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Metoprolol
Generic Name: Metoprolol
Brand Name: Lopressor
Indications
Metoprolol is indicated to reduce hypertension (high blood pressure), to treat chest pain (angina), to treat heart failure, and to reduce the risk that a heart attack will recur.
Dosage and Administration
Lopressor tablets are available in strengths of 50mg and 100mg. Lopressor injection is available as ampuls of 5mL.
Normal Dosage:
Hypertension: The dosage of Lopressor should be individualized. Lopressor should be taken with or immediately following meals. The usual initial dosage is 100 mg daily in single or divided doses, whether used alone or added to a diuretic. The dosage may be increased 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 is 100- 450 mg per day.
Angina pectoris: The usual initial dosage is 100 mg daily, given in two divided doses. The dosage may be gradually increased at weekly intervals until optimum clinical response has been obtained or there is pronounced slowing of the heart rate. The effective dosage range is 100-400 mg per day.
Myocardial Infarction: During the early phase of definite or suspected acute myocardial infarction, treatment with Lopressor can be initiated 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.
Treatment in this early phase should begin with the intravenous administration of three bolus injections of 5 mg of Lopressor each; the injections should be given at approximately 2-minute intervals. During the intravenous administration of Lopressor, blood pressure, heart rate, and electrocardiogram should be carefully monitored.
Overdose: Overdose symptoms include a slow heart- beat, shortness of breath, fainting, dizziness, weakness, confusion, nausea, and vomiting.
Drug description
Metoprolol tartrate USP is (±)-1-(Isopropylamino)-3-[ p-(2-methoxyethyl)phenoxy]-2-propanol L-(+)- tartrate (2:1) salt, and its structural formula is
Metoprolol tartrate USP is a white, practically odorless, crystalline powder with a molecular weight of 684.82. It is very soluble in water; freely soluble in methylene chloride, in chloroform, and in alcohol; slightly soluble in acetone; and insoluble in ether.
Side effects
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Slower than normal heart beat (bradycardia)
- Inability of the heart to pump blood efficiently (heart failure)
- Disturbed sleep
- Fatigue
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Dizziness
- Breathing difficulties due to a narrowing of the airways (bronchospasm)
- Cold extremities, eg hands and feet
- Rash
Precautions
- Use caution while driving, operating machinery, or performing other hazardous activities.
- Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking this drug.
- Tell your doctor and dentist that you are taking this medication before having surgery.
- This drug belongs to the FDA pregnancy category C. This means that it is not known whether this medication will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
Drug Interactions
Before taking this medication, tell your doctor if you are taking:
- a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cardizem, Dilacor XR), clonidine (Catapres), digoxin (Lanoxin), doxazosin (Cardura), guanadrel (Hylorel), prazosin (Minipress), or terazosin (Hytrin)
- a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage)
- a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen (Orudis, Orudis KT, Oruvail), and others
- a respiratory medication such as albuterol (Ventolin, Proventil, Volmax, others), bitolterol (Tornalate), metaproterenol (Alupent, Metaprel), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), or theophylline (Theo-Dur, Theochron, Theolair, others), and others
- the stomach medication cimetidine (Tagamet, Tagamet HB)
- prescription or over-the-counter cough medicines, cold medicines, or diet pills
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