover, dosages may vary from patient to patient based on the condition being treated. Generally, adults are prescribed an initial dose of 100 mg per day, with possible adjustments. It is suitable for adults, and a healthcare provider should carefully monitor and adjust the dosage.

Common side effects include dizziness, fatigue, depression, and shortness of breath. Patients are advised to avoid abrupt discontinuation of the medication, as this can result in adverse cardiovascular events. If a dose is missed, it should be taken as soon as possible unless it is time for the next dose. In case of an overdose, immediate medical attention is necessary. Always follow the prescribed dosage schedule and consult a healthcare professional for any concerns or unusual symptoms.

It is used to treat:

• High blood pressure
• Prevents strokes, heart attacks, and kidney problems
• Chest pain
• Improves survival after a heart attack

What Are the Forms & Strengths of Metoprolol Tartrate?

Metoprolol Tartrate comes in various strengths that are as follows:

• 25 mg
• 37.5 mg
• 50 mg
• 75 mg, and
• 100 mg

What Is the Recommended Dosage of Metoprolol Tartrate?

The dosage of Metoprolol Tartrate for heart disease varies from person to person and is based on multiple factors, such as the condition which is being treated & the tolerability of the patient. It also depends on the type, duration of the prescription, and how often you use it. The dosage mentioned here is applicable to everyone, and if your doctor has prescribed you a different dosage, you should follow their guidance and do not alter your dosage without talking to them first, as it can cause harm.

For Hypertension

• Take a 100 mg dose daily with or immediately after meals, either in single or divided doses.
• Doctors may increase the dosage weekly or at longer intervals until the required blood pressure level is achieved. The effective dosage ranges from 100 to 450 mg each day.
• Do not exceed the maximum daily dose, i.e., 450 mg daily.

For Angina Pectoris

• The standard starting dose of this medication is 100 mg daily, divided into two doses.
• Doctors may adjust the dosage at weekly intervals until the required results are achieved.
• The effective dosage ranges from 100 to 400 mg each day.
• Do not take more than the maximum daily dose, i.e., 400 mg daily.
• If the treatment needs to be stopped, doctors may gradually reduce the dosage over 1 or 2 weeks.

For Myocardial Infarction

• In the initial stages of harmful myocardial infarction, Lopressor treatment will be initiated immediately.
• Treatment will done under coronary care with intravenous administration of three 5 mg bolus injections of Lopressor.
• Doctors will administer these injections at 2-minute intervals.
• For patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets at 50 mg every 6 hours. This should start 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, switch to a maintenance dosage of 100 mg twice daily.
• For patients who do not tolerate the full intravenous dose, start with Lopressor tablets at 25 or 50 mg every 6 hours, beginning 15 minutes after the last intravenous dose or as soon as the clinical condition allows.
• For patients who cannot receive early treatment or cannot tolerate the full early dose, start Lopressor tablets at 100 mg twice daily as soon as clinically feasible.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

• Ask your pharmacist for the patient information leaflet and read it carefully for important details.
• Follow your doctor’s advice and take your doses as instructed.
• Take the Metoprolol Tartrate oral tablets by mouth, usually one to three times daily.
• Swallow them as a whole with or immediately post your meal, as directed by your healthcare practitioner.
• Take the medication with a glass of water unless instructed otherwise.
• Do not overlook your doctor’s instructions; follow your dosing schedule regardless of the medication form.
• Avoid chewing or crushing the tablets.
• If you are unable to swallow your tablets, talk to your medical practitioner. They will surely suggest alternate options.
• Do not abruptly discontinue the use of Metoprolol Tartrate without consulting your doctor. This can result in serious side effects, which may include heart attack or severe chest pain.
• If you are taking other medications with Metoprolol, follow the instructions provided by your medical practitioner.
• Take your medicines at the same time each day for effective results.
• Keep using the medication even if you feel well. Many people with hypertension may not feel sick.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Metoprolol Tartrate and Succinate both belong to the same class of drugs known as beta-blockers. A class of drugs is a group of medications that are used to treat similar medical conditions and work in the same way. The main reason for high blood pressure is tightened blood vessels. When these blood vessels contract, they strain the heart and raise the body’s demand for oxygen. Here comes the role of beta-blockers. These blockers work by preventing epinephrine, which is an adrenalin, from acting on beta receptors that are present in blood vessels and the heart. This whole process helps relax blood vessels, thus reducing the heart rate and the heart’s demand for oxygen. As a result, patients experience reduced blood pressure and chest pain.

Common side effects of Metoprolol Tartrate: Like other medications, Metoprolol Tartrate can cause certain temporary side effects in some people using it, which usually resolve on their own within a couple of days or weeks without any medical intervention as your body adjusts to the drug. Talk to your doctor beforehand if you are concerned about any side effects. Common side effects of Metoprolol include: 

• Diarrhea: This medication can cause diarrhea in some people using it, which can occur because beta-blockers can affect the autonomic nervous system. The system regulates intestinal motility, further causing increased bowel movements. To manage this, you should ensure that you follow a bland diet until your symptoms resolve. You should stay adequately hydrated if you have severe or persistent diarrhea to avoid dehydration. If the symptoms are bothersome, consult a licensed healthcare professional. 
• Dizziness: This is a common side effect of Metoprolol, especially noticeable during the initial days of starting treatment with this medication or making a dosage alteration. This occurs because metoprolol can decrease blood pressure, which can further reduce the flow of blood to the brain, further leading to lightheadedness. To avoid this side effect, you should get up slowly after sitting or lying down for extended periods and avoid sudden movements. If dizziness persists, talk to your doctor. They are most likely to recommend that you make alterations to your dosage. 
• Tiredness: This can occur due to the reduced workload of the heart caused by the effects of this medication. While this conserves energy, it can also cause fatigue. To manage this unusual feeling of fatigue, you should ensure you take proper rest, engage in moderate physical activity as tolerated, and maintain a balanced diet. If fatigue is severe or persistent, talk to your doctor or healthcare provider. 
• Constipation: This medication can slow gastrointestinal motility, causing constipation. To prevent this, you should include high-fiber foods in your diet, stay adequately hydrated, and engage in regular physical activity. If constipation persists, you should discuss possible management options with your doctor. 
• Shortness of breath: This medication can cause bronchoconstriction in some people using it, which can further lead to shortness of breath, especially in some users with existing respiratory conditions such as asthma or COPD. If you experience this symptom, you should promptly contact your medical provider, as it may require a dosage adjustment. 
• Cough: While being treated with Metoprolol, it is possible for some users to experience persistent cough, though this side effect is less common. This may be due to bronchospasm or increased airway sensitivity. If you develop a new or worsening cough, you should tell your doctor to rule out other causes and consider alternative treatment options.
• Wheezing: This may indicate that this medication is affecting your airways, especially if you have a history of respiratory issues. If you have wheezing, seek prompt medical attention, as this side effect makes it essential for you to discontinue using the drug. 
• Disinterest in sex: This medication can cause a decrease in libido, which can be becuase of its impact on blood flow and energy levels. If this becomes severe or persistent, you should talk to your healthcare provider. They may recommend you change your dosage or suggest alternative treatment options. 
• Rash: This may develop as an allergic reaction to Metoprolol. If you have a rash, you should discontinue using the drug & immediately consult your doctor, as this could indicate a severe reaction requiring prompt medical attention. 
• Headache: Some users may experience headaches while using metoprolol, potentially due to blood pressure changes or vascular effects. To manage headaches, you should stay hydrated throughout the day, avoid unknown triggers of headaches, and consider over-the-counter pain relief medicines after talking to your doctor. 
• Insomnia: This medication can cause sleep disturbances, including insomnia, in some people due to its effects on the central nervous system. To improve the quality of your sleep, you should follow a proper sleep routine, minimize coffee intake, and avoid using electronic devices, including mobile phones and television, before bedtime. If have problems getting to sleep or remaining asleep, you should discuss this with your doctor. 
• Cold hands and feet: Decreased blood flow in extreme levels to hands and feet, leading to coldness while being treated with Metoprolol. To alleviate this symptom, you should keep yourself warm, avoid smoking, and engage in regular physical activity to improve circulation. If the problem persists, you should talk to a licensed healthcare professional. 
• Swelling in arms or legs: Also known as edema, swelling in the arms or legs can occur due to fluid retention caused by using metoprolol. To manage swelling, you should elevate the affected limbs, reduce your intake of sodium, and monitor your weight on a regular basis. If you experience severe or persistent swelling, seek medical advice. 
• Nausea: This can be a side effect of metoprolol, possibly due to its action on the gastrointestinal system. Taking Metoprolol Tartrate with food, eating smaller and more frequent meals & avoiding rich, greasy or spicy foods may help prevent nausea. If this is persistent, talk to your doctor. 
• Vomiting: Though less common, vomiting may occur with metoprolol use. Ensure you stay hydrated and avoid foods that may trigger nausea. If vomiting is severe or persistent, contact your healthcare provider.
• Gas: Increased gas can result from metoprolol’s effects on the digestive system. To minimize this, avoid gas-producing foods, eat slowly, and consider over-the-counter remedies if appropriate. If discomfort continues, discuss it with your doctor. 

Tell your doctor at once if any of these symptoms worsen or persist. You should report any new or worsening symptoms to your doctor and visit your doctor on a regular basis to look for unwanted side effects and ensure that this medication is working as well as it should.

Serious side effects of Metoprolol Tartrate: In certain cases, this medication can cause rare but potentially serious side effects in some people. These side effects require prompt emergency medical attention and can become fatal if not treated promptly. You should call your doctor or 911 if you experience any of the following symptoms: 

• Heart rate changes: This medication can cause your heart to beat slower than normal. Call your physician or medical provider immediately if you experience confusion, weakness, lightheadedness, dizziness, fainting, fatigue, shortness of breath, or chest pain. 
• Decreased blood pressure: This medication can cause (hypotension) low blood pressure. If you feel dizziness or faintness, you should lie down. Let your doctor or healthcare provider immediately know if you have confusion, dizziness, fainting, fatigue or weakness. 
• New or worsening heart failure: This medication can worsen existing heart failure or lead to fluid buildup in your body. For individuals with existing heart conditions or heart damage, this medication can potentially lead to heart failure when used for the long term. Immediately tell your doctor or medical professional if you have rapid unusual weight gain, fatigue, shortness of breath, or swelling in your ankles, feet, or legs. 
• Breathing problems: This medication can cause a condition known as bronchospasm, in which the airway muscles tighten instead of relaxing, which can be serious in some cases. You should immediately discontinue using this medication & get in touch with your physician or medical provider if you have difficulty breathing. 
• Peripheral vascular disease: This medication can cause the heart to pump less blood to other body parts, worsening blood flow problems in the arms, legs & intestines. 
• Mood changes: While using this medication, some users may experience mood alterations, including feelings of depression or anxiety. The exact mechanism behind this is not still entirely understood, but it is believed to be due to the medication’s ability to cross the blood-brain barrier, and its effects on neurotransmitter activity may play a role. To manage these symptoms, you should monitor your symptoms closely. If you experience persistent sensations of sadness, anxiety, or any other significant mood changes, talk to your doctor or healthcare provider. They may adjust your dosage or consult a medical professional. 
• Low blood pressure (hypotension): This medication can reduce heart rate and the force of contraction, which can cause decreased blood pressure, which is a desired therapeutic effect that can sometimes cause hypotension. Its signs may include:
  • Severe dizziness
  • Fainting
  • Lightheadedness
  • Slow heart rate (bradycardia)
• Extreme fatigue: Feelings of unusual tiredness or fatigue that worsen throughout the day can occur with metoprolol use. This may be due to the medication’s effect on slowing the heart rate, leading to reduced oxygen delivery to tissues. Its symptoms may include:
  • Feeling tired than usual
  • Tiredness that worsens with the passing day
• Depression: This medication is known to cause certain depressive symptoms in some people using it. The exact cause is not well understood, but it may relate to the drug’s central nervous system effects. Its signs are:
  • Continuous feelings of sadness or anxiety
  • Feelings of hopelessness and worthlessness
  • Lack of interest in things that you enjoy doing
  • Irregular eating patterns
  • Finding hard to concentrate
• Allergic reaction: This medication can cause allergic reactions, including severe symptoms, in some people using it. You should not use this medication if you have ever had an allergic reaction to any of the active or inactive ingredients present in the product. Immediately discontinue using Metoprolol and call a medical professional if you experience any signs and symptoms of an allergic reaction. Signs may include:
  • Rash
  • Itching
  • Swelling
  • Trouble breathing

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Metoprolol Tartrate?

• Heart Failure: Metoprolol can weaken the heart’s ability to contract and may lead to heart failure or cardiogenic shock. If you are experiencing any signs or symptoms of heart failure, talk to your medical practitioner. They may lower your doses or suggest alternate options.
• Surgery: The need and desirability of discontinuing beta-blocking therapy, including Lopressor, before major surgeries is a bit controversial. The impaired ability of the heart to respond to stress may increase the risks of general anesthesia and surgery. Talk to your medical practitioner and follow their expert advice. 
• Bradycardia: People using this medication have reported bradycardia, including heart block, cardiac arrest, and sinus pause. So, if you have first-degree atrioventricular block or sinus node dysfunction, you are at increased risk. Discuss with your healthcare provider; they may reduce your doses or make you stop taking Metoprolol.
• Diabetes and Hypoglycemia: Beta-blockers can hide some signs of low blood glucose, such as a fast heartbeat, but not others, like dizziness and sweating. Consult with a medical professional before starting your treatment with this medication.
• Pheochromocytoma: If you have this rare tumor, use Metoprolol with an alpha-blocker only once the alpha-blocker has been initiated. Using these beta-blockers alone with such conditions may raise blood pressure.
• Thyrotoxicosis: Metoprolol can hide signs of an overactive thyroid, such as a fast heartbeat. Do not stop taking it suddenly, as it might trigger a severe reaction known as a thyroid storm.

What Are the FDA Boxed Warning for Metoprolol Tartrate?

Metoprolol has received a black box warning from the FDA. A boxed warning is the most critical warning that the FDA issues to make patients and doctors cautious about the serious side effects of particular medications. Patients with coronary artery disease should not abruptly discontinue the use of this medication, as doing so can exacerbate conditions like angina, ventricular arrhythmias, and myocardial infarction. If patients want to stop their treatment with Metoprolol Tartrate, the dosage should be gradually lowered over a period of 1 to 2 weeks, followed by close monitoring. Since many people have coronary artery disease without them knowing, it is generally best not to stop the use of this medication suddenly, even if you are only taking it for high blood pressure.

• Before taking this medication, make sure to inform your doctor if you are allergic to any of the ingredients of Metoprolol or other beta-blockers like atenolol or propranolol. This product may contain certain inactive components that can cause severe allergic reactions.
• Inform a professional healthcare provider about your medical history before starting your treatment with this medication. If you have or had any of the following conditions, immediately discuss it with a professional:
  • Slow heartbeat
  • Second/third-degree atrioventricular block
  • Asthma
  • Chronic bronchitis
  • Sick sinus syndrome
  • Emphysema
  • Liver disease
  • Heart failure
  • Blood circulation problems
  • Mood disorders
  • Myasthenic gravis
• Before undergoing any surgery or medical procedure, inform your healthcare practitioner about the products you use, including prescription drugs, nonprescription drugs, or herbal products.
• Avoid drinking alcohol or taking marijuana while taking Metoprolol, as it can make you dizzy. In such situations, do not drive or use machinery that requires alertness.
• If you have diabetes, this medicine may make it harder to control blood glucose levels. Therefore, closely monitor your blood sugar as directed by your doctor. Inform your doctor/physician immediately if you notice signs of high blood sugar, which may include increased thirst or urination. They may change your diabetes medication, exercise routine, or diet.
• Children using this medicine may have a higher risk of low blood glucose, especially if they are vomiting or not eating regularly. To help prevent such conditions, ensure children eat regularly. If your child cannot eat regularly, is vomiting, or shows symptoms of low blood sugar (such as sweating or shaking), contact the doctor immediately.
• During pregnancy, use this medication only if needed, as it may harm the unborn baby. Discuss every risk and benefit with your doctor.
• This medicine enters into breast milk but is unlikely to harm the child. Consult a medical professional before breastfeeding.
• Do not use this medication immediately when you feel chest pain or migraines. Use other drugs to relieve the sudden attacks. For example, you can place nitroglycerin tablets under your tongue for chest pain and sumatriptan for migraines.
• Seek medical assistance if the condition is not improving or if it gets worse.

Certain groups of people should not use this medication. This includes:

• People with heart failure should remain cautious while taking this medicine as it can exacerbate the symptoms of such medical conditions.
• People with Asthma
• Patients having diabetes
• People whose heart rates are slower than usual (bradycardia) or have low blood pressure.
• Patients with liver diseases
• Patients suffering from overactive thyroid (hyperthyroidism)

Patients are strictly advised not to skip any of their doses as skipping or taking doses at different times may lead to serious risks of blood pressure fluctuations. This will ultimately increase the chances of a heart attack. However, if someone has mistakenly missed a dose of their medication, they can follow the below steps:

• Take the missed dose as soon as possible, whenever remembered.
• If it is time for the next dose, do not take the missed medicine and continue with your regular dosing schedule. Remember, this will work if you have missed only a dose of your medication.
• Do not try to double dose; this can lead to adverse reactions.
• Take the help of medication apps or set reminders on the phone to avoid missing doses.
• If you habitually forget things, talk to your medical provider, as they may suggest better options.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Exceeding the maximum daily dose of Metoprolol Tartrate is not a minor problem; it needs immediate attention. Overdosing this medication can lead to drug buildup in the body, which can be dangerous. Due to drug accumulation, patients can experience unusual symptoms of overdose, which may include:

• Irregular heart rhythms
• Nausea
• Vomiting
• Extremely low blood pressure

In such situations, people must be calm and seek medical help as soon as possible. For quick medical assistance, patients can call 911.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Following proper storage guidelines for Metoprolol Tartrate is essential to ensure its potency and accuracy. Keep in a cool and dry place, away from direct exposure to sunlight, heat, and moisture. Ask your healthcare provider or pharmacist about appropriate storage and refer to the instructions given below:

• Store the oral tablets at room temperature of 20°C and 25°C.
• You can also briefly store the medicines at a temperature as low as 15°C or as high as 30°C.
• Make sure to keep the medication in a locked container.
• Keep it away from children and pets’ reach.
• Do not keep the drug under direct sunlight.
• Avoid keeping your medication in damp areas like the bathroom or near the sink.
• Do not flush the tablets or their containers down the toilet.
• Read your product’s label for detailed storage instructions.
• Ask your healthcare provider or pharmacist how to properly dispose of the product when it is not in use.
• Avoid keeping expired products or medication.
• Keep it away from heat and light.
• Do not refrigerate it.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Metoprolol Tartrate?

Certain medications are known to interact with Metoprolol Tartrate, which can reduce its effectiveness or cause unwanted side effects. To prevent potential drug interactions with this medication, you should tell your doctor or healthcare provider about all medicines you are currently using or plan to take, including all prescription medications, non-prescription or over-the-counter drugs, herbs, or vitamins. To manage this, your doctor may change your dosage of one or both medications or ask you to switch to a different treatment altogether. Some of the interactions which you should consider may include:

• Deutetrabenazine
• Reserpine
• Tetrabenazine
• Valbenazine
• Digoxin
• Amlodipine
• Diltiazem
• Nicardipine
• Fluoxetine
• Paroxetine
• Sertraline
• Haloperidol
• Diphenhydramine
• Terbinafine
• Hydralazine
• Reserpine
• Methyldopa
• Prazosin
• Dipyridamole
• Bromocriptine
• Cabergoline
• Ergotamine
• Methylergonovine

[Note: This isn’t a complete list, and there could be other drugs that interact with Metoprolol Tartrate. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Other Metoprolol Tartrate Interactions?

Apart from medications, Metoprolol tartrate can interact with multivitamins and minerals, herbal supplements, and other over-the-counter items. It can also interact with certain calcium channel blockers, digoxin, clonidine, and diphenhydramine. There are certain disease interactions with Metoprolol tartrate which you should consider before using it. They include:

• Arrhythmia
• Heart Pump Failure
• Heart Dysfunction
• Blood Sugar Disorder
• Kidney Filtration Disorder
• Allergic Reaction
• Coronary Artery Disease
• Vascular Obstruction
• Hepatic Disorder
• Brain Blood Flow Disorder
• Optic Nerve Damage
• Lipid Imbalance
• Overactive Thyroid
• Muscle Fatigue Syndrome
• Adrenal Gland Tumor
• Skin Inflammation Disorder
• Rapid Heartbeat
• Breathing Difficulty Syndrome
• Chronic Lung Disease

While Metoprolol Tartrate is an effective medication, it may not be suitable for everyone using it. It can cause certain unfavorable outcomes or may be contraindicated for use. In such cases, people look for suitable substitutes for the medication. If you plan to change your current prescription or start a new one, do not do so without talking with your doctor first. Discuss with them, and based on your condition, age, and other factors, they will help you choose the medication that will work best for you. Some of the most popular Metoprolol Tartrate alternatives present in the market include:

• Coreg (carvedilol)
• Zestril (lisinopril)
• Benazepril (lotensin)
• Tenormin (atenolol)
• Bystolic (nebivolol)
• Corgard (nadolol)
• Inspra (eplerenone)
• Betaxolol
• Bisoprolol
• Labetalol
• Acebutolol
• Captopril
• Chlorthalidone
• Hydrochlorothiazide
• Doxazosin (cardura)
• Clonidine (catapres)
• Amlodipine (norvasc)
• Ranolazine (ranexa)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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