The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us. Switching from immediate-release to extended-release: Use same total daily dose of metoprolol Switching between oral and IV dosage forms: Equivalent beta-blocking effect is achieved in 2.5:1 (oral-to-IV) ratio Dizziness (10%) Headache (10%) Tiredness (10%) Depression (5%) Diarrhea (5%) Pruritus (5%) Bradycardia (9%) Rash (5%) Dyspnea (1-3%) Cold extremities (1%) Constipation (1%) Dyspepsia (1%) Heart failure (1%) Hypotension (1%) Nausea (1%) Flatulence (1%) Heartburn (1%) Xerostomia (1%) Wheezing (1%) Bronchospasm (1%) Anxiety/nervousness Hallusinations Paresthesia Hepatitis Vomiting Arthralgia Male impotence Reversible alopecia Agranulocytosis Dry eyes Worsening of psoriasis Pyronie’s disease Sweating Photosensitivity Taste disturbance Lopressor and Toprol XL only Ischemic heart disease may be exacerbated after abrupt withdrawal Hypersensitivity to catecholamines has been observed during withdrawal Exacerbation of angina and, in some cases, myocardial infarction (MI) may occur after abrupt discontinuance When long-term beta blocker therapy (particularly with ischemic heart disease) is discontinued, dosage should be gradually reduced over 1-2 weeks with careful monitoring If angina worsens markedly or acute coronary insufficiency develops, beta-blocker administration should be promptly reinitiated, at least temporarily (in addition to other measures appropriate for unstable angina) Patients should be warned against interruption or discontinuance of beta-blocker therapy without physician advice Because coronary artery disease (CAD) is common and may be unrecognized, beta-blocker therapy must be discontinued slowly, even in patients treated only for hypertension Use with caution in cerebrovascular insufficiency, CHF, cardiomegaly, myasthenia gravis, hyperthyroidism or thyrotoxicosis (may mask signs or symptoms), liver disease, renal impairment, peripheral vascular disease, psoriasis (may cause exacerbation of psoriasis) May exacerbate bronchospastic disease; monitor closely Beta blockers can cause myocardial depression and may precipitate heart failure and cardiogenic shock Sudden discontinuance can exacerbate angina and lead to MI and ventricular arrhythmias in patients with CAD Worsening cardiac failure may occur during up-titration of metoprolol succinate; if such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of metoprolol succinate; it may be necessary to lower the dose of metoprolol succinate or temporarily discontinue it Bradycardia, including sinus pause, heart block, and cardiac arrest, has been reported; patients with 1° atrioventricular block, sinus node dysfunction, or conduction disorders may be at increased risk Increased risk of stroke after surgery May potentiate hypoglycemia in patients with diabetes mellitus and may mask signs and symptoms Avoid starting high-dose regimen of extended-release metoprolol in patients undergoing noncardiac surgery; use in patients with cardiovascular risk factors is associated with bradycardia, hypotension, stroke, and death Long-term beta blockers should not be routinely withdrawn before major surgery; however, impaired ability of the heart to respond to reflex adrenergic stimuli may augment risks of general anesthesia and surgical procedures Metoprolol loses beta-receptor selectivity at high doses and in poor metabolizers If drug is administered for tachycardia secondary to pheochromocytoma, it should be given in combination with an alpha blocker (which should be started before metoprolol is started) While taking beta blockers, patients with history of severe anaphylactic reaction to variety of allergens may be more reactive to repeated challenge Extended release tablet should not be withdrawn routinely prior to major surgery Hydrochlorothiazide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma, which can lead to permanent vision loss if not treated; discontinue hydrochlorothiazide as rapidly as possible if symptoms occur; prompt medical or surgical treatments may need to be considered if intraocular pressure remains uncontrolled; risk factors for developing acute angle-closure glaucoma may include history of sulfonamide or penicillin allergy Caution in patients with history of psychiatric illness; may cause or exacerbate CNS depression Beta-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease There are no adequate and well-controlled studies in pregnant women Limited data on the use of metoprolol in pregnant women Risk to fetus/mother is unknown; because animal reproduction studies are not always predictive of human response, use if clearly needed Bioavailability: 40-50% (immediate-release) ; 65-77% (extended-release) relative to immediate release Onset: 20 min (IV), when infused over 10 min; onset may be immediate, depending on clinical setting; 1-2 hr (PO) Duration: 3-6 hr (PO); duration is dose-related; 24 hr (ER); 5-8 hr (IV) Peak plasma time: 1.5-2 hr (immediate-release); 3.3 hr (extended-release) Therapeutic range: 35-212 ng/m L The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Duloxetine 20 mg Lasix 40 mg price Azithromycin side effects in dogs Valtrex monograph Re Anyone take metoprolol in a real low dose and split the pills? I think I am dealing with a similar situation. Several weeks ago I experienced a sudden drop in blood pressure from my then normal readings of about high 120's or low 130's over 85 or so diastolic. One of metoprolol's effects is slowing the heart rate, and when people suddenly stop taking this medication, a rebound effect may occur, causing the resting heart rate to rise above normal limits. The immediate and extended release products may not give same clinical response on mgmg basis; monitor response and side effects when interchanging between metoprolol products. Concomitant amiodarone, digoxin, disopyramide, or non-dihydropyridine calcium channel blockers may increase the risk of bradycardia. Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Your dose may need to be changed several times in order to find out what works best for you. In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of food you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should first check with your doctor before changing your diet. Many patients who have high blood pressure will not notice any signs of the problem. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well. It comes as immediate-release and extended-release oral tablets, and extended-release oral capsules. It also comes in an injectable form that’s only given by a healthcare provider. Metoprolol oral tablets are available as the brand-name drugs Lopressor and Toprol XL. Generic drugs usually cost less than the brand-name versions. In some cases, they may not be available in all strengths or forms as the brand-name drugs. The two brand-name forms of metoprolol (as well as the different generic forms) are different versions of the medication. They’re both metoprolol, but they contain different salt forms. The different salt forms enable the drugs to be used to treat different conditions. Metoprolol succinate is an extended-release version of metoprolol, so it remains in your bloodstream for a longer time. Metoprolol normal dose Acetaminophen, Digoxin, Metoprolol, Furosemide, Opioids., Are There Side Effects When You Stop Taking Metoprolol. Buy tretinoin gel 0.05Buy xenical online europeAmoxicillin forte If you have certain allergies, your reactions may be worse while you are taking metoprolol. You also might not respond to your usual dose of. Metoprolol Lopressor - Side Effects, Dosage, Interactions - Drugs. Metoprolol - American College of Cardiology. Metoprolol Uses, Dosage & Side Effects FindATopDoc. Trust in 4 dosage strengths to suit your patient’s needs. TOPROL-XL and its authorized generic, metoprolol succinate distributed by Lannett Company, Inc. are available in 4 dosage strengths—25 mg, 50 mg, 100 mg, and 200 mg.* Available in identical dosing options for the authorized generic of TOPROL-XL— 25 mg, 50 mg, 100 mg, and 200 mg* Indications, dose, contra-indications, side-effects, interactions, cautions. Usual dose 50 mg 2–3 times a day, then increased if necessary up to 300 mg daily in. Usual Adult Dose for Hypertension. METOPROLOL TARTRATE IMMEDIATE RELEASE TABLETS Initial dose 100 mg orally per day in single.