| name | Metoprolol |
| classification | Beta-blocker, selective beta-1 receptor blocker |
| pharmacokinetics | Metoprolol is rapidly absorbed after oral administration. Peak plasma concentrations are typically reached within 1-2 hours. Significant first-pass metabolism occurs. Excretion is primarily through the kidneys, with metabolites also excreted. Renal clearance is important to consider, particularly in patients with kidney impairment. |
| dosage | | initial | 25-100 mg orally twice daily | | maintenance | 50-200 mg orally twice daily | | maximum | 450 mg/day | | notes | Dosage should be individualized based on patient response and comorbidities. |
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| indications | Angina pectoris, hypertension, myocardial infarction, supraventricular tachycardia, and other conditions requiring decreased heart rate and blood pressure reduction. |
| safety in pregnancy | Use during pregnancy should be carefully considered. Potential risks to the fetus should be weighed against potential maternal benefit. Not recommended for routine use during pregnancy. |
| safety in breastfeeding | Metoprolol is excreted in breast milk. Decision to breastfeed should be carefully considered, weighing potential benefits and risks to the infant. Careful monitoring may be needed. |
| side effects | | 1 | | category | Common | | effects | | 1 | Fatigue | | 2 | Dizziness | | 3 | Nausea | | 4 | Hypotension | | 5 | Bradycardia |
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| | 2 | | category | Less Common | | effects | | 1 | Sleep disturbances | | 2 | Nightmares | | 3 | Depression | | 4 | Erectile dysfunction |
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| | 3 | | category | Serious | | effects | | 1 | Bronchospasm (in susceptible individuals) | | 2 | Heart block | | 3 | Heart failure worsening | | 4 | Severe hypotension |
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| contraindications | Severe bradycardia, second- or third-degree heart block, cardiogenic shock, severe hypotension, asthma or COPD, severe peripheral vascular disease |
| interactions | Many medications can interact with metoprolol, including calcium channel blockers, digoxin, non-steroidal anti-inflammatory drugs, verapamil, and some antibiotics. Consult with a physician before starting any new medication. |
| warnings and precautions | Monitor for signs of worsening heart failure, especially in patients with pre-existing heart conditions. Monitor blood pressure and heart rate closely, particularly in the first few weeks of treatment. Caution when co-administering with other drugs that may lower heart rate. |
| additional information | Metoprolol is available in various formulations (immediate and extended release). Extended-release formulations may offer more convenient dosing. |
| special considerations 25 years 70kg | A 25-year-old male weighing 70kg generally has a normal weight and is in a healthy age range for beta-blocker therapy; however, thorough evaluation by a physician is essential to identify potential underlying cardiovascular or other health concerns that may influence dosage, beta-blocker choice, or the need for additional monitoring. |
