Article Contents ::
Details About Generic Salt :: Metoprolol
Main Medicine Class:: Cardiovascular System Sub Medicine Class :: Anti Anginals
| 4D. ANTI-HYPERTENSIVES in 4. CARDIOVASCULAR SYSTEM |
| METOPROLOL |
| SELECTIVE ß-ADRENERGIC BLOCKER | ANTI-HYPERTENSIVE, ANTI-ANGINAL |
| also comes under 1H. Anti-Migraine & Anti- Vertigo Drugs in 1. Nervous System, 4A. Drugs for Cardiac Failure & Shock in 4. Cardiovascular System, 4B. Anti-Arrhythmics in 4. Cardiovascular System, 4C. Anti-Anginals in 4. Cardiovascular System |
| PK: A: Rapid & complete D: 5.5 L/kg (Vd) M: Hepatic E: Urine |
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Indications & Dose: ANGINA PO Adult IR tablet: Initially 50mg BID, usual dosage range 50-200mg BID max 400mg/day. Increase dose at weekly intervals to desired effect. ER tablet: Initially 100mg/day max 400mg/day | ARRHYTHMIAS PO Adult 50mg BID/TID, max 300mg/day in divided doses if required Child 12-18 yr: Same as adult dose | ATRIAL FIBRILLATION IV Adult 2.5-5mg q2-5 min, max 15mg over a 10-15min period | HEART FAILURE PO Adult ER tablet: Initially 25mg/day (reduce to 12.5mg OD in NYHA class higher than class II), may double dosage q2wk as tolerated | HYPERTENSION PO Adult IR tablet: Initially 50mg BID, effective dosage range 100-450mg/day in 2-3 divided doses. Increase at weekly intervals to desired effect, max 450mg/day, usual dosage range 50-100mg/day. ER tablet: Initially 25-100mg OD, increase doses at weekly (or longer) intervals to desired effect max 400mg/day, usual dosage range 50-100mg/day Child 1 month-12 yr: Initially 1mg/kg BID, increased to 8mg/kg/day if required in 2-4 divided doses, 12-18 yr: Initially 50-100mg/day, increased to 200mg/day in 1-2 divided doses max 400mg/day | MIGRAINE Prophylactic therapy PO Adult 100-200mg/day in divided doses | MYOCARDIAL INFARCTION Acute IV Adult 5mg q2min for 3 doses in early treatment of MI, thereafter give 50mg PO q6h beginning 15 min after last IV dose and continue for 48h MD 100mg BID | SUPRAVENTRICULAR TACHYCARDIA IV Adult 2.5-5mg q2-5 min, max 15mg over a 10-15min period |
| Contra: hypersensitivity, history of obstructive airways disease, metabolic acidosis, cardiogenic shock, hypotension, severe PAD, overt HF, marked sinus bradycardia, heart block greater than first-degree, Prinzmetal’s angina, sinus bradycardia
Precautions: first-degree heart block, during drug withdrawal, pheochromocytoma, DM, conduction abnormality, hepatic/renal impairment, myasthenia gravis, PVD, Raynaud’s disease, psoriasis, psychiatric disease, thyrotoxicosis ADR: Serious: orthostatic hypotension, peripheral vasoconstriction, bradycardia, blurred vision, HF, pulmonary edema, hepatitis, hypoglycemia, bronchospasm, decreased libido, erectile dysfunction, Others: fatigue, weakness, anxiety, dizziness, drowsiness, insomnia, nervousness, nightmares, nausea, vomiting, constipation, diarrhea, flatulence, heartburn, dry mouth, urinary frequency, hyperglycemia, wheezing, rash, drug-induced lupus syndrome DDI: Serious Hydroxy chloroquine/Chloroquine increase drug levels, Rifampicin increases drug clearance, Paroxetine increases drug effects, Moclobemide/MAOIs increases hypotensive effect of drug, Diltiazem/Citalopram/Dronedarone/Escitalopram increases serum levels of drug, Diphenhydramine moderately inhibits drug metabolism, Quinidine/Propafenone/Ritonavir raises plasma levels of drug, Barbiturates reduces plasma levels & effects of ß-blockers, Ciprofloxacin reduces the clearance of drug Diet: With food Monitor: ECG, BP with IV administration, HR |