Metoprolol tartrate (tablet): Difference between revisions

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{{DrugProjectFormSinglePage
|-
|authorTag={{Alonso}}
! style="font-size: 80%; padding: 0 5px; background: #104E8B;" | [[{{PAGENAME}}|{{fontcolor|#F8F8FF|{{PAGENAME}}®}}]]
|genericName=Metoprolol tartrate
|-
|aOrAn=a
! style="font-size: 80%; padding: 0 5px; background: #000000; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Black Box Warning|{{fontcolor|#FF0000|Black Box Warning}}]]
|drugClass=anti-[[angina|anginal]], [[antiarrhythmic]], [[beta-adrenergic blocker]]
|-
|indication=[[acute myocardial infarction|acute myocardial infarction (AMI)]]
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Adult Indications and Dosage|{{fontcolor|#F8F8FF|Adult Indications and Dosage}}]]
|adverseReactions=[[bradyarrhythmia]], [[constipation]], [[depression]], [[diarrhea]], [[dizziness]], [[dyspnea]], [[fatigue]], [[headache]], [[heart block]], [[heart failure]], [[hypotension]], [[indigestion]], [[nausea]], [[pruritus]], [[rash]], and [[wheezing]]
|-
|blackBoxWarningTitle=Warning Title
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Pediatric Indications and Dosage|{{fontcolor|#F8F8FF|Pediatric Indications and Dosage}}]]
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
|-
|fdaLIADAdult======Hypertension=====
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|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Warnings|{{fontcolor|#F8F8FF|Warnings}}]]
|-
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|-
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|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Use in Specific Populations|{{fontcolor|#F8F8FF|Use in Specific Populations}}]]
|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Administration and Monitoring|{{fontcolor|#F8F8FF|Administration and Monitoring}}]]
|-
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|-
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|-
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|-
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|-
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! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Patient Information|{{fontcolor|#F8F8FF|Patient information}}]]
|-
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|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [[{{PAGENAME}}#Brand Names|{{fontcolor|#F8F8FF|Brand Names}}]]
|-
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|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [http://www.fda.gov/drugs/drugsafety/drugshortages/ucm050792.htm {{fontcolor|#F8F8FF|Drug Shortage Status}}]
|-
! style="font-size: 80%; padding: 0 5px; background: #6D9CC9; border-radius: 5px 5px 5px 5px;" align=left | [http://www.goodrx.com/{{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}/price {{fontcolor|#F8F8FF|Price}}]
|-
|}
<div style="width: 80%">
__NOTOC__
{{Main|Metoprolol}}


{{CMG}}
* Dosing Information
 
{{SB}}
 
==Disclaimer==
 
'''''WikiDoc Drug Project is a constellation of drug information for healthcare providers and patients vigorously vetted on the basis of FDA package insert, MedlinePlus, Practice Guidelines, Scientific Statements, and scholarly medical literature.  The information provided is not a medical advice or treatment.  WikiDoc does not promote any medication or off-label use of drugs. Please read our full disclaimer [[wikidoc:General_disclaimer|{{fontcolor|#FF0000|here}}]].'''''
 
==<span style="color:#FF0000; background:#000000;">Black Box Warning</span>==
 
FDA Package Insert for {{PAGENAME}} contains no information regarding ''Black Box Warning''.
 
==Overview==
 
[[Lopressor injection]] is a anti-[[angina|anginal]], [[antiarrhythmic]], [[beta-adrenergic blocker]] drug that is FDA approved for the treatment of [[acute myocardial infarction|acute myocardial infarction (AMI)]]. Common adverse reactions include [[bradyarrhythmia]], [[constipation]], [[depression]], [[diarrhea]], [[dizziness]], [[dyspnea]], [[fatigue]], [[headache]], [[heart block]], [[heart failure]], [[hypotension]], [[indigestion]], [[nausea]], [[pruritus]], [[rash]], and [[wheezing]].
 
==Adult Indications and Dosage==


===FDA-Labeled Indications and Dosage (Adult)===
:* Individualize the dosage of Lopressor tablets. Lopressor tablets should be taken with or immediately following meals.
:* The usual initial dosage of Lopressor tablets is 100 mg daily in single or divided doses, whether used alone or added to a diuretic. Increase the dosage at weekly (or longer) intervals until optimum [[blood pressure]] reduction is achieved. In general, the maximum effect of any given dosage level will be apparent after 1 week of therapy. The effective dosage range of Lopressor tablets is 100-450 mg per day. Dosages above 450 mg per day have not been studied. While once-daily dosing is effective and can maintain a reduction in [[blood pressure]] throughout the day, lower doses (especially 100 mg) may not maintain a full effect at the end of the 24-hour period, and larger or more frequent daily doses may be required. This can be evaluated by measuring [[blood pressure]] near the end of the dosing interval to determine whether satisfactory control is being maintained throughout the day. Beta1 selectivity diminishes as the dose of Lopressor is increased.


=====Acute Myocaridal Infarction=====
=====Angina Pectoris=====


* Dosing Information
* Dosing Information


:* Upon patient presentation: [[Lopressor injection]] 5 mg IV x 3 boluses at 2-min intervals
:* The dosage of Lopressor tablets should be individualized. Lopressor tablets should be taken with or immediately following meals.
 
:* The usual initial dosage of Lopressor tablets is 100 mg daily, given in two divided doses. gradually increase the dosage at weekly intervals until optimum clinical response has been obtained or there is pronounced slowing of the heart rate. The effective dosage range of Lopressor tablets is 100-400 mg per day. Dosages above 400 mg per day have not been studied. If treatment is to be discontinued, gradually decrease the dosage over a period of 1-2 weeks
:* 15 minutes after the full IV dose: [[Lopressor tablet]] 50 mg PO q6h for 2 days followed by [[Lopressor tablet]] 100 mg PO q12h (or ''[[Lopressor tablet]]'' 25—50 mg PO q6h for 2 days if intolerable to the full IV dose; discontinue [[Lopressor]] in patients with severe intolerance.)


[[Lopressor injection]] is indicated in the treatment of [[hemodynamics|hemodynamically]] stable patients with definite or suspected [[acute myocardial infarction]] to reduce cardiovascular [[mortality]] when used in conjunction with [[Lopressor tablet|oral Lopressor]] maintenance therapy. Treatment with [[Lopressor injection]] can be initiated as soon as the patient’s clinical condition allows.
=====Myocardial Infarction=====


Early Treatment: During the early phase of definite or suspected [[acute myocardial infarction]], initiate treatment with [[Lopressor injection]] as soon as possible after the patient’s arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient’s [[hemodynamic]] condition has stabilized. Begin treatment in this early phase with the [[intravenous]] administration of three bolus injections of 5 mg of [[Lopressor injection]] each; give the injections at approximately 2-minute intervals. During the [[intravenous]] administration of [[Lopressor]], monitor [[blood pressure]], [[heart rate]], and [[electrocardiogram]].
* Dosing information


In patients who tolerate the full [[intravenous]] dose (15 mg), initiate [[Lopressor tablet]]s, 50 mg every 6 hours, 15 minutes after the last [[intravenous]] dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full [[intravenous]] dose on [[Lopressor tablet]]s either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see ''[[Lopressor injection#Warnings|Warnings]]'').<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = LOPRESSOR (METOPROLOL TARTRATE) INJECTION, SOLUTION [NOVARTIS PHARMACEUTICALS CORPORATION] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6640cc61-edee-4808-a26f-cbc2c0b7af86#nlm34067-9 | publisher =  | date =  | accessdate = }}</ref>
:* '''''Early treatment:'''''
 
::* During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor as soon as possible after the patient's arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient's hemodynamic condition has stabilized.
===Off-Label Use and Dosage (Adult)===
::* Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor [[blood pressure]], [[heart rate]], and [[electrocardiogram]].
 
::* In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg twice daily.
====Guideline-Supported Use====
::* Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor.
 
:* '''''Late treatment:''''' Start patients with contraindications to treatment during the early phase of suspected or definite [[myocardial infarction]], patients who appear not to tolerate the full early treatment, and patients in whom the physician wishes to delay therapy for any other reason on Lopressor tablets, 100 mg twice daily, as soon as their clinical condition allows. Continue therapy for at least 3 months. Although the efficacy of Lopressor beyond 3 months has not been conclusively established, data from studies with other [[beta blockers]] suggest that treatment should be continued for 1-3 years.
=====[[Atrial Fibrillation]], Rate Control=====
|offLabelAdultGuideSupport======Atrial Fibrillation, Rate Control=====


* Developed by: [[American College of Cardiology|American College of Cardiology (ACC)]] and [[American Heart Association|American Heart Association (AHA)]]
* Developed by: [[American College of Cardiology|American College of Cardiology (ACC)]] and [[American Heart Association|American Heart Association (AHA)]]
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In the absence of [[preexcitation]], [[intravenous]] administration of [[beta blockers]] ([[esmolol]], [[metoprolol]], or [[propranolol]]) or nondihydropyridine [[calcium channel antagonist]]s ([[verapamil]], [[diltiazem]]) is recommended to slow the ventricular response to [[atrial fibrillation]] in the acute setting, exercising caution in patients with [[hypotension]] or [[heart failure]].<ref name="Wann-2013">{{Cite journal  | last1 = Wann | first1 = LS. | last2 = Curtis | first2 = AB. | last3 = Ellenbogen | first3 = KA. | last4 = Estes | first4 = NA. | last5 = Ezekowitz | first5 = MD. | last6 = Jackman | first6 = WM. | last7 = January | first7 = CT. | last8 = Lowe | first8 = JE. | last9 = Page | first9 = RL. | title = Management of patients with atrial fibrillation (compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. | journal = Circulation | volume = 127 | issue = 18 | pages = 1916-26 | month = May | year = 2013 | doi = 10.1161/CIR.0b013e318290826d | PMID = 23545139 }}</ref>
In the absence of [[preexcitation]], [[intravenous]] administration of [[beta blockers]] ([[esmolol]], [[metoprolol]], or [[propranolol]]) or nondihydropyridine [[calcium channel antagonist]]s ([[verapamil]], [[diltiazem]]) is recommended to slow the ventricular response to [[atrial fibrillation]] in the acute setting, exercising caution in patients with [[hypotension]] or [[heart failure]].<ref name="Wann-2013">{{Cite journal  | last1 = Wann | first1 = LS. | last2 = Curtis | first2 = AB. | last3 = Ellenbogen | first3 = KA. | last4 = Estes | first4 = NA. | last5 = Ezekowitz | first5 = MD. | last6 = Jackman | first6 = WM. | last7 = January | first7 = CT. | last8 = Lowe | first8 = JE. | last9 = Page | first9 = RL. | title = Management of patients with atrial fibrillation (compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. | journal = Circulation | volume = 127 | issue = 18 | pages = 1916-26 | month = May | year = 2013 | doi = 10.1161/CIR.0b013e318290826d | PMID = 23545139 }}</ref>
 
|offLabelAdultNoGuideSupport======Atrial flutter=====
====Non–Guideline-Supported Use====
 
=====[[Atrial flutter]]=====


* Dosing Information
* Dosing Information
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:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>
:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>


=====[[Multifocal atrial tachycardia]]=====
=====Multifocal atrial tachycardia=====


* Dosing Information
* Dosing Information
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:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>
:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>


=====[[Supraventricular tachycardia]]=====
=====Supraventricular Tachycardia=====


* Dosing Information
* Dosing Information


:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>
:: [[Lopressor injection]] dose range: 2—15 mg<ref name="Amsterdam-1991">{{Cite journal  | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi =  | PMID = 1880230 }}</ref>
=====Aggressive Behavior=====


=====Injection Site Pain Associated with Propofol Use=====
=====Injection Site Pain Associated with Propofol Use=====
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:: Pretreatment with [[Lopressor injection]] 2 mg.<ref name="Aşik-2003">{{Cite journal  | last1 = Aşik | first1 = I. | last2 = Yörükoğlu | first2 = D. | last3 = Gülay | first3 = I. | last4 = Tulunay | first4 = M. | title = Pain on injection of propofol: comparison of metoprolol with lidocaine. | journal = Eur J Anaesthesiol | volume = 20 | issue = 6 | pages = 487-9 | month = Jun | year = 2003 | doi =  | PMID = 12803269 }}</ref>
:: Pretreatment with [[Lopressor injection]] 2 mg.<ref name="Aşik-2003">{{Cite journal  | last1 = Aşik | first1 = I. | last2 = Yörükoğlu | first2 = D. | last3 = Gülay | first3 = I. | last4 = Tulunay | first4 = M. | title = Pain on injection of propofol: comparison of metoprolol with lidocaine. | journal = Eur J Anaesthesiol | volume = 20 | issue = 6 | pages = 487-9 | month = Jun | year = 2003 | doi =  | PMID = 12803269 }}</ref>
 
|fdaLIADPed======Condition 1=====
==Pediatric Indications and Dosage==
 
===FDA-Labeled Indications and Dosage (Pediatric)===
 
=====Condition 1=====


* Dosing Information
* Dosing Information
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:* (Dosage)
:* (Dosage)
 
|offLabelPedGuideSupport======Condition 1=====
===Off-Label Use and Dosage (Pediatric)===
 
====Guideline-Supported Use====
 
=====Condition 1=====


* Developed by: (Organisation)
* Developed by: (Organisation)
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:* (Dosage)
:* (Dosage)
 
|offLabelPedNoGuideSupport======Condition 1=====
====Non–Guideline-Supported Use====
 
=====Condition 1=====


* Dosing Information
* Dosing Information
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:* (Dosage)
:* (Dosage)
 
|contraindications=* Condition 1
==Contraindications==
 
* Condition 1
* Condition 2
* Condition 2
* Condition 3
* Condition 3
* Condition 4
* Condition 4
* Condition 5
* Condition 5
 
|warnings======Conidition 1=====
==Warnings==
 
=====Conidition 1=====
 
(Description)
 
=====Conidition 2=====
 
(Description)
 
=====Conidition 3=====


(Description)
(Description)
 
|clinicalTrials=======Central Nervous System======
==Adverse Reactions==
 
===Clinical Trials Experience===
 
=====Condition 1=====
 
======Central Nervous System======


: (list/description of adverse reactions)
: (list/description of adverse reactions)
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: (list/description of adverse reactions)
: (list/description of adverse reactions)
 
|postmarketing=(Description)
===Postmarketing Experience===
|drugInteractions=* Drug 1
 
(Description)
 
==Drug Interactions==
 
* Drug 1
* Drug 2
* Drug 2
* Drug 3
* Drug 3
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(Description)
(Description)
 
|useInPregnancyFDA=(Description)
==Use in Specific Populations==
|useInPregnancyAUS=(Description)
 
|useInLaborDelivery=(Description)
====Pregnancy====
|useInNursing=(Description)
 
|useInPed=(Description)
* '''[[Pregnancy category#United States|Pregnancy Category (FDA)]]: X'''
|useInGeri=(Description)
 
|useInGender=(Description)
* '''[[Pregnancy category#Australia|Pregnancy Category (AUS)]]: {{PAGENAME}} is not included in Australian Drug Evaluation Committee (ADEC) Pregnancy Categories.'''
|useInRace=(Description)
 
|useInRenalImpair=(Description)
(Description)
|useInHepaticImpair=(Description)
 
|useInReproPotential=(Description)
====Labor and Delivery====
|useInImmunocomp=(Description)
 
|othersTitle=Others
(Description)
|useInOthers=(Description)
 
|administration=(Oral/Intravenous/etc)
====Nursing Mothers====
|monitoring======Condition 1=====
 
(Description)
 
====Pediatric Use====
 
(Description)
 
====Geriatric Use====
 
(Description)
 
====Gender====
 
(Description)
 
====Race====
 
(Description)
 
====Renal Impairment====
 
(Description)
 
====Hepatic Impairment====
 
(Description)
 
====Carcinogenesis, Mutagenesis, Impairment of Fertility====
 
(Description)
 
====Immunocompromised Patients====
 
(Description)
 
====Miscellaneous====
 
(Description)
 
==Administration and Monitoring==
 
====Administration====
 
(Oral/Intravenous/etc)
 
====Monitoring====
 
=====Condition 1=====


(Description regarding monitoring, from ''Warnings'' section)
(Description regarding monitoring, from ''Warnings'' section)
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(Description regarding monitoring, from ''Warnings'' section)
(Description regarding monitoring, from ''Warnings'' section)
 
|IVCompat====Solution===
==IV Compatibility==
 
===Solution===


====Compatible====
====Compatible====
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* Solution 2
* Solution 2
* Solution 3
* Solution 3
 
|overdose====Acute Overdose===
==Overdosage==
 
===Acute Overdose===


====Signs and Symptoms====
====Signs and Symptoms====
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(Description)
(Description)
 
|drugBox={{Drugbox2
==Pharmacology==
 
{{Drugbox2
| verifiedrevid =  
| verifiedrevid =  
| IUPAC_name =  
| IUPAC_name =  
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| melting_point =  
| melting_point =  
}}
}}
 
|mechAction=(Description)
===Mechanism of Action===
|structure=(Description with picture)
 
|PD=(Description)
(Description)
|PK=(Description)
 
|nonClinToxic=(Description)
===Structure===
|clinicalStudies======Condition 1=====
 
(Description with picture)
 
===Pharmacodynamics===
 
(Description)
 
===Pharmacokinetics===
 
(Description)
 
===Nonclinical Toxicology===
 
(Description)
 
==Clinical Studies==
 
=====Condition 1=====


(Description)
(Description)
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(Description)
(Description)
 
|howSupplied=(Description)
==How Supplied==
|fdaPatientInfo=(Patient Counseling Information)
 
|alcohol=Alcohol-SandboxAlonso interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
(Description)
|lookAlike=* (Paired Confused Name 1a) — (Paired Confused Name 1b)
 
* National Drug Code (NDC):
* Storage:
* Manufactured by: 
* Distributed by:
 
==Images==
 
===Drug Images===
 
{|
| [[File:PILLIMAGE.jpg|thumb|300px|<p style="text-align: left;">
'''Drug Name''':  <BR>
'''Ingredient(s)''':  <BR>
'''Imprint''':  <BR>
'''Color(s)''':  <BR>
'''Shape''':  <BR>
'''Size (mm)''':  <BR>
'''Score''':  <BR>
'''Drug Label Author''':  ]]</p>
|}
 
===Package and Label Display Panel===
 
(Package Images)
 
(Display Panel Images)
 
==Patient Information==
 
===Patient Information from FDA===
 
(Patient Counseling Information)
 
===Patient Information from NLM===
 
(Link to patient information page)
 
==Precautions with Alcohol==
 
Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
 
==Brand Names==
 
Brand Names®
 
==Look-Alike Drug Names==
 
* (Paired Confused Name 1a) — (Paired Confused Name 1b)
* (Paired Confused Name 2a) — (Paired Confused Name 2b)
* (Paired Confused Name 2a) — (Paired Confused Name 2b)
* (Paired Confused Name 3a) — (Paired Confused Name 3b)
* (Paired Confused Name 3a) — (Paired Confused Name 3b)
 
|nlmPatientInfo=(Link to patient information page)
==[http://www.fda.gov/drugs/drugsafety/drugshortages/ucm050792.htm Drug Shortage Status]==
|drugShortage=Drug Shortage
 
}}
==[http://www.goodrx.com/{{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}/price Price]==
 
==References==
 
{{reflist}}
 
</div>

Revision as of 13:34, 7 July 2014

Metoprolol tartrate (tablet)
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]

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Overview

Metoprolol tartrate (tablet) is a anti-anginal, antiarrhythmic, beta-adrenergic blocker that is FDA approved for the {{{indicationType}}} of acute myocardial infarction (AMI). Common adverse reactions include bradyarrhythmia, constipation, depression, diarrhea, dizziness, dyspnea, fatigue, headache, heart block, heart failure, hypotension, indigestion, nausea, pruritus, rash, and wheezing.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Hypertension
  • Dosing Information
  • Individualize the dosage of Lopressor tablets. Lopressor tablets should be taken with or immediately following meals.
  • The usual initial dosage of Lopressor tablets is 100 mg daily in single or divided doses, whether used alone or added to a diuretic. Increase the dosage at weekly (or longer) intervals until optimum blood pressure reduction is achieved. In general, the maximum effect of any given dosage level will be apparent after 1 week of therapy. The effective dosage range of Lopressor tablets is 100-450 mg per day. Dosages above 450 mg per day have not been studied. While once-daily dosing is effective and can maintain a reduction in blood pressure throughout the day, lower doses (especially 100 mg) may not maintain a full effect at the end of the 24-hour period, and larger or more frequent daily doses may be required. This can be evaluated by measuring blood pressure near the end of the dosing interval to determine whether satisfactory control is being maintained throughout the day. Beta1 selectivity diminishes as the dose of Lopressor is increased.
Angina Pectoris
  • Dosing Information
  • The dosage of Lopressor tablets should be individualized. Lopressor tablets should be taken with or immediately following meals.
  • The usual initial dosage of Lopressor tablets is 100 mg daily, given in two divided doses. gradually increase the dosage at weekly intervals until optimum clinical response has been obtained or there is pronounced slowing of the heart rate. The effective dosage range of Lopressor tablets is 100-400 mg per day. Dosages above 400 mg per day have not been studied. If treatment is to be discontinued, gradually decrease the dosage over a period of 1-2 weeks
Myocardial Infarction
  • Dosing information
  • Early treatment:
  • During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor as soon as possible after the patient's arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient's hemodynamic condition has stabilized.
  • Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor blood pressure, heart rate, and electrocardiogram.
  • In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg twice daily.
  • Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor.
  • Late treatment: Start patients with contraindications to treatment during the early phase of suspected or definite myocardial infarction, patients who appear not to tolerate the full early treatment, and patients in whom the physician wishes to delay therapy for any other reason on Lopressor tablets, 100 mg twice daily, as soon as their clinical condition allows. Continue therapy for at least 3 months. Although the efficacy of Lopressor beyond 3 months has not been conclusively established, data from studies with other beta blockers suggest that treatment should be continued for 1-3 years.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Atrial Fibrillation, Rate Control
  • Dosing Information
Acute Setting: Lopressor injection 2.5—5 mg IV bolus over 2 min; up to 3 doses[1]

In the absence of preexcitation, intravenous administration of beta blockers (esmolol, metoprolol, or propranolol) or nondihydropyridine calcium channel antagonists (verapamil, diltiazem) is recommended to slow the ventricular response to atrial fibrillation in the acute setting, exercising caution in patients with hypotension or heart failure.[2]

Non–Guideline-Supported Use

Atrial flutter
  • Dosing Information
Lopressor injection dose range: 2—15 mg[3]
Multifocal atrial tachycardia
  • Dosing Information
Lopressor injection dose range: 2—15 mg[3]
Supraventricular Tachycardia
  • Dosing Information
Lopressor injection dose range: 2—15 mg[3]
Aggressive Behavior
Injection Site Pain Associated with Propofol Use
  • Dosing Information
Pretreatment with Lopressor injection 2 mg.[4]

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition 1
  • Dosing Information
  • (Dosage)
Condition 2
  • Dosing Information
  • (Dosage)

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition 1
  • Developed by: (Organisation)
  • Class of Recommendation: (Class) (Link)
  • Strength of Evidence: (Category A/B/C) (Link)
  • Dosing Information/Recommendation
  • (Dosage)
Condition 2
  • Developed by: (Organisation)
  • Class of Recommendation: (Class) (Link)
  • Strength of Evidence: (Category A/B/C) (Link)
  • Dosing Information/Recommendation
  • (Dosage)

Non–Guideline-Supported Use

Condition 1
  • Dosing Information
  • (Dosage)
Condition 2
  • Dosing Information
  • (Dosage)
Condition 3
  • Dosing Information
  • (Dosage)

Contraindications

  • Condition 1
  • Condition 2
  • Condition 3
  • Condition 4
  • Condition 5

Warnings

Conidition 1

(Description)

Adverse Reactions

Clinical Trials Experience

Central Nervous System
(list/description of adverse reactions)
Cardiovascular
(list/description of adverse reactions)
Respiratory
(list/description of adverse reactions)
Gastrointestinal
(list/description of adverse reactions)
Hypersensitive Reactions
(list/description of adverse reactions)
Miscellaneous
(list/description of adverse reactions)
Condition 2
Central Nervous System
(list/description of adverse reactions)
Cardiovascular
(list/description of adverse reactions)
Respiratory
(list/description of adverse reactions)
Gastrointestinal
(list/description of adverse reactions)
Hypersensitive Reactions
(list/description of adverse reactions)
Miscellaneous
(list/description of adverse reactions)

Postmarketing Experience

(Description)

Drug Interactions

  • Drug 1
  • Drug 2
  • Drug 3
  • Drug 4
  • Drug 5
Drug 1

(Description)

Drug 2

(Description)

Drug 3

(Description)

Drug 4

(Description)

Drug 5

(Description)

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): (Description)
Pregnancy Category (AUS): (Description)

Labor and Delivery

(Description)

Nursing Mothers

(Description)

Pediatric Use

(Description)

Geriatic Use

(Description)

Gender

(Description)

Race

(Description)

Renal Impairment

(Description)

Hepatic Impairment

(Description)

Females of Reproductive Potential and Males

(Description)

Immunocompromised Patients

(Description)

Others

(Description)

Administration and Monitoring

Administration

(Oral/Intravenous/etc)

Monitoring

Condition 1

(Description regarding monitoring, from Warnings section)

Condition 2

(Description regarding monitoring, from Warnings section)

Condition 3

(Description regarding monitoring, from Warnings section)

IV Compatibility

Solution

Compatible

  • Solution 1
  • Solution 2
  • Solution 3

Not Tested

  • Solution 1
  • Solution 2
  • Solution 3

Variable

  • Solution 1
  • Solution 2
  • Solution 3

Incompatible

  • Solution 1
  • Solution 2
  • Solution 3

Y-Site

Compatible

  • Solution 1
  • Solution 2
  • Solution 3

Not Tested

  • Solution 1
  • Solution 2
  • Solution 3

Variable

  • Solution 1
  • Solution 2
  • Solution 3

Incompatible

  • Solution 1
  • Solution 2
  • Solution 3

Admixture

Compatible

  • Solution 1
  • Solution 2
  • Solution 3

Not Tested

  • Solution 1
  • Solution 2
  • Solution 3

Variable

  • Solution 1
  • Solution 2
  • Solution 3

Incompatible

  • Solution 1
  • Solution 2
  • Solution 3

Syringe

Compatible

  • Solution 1
  • Solution 2
  • Solution 3

Not Tested

  • Solution 1
  • Solution 2
  • Solution 3

Variable

  • Solution 1
  • Solution 2
  • Solution 3

Incompatible

  • Solution 1
  • Solution 2
  • Solution 3

TPN/TNA

Compatible

  • Solution 1
  • Solution 2
  • Solution 3

Not Tested

  • Solution 1
  • Solution 2
  • Solution 3

Variable

  • Solution 1
  • Solution 2
  • Solution 3

Incompatible

  • Solution 1
  • Solution 2
  • Solution 3

Overdosage

Acute Overdose

Signs and Symptoms

(Description)

Management

(Description)

Chronic Overdose

Signs and Symptoms

(Description)

Management

(Description)

Pharmacology

Metoprolol tartrate (tablet)
Systematic (IUPAC) name
?
Identifiers
CAS number ?
ATC code ?
PubChem ?
Chemical data
Formula ?
Mol. mass ?
Pharmacokinetic data
Bioavailability ?
Metabolism ?
Half life ?
Excretion ?
Therapeutic considerations
Pregnancy cat.

?

Legal status
Routes ?

Mechanism of Action

(Description)

Structure

(Description with picture)

Pharmacodynamics

(Description)

Pharmacokinetics

(Description)

Nonclinical Toxicology

(Description)

Clinical Studies

Condition 1

(Description)

Condition 2

(Description)

Condition 3

(Description)

How Supplied

(Description)

Storage

There is limited information regarding Metoprolol tartrate (tablet) Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Metoprolol tartrate (tablet) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Metoprolol tartrate (tablet) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

(Patient Counseling Information)

Precautions with Alcohol

Alcohol-SandboxAlonso interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Metoprolol tartrate (tablet) Brand Names in the drug label.

Look-Alike Drug Names

  • (Paired Confused Name 1a) — (Paired Confused Name 1b)
  • (Paired Confused Name 2a) — (Paired Confused Name 2b)
  • (Paired Confused Name 3a) — (Paired Confused Name 3b)

Drug Shortage Status

Drug Shortage

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. ↑ Fuster, V.; Rydén, LE.; Cannom, DS.; Crijns, HJ.; Curtis, AB.; Ellenbogen, KA.; Halperin, JL.; Le Heuzey, JY.; Kay, GN. (2006). "ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation)". Eur Heart J. 27 (16): 1979–2030. doi:10.1093/eurheartj/ehl176. PMID 16885201. Unknown parameter |month= ignored (help)
  2. ↑ Wann, LS.; Curtis, AB.; Ellenbogen, KA.; Estes, NA.; Ezekowitz, MD.; Jackman, WM.; January, CT.; Lowe, JE.; Page, RL. (2013). "Management of patients with atrial fibrillation (compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines". Circulation. 127 (18): 1916–26. doi:10.1161/CIR.0b013e318290826d. PMID 23545139. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 3.2 Amsterdam, EA.; Kulcyski, J.; Ridgeway, MG. (1991). "Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias". J Clin Pharmacol. 31 (8): 714–8. PMID 1880230. Unknown parameter |month= ignored (help)
  4. ↑ Aşik, I.; Yörükoğlu, D.; Gülay, I.; Tulunay, M. (2003). "Pain on injection of propofol: comparison of metoprolol with lidocaine". Eur J Anaesthesiol. 20 (6): 487–9. PMID 12803269. Unknown parameter |month= ignored (help)
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