| drug | Metoprolol |
| classification | Beta-blocker, Cardioselective |
| pharmacokinetics | | absorption | Rapidly absorbed after oral administration, peak plasma concentrations typically reached within 1-2 hours. | | distribution | Distributed throughout the body, with significant binding to plasma proteins. | | metabolism | Metabolized primarily in the liver, with some renal excretion of unchanged drug and metabolites. | | excretion | Excreted primarily in the urine, both as unchanged drug and metabolites. |
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| suggested dosage | | oral | | typical range | 25-200 mg/day, administered in divided doses or as a single dose. | | note | Dosage should be individualized based on patient response, blood pressure, and heart rate. Initial dosing for a 25-year-old male weighing 70 kg is likely to be lower and titrated upward as needed. |
| | IV | | note | IV administration is reserved for acute situations and should only be administered by qualified healthcare professionals. Dosage is highly dependent on the clinical situation and should never be self-administered. |
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| indications | | 1 | Hypertension | | 2 | Angina pectoris | | 3 | Heart failure (certain forms, with caution) | | 4 | Migraine prevention | | 5 | Atrial fibrillation | | 6 | Post-myocardial infarction |
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| safety pregnancy | | category | Category C | | note | Use during pregnancy only if clearly needed and under careful consideration of potential risks to the fetus and benefits to the mother. Consult with a healthcare provider. |
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| safety breastfeeding | | potential effects | Metoprolol passes into breast milk, potentially slowing the infant's heart rate. | | note | Monitor the infant for adverse effects (e.g., bradycardia, lethargy). The decision to continue breastfeeding should be made after weighing potential benefits for the mother versus risks to the infant. Consult with a healthcare professional. |
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| side effects | | 1 | Bradycardia | | 2 | Hypotension | | 3 | Fatigue | | 4 | Dizziness | | 5 | Weakness | | 6 | Cold extremities | | 7 | Nausea | | 8 | Vomiting | | 9 | Constipation | | 10 | Depression | | 11 | Impotence | | 12 | Breathing difficulties (rare) |
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| alternatives | |
| contraindications | | 1 | Severe bradycardia | | 2 | Cardiogenic shock | | 3 | Severe heart block | | 4 | Hypersensitivity to metoprolol or other beta-blockers | | 5 | Significant airway obstruction (e.g., asthma or chronic bronchitis) – use with extreme caution. |
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| interactions | | 1 | Other medications affecting heart rate or blood pressure (e.g., calcium channel blockers, antiarrhythmics) | | 2 | Nonsteroidal anti-inflammatory drugs (NSAIDs) | | 3 | Verapamil | | 4 | Quinidine |
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| warnings precautions | | 1 | Monitor blood pressure and heart rate closely, especially during initial therapy. | | 2 | Avoid abrupt discontinuation of therapy. | | 3 | May mask symptoms of hypoglycemia (low blood sugar) in diabetic patients. | | 4 | Patients with underlying cardiovascular disease should be monitored closely. | | 5 | Use caution in patients with asthma or COPD. |
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| additional information | | 1 | Monitor blood glucose in diabetic patients. | | 2 | Advise patients to avoid driving or operating heavy machinery until they adjust to the medication. | | 3 | Dosage adjustments may be needed in patients with renal or hepatic impairment. |
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| patient details | |
