Metoprolol is useful for reducing heart rate, blood pressure, and heart workload. This medication is usually used to treat high blood pressure, chest pain (angina), and heart failure.

Metoprolol relieves the heart's workload by blocking certain body chemicals, such as epinephrine, that make the heart work harder and raise blood pressure.

Trademarks:  Fapressor, Lopresor, Loprolol

Metoprolol is available in the form of tablets, film-coated tablets, and injections. In addition to the above purposes, this drug is sometimes used as part of the treatment of arrhythmias, heart attacks, and hyperthyroidism, and to prevent migraines.

Metoprolol trademarks:  Fapressor, Lopresor, Loprolol

What is Metoprolol

class Prescription drug
Category Beta blockers  ( beta blockers )
Benefit Lowers heart rate, lowers blood pressure, and reduces the workload of the heart
Used by Mature
Metoprolol for pregnant and lactating women Category C: Animal studies have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Metoprolol can be absorbed into breast milk and cause dry mouth, dry skin, slow heartbeat, diarrhea, or constipation in the baby. If you are breastfeeding, do not use this medication without consulting your doctor.

Drug form Tablets, film-coated tablets and injections

Warning Before Using Metoprolol

Metoprolol is a drug that should not be used carelessly. Before using metoprolol, pay attention to the following things:

  • Do not use metoprolol if you are allergic to it or to other beta-blocking drugs, such as atenolol , labetalol, carvedilol , nadolol, nebivolol, propranolol , and sotalol.
  • Do not use metoprolol if you have severe circulatory disorders, peripheral arterial disease , slow heart rate ( bradycardia ), untreated tumor of the adrenal glands ( pheochromocytoma ), AV block heart disease , sick sinus syndrome , and severe heart failure.
  • Share your medical history, especially if you have asthma, COPD , chronic bronchitis, emphysema , diabetes, sleep apnea , liver disease, congestive heart failure , thyroid disorders, and Raynaud's syndrome .
  • Tell your doctor about any medicines you use, including supplements or herbal products.
  • Do not smoke while on metoprolol, as this can increase the risk of reduced blood flow to the hands and feet.
  • Do not consume alcoholic beverages while using this medication because it can increase the risk of side effects.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • Do not drive a vehicle or do activities that require alertness after taking metoprolol, because this drug can cause dizziness or drowsiness.
  • Consult your doctor about using metoprolol if you are planning surgery, including dental surgery.
  • Do not stop treatment suddenly because it can worsen your condition. Stop treatment as advised and under the supervision of a doctor.
  • Immediately see a doctor if there is an allergic drug reaction or overdose after using metoprolol.

Dosage and Rules for Use Metoprolol

The dosage prescribed by the doctor will be adjusted to the patient's condition. Here are the common doses of metoprolol for adults:

  • Purpose:  Treatment of heart failure
    12.5–25 mg sustained-release tablet once daily  . If needed, the dose may be increased every 2 weeks, up to a maximum of 200 mg per day.
  • Purpose:  Treating high blood pressure ( hypertension ).
    Preparation: 100 mg  tablet
    per day, once a day or divided into 2 consumption schedules. Dosage can be increased every week, depending on the body's response to the drug. The usual maintenance dose is 200 mg per day. The maximum dose is 400 mg/day.
  • Purpose: Treating heart rhythm disorders ( arrhythmias )
    50 mg tablets , 2-3 times a day. Dosage can be increased up to 300 mg per day, divided into several consumption schedules.
  • Purpose:  Treat emergency arrhythmias
    Preparation:  Intravenously inject
    5 mg at a rate of 1–2 mg per minute. The dose may be repeated at 5-minute intervals if needed. The maximum dose is 10–15 mg.
  • Purpose:  Treatment of angina pectoris
    Preparation: 50–100 mg  tablets
    , 2–3 times daily. The maximum dose is 400 mg daily.
  • Purpose:  Adjunctive therapy for cardiac arrest
    Preparation:  Intravenous injection of
    5 mg, 3 times, with an interval of 2 minutes each administration. Dosage given within 12 hours of chest pain symptoms appearing.
    Preparation:  Tablets
    Treatment is continued by giving 50 mg tablets every 6 hours for 2 days, starting 15 minutes after the last injection. Maintenance dose 100 mg, 2 times a day.
  • Purpose: Prevent migraines
    . Preparation: 100–200 mg  tablets
    per day, which are divided into 2 times the consumption schedule.
  • Purpose: As adjunctive therapy for hyperthyroidism
    . Preparation:
    50 mg  tablets , 4 times a day. Dosage can be reduced once the thyroid condition stabilizes.

How to Use Metoprolol Properly

Follow the doctor's recommendations and read the instructions for use listed on the metoprolol packaging when using this medicine.

Metoprolol in injection form will be given by a doctor or medical officer on the doctor's instructions.

Metoprolol tablets and film-coated tablets can be taken with meals or immediately after meals. Do not split, chew, or grind the drug before taking it. Swallow the medicine whole. Take metoprolol at the same time every day, so that the results of the treatment are maximized.

If you forget to take metoprolol, do it immediately if the break with the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.

Store metoprolol in a cool, dry place. Avoid drugs from hot temperatures and exposure to direct sunlight. Keep medicine out of reach of children.

Metoprolol interactions with other drugs

The following are interaction effects that can occur if metoprolol is used with certain drugs:

  • Increased risk of heart rhythm disturbances (faster or slower) when used with diltiazem , digitalis glycosides, clonidine  and verapamil.
  • Increased risk of side effects or overdose from metoprolol when used with CYP2D6 inhibitors, such as fluoxetine, quinidine , paroxetine, and propafenone .
  • Increased blood vessel constriction (vasoconstriction) effect of ergot alkaloid drugs, such as ergotamine and dihydroergotamine
  • Increased blood sugar-lowering effect of insulin and antidiabetic drugs.
  • Increased blood pressure lowering effect of tricyclic antidepressants , barbiturates , phenothiazines and other antihypertensive drugs.
  • Decreased blood pressure-lowering (antihypertensive) effect when used with NSAIDs , such as indomethacin and ibuprofen.

Side Effects and Dangers of Metoprolol

Side effects that may arise after using metoprolol are:

  • Dizziness or drowsiness
  • Fatigue
  • Low mood, easy to forget
  • Limp body
  • Hands and feet feel cold
  • Diarrhea
  • Stomach ache

Call your doctor if the side effects above don't improve or get worse. Immediately see a doctor if you experience an allergic drug reaction  and serious side effects, such as:

  • Hard to breathe
  • Head feels floating, like going to pass out
  • The fingers and toes are bluish
  • Swelling of the legs
  • Unexplained weight gain
  • Depression
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