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In the management of:
Hypertension
Angina pectoris
Cardiac arrhythmias (in particular supraventricular tachycardias)
As an adjunctive treatment of thyrotoxicosis
Early intervention of metoprolol tartrate in acute myocardial infarction reduces infarct size and the incidence of ventricular fibrillation. Pain relief may also decrease the need for opiate analgesics.
Long-term prophylaxis after recovery from acute myocardial infarction
Prophylaxis of migraine
Metoprolol tartrate has been shown to reduce mortality when administered to patients with acute myocardial infarction. Metoprolol is indicated in adults.
Dosage
The following dosage regimes are intended only as a guideline and should always be adjusted to the individual requirements of the patient but should not exceed 400 mg/day.
Dizziness, headache, Rare: Alertness decreased, somnolence or insomnia, paraesthesia, Bradycardia, Heart failure, Rare: cardiac arrhythmias, palpitation, Orthostatic hypotension (occasionally with syncope), Exertional dyspnea, Nausea and vomiting, abdominal pain, Fatigue, Very rare: Dysgeusia (Taste disturbances)
Abrupt cessation of therapy with a beta-blocker should be avoided especially in patients with ischaemic heart disease. When possible, metoprolol should be withdrawn gradually over a period of 10 days, the doses diminishing to 25mg for the last 6 days.
Although metoprolol has proved safe in a large number of asthmatic patients, it is advisable to exercise care in the treatment of patients with chronic obstructive pulmonary disease.
Metoprolol Tartrate tablets may not be administered to patients with untreated congestive heart failure. The congestive heart failure needs to be brought under control first of all.
When a beta blocker is being taken, a serious, sometimes even life-threatening deterioration in cardiac function can occur, in particular in patients in whom the action of the heart is dependent on the presence of sympathetic system support.
Before a patient undergoes an operation, the anaesthetist must be informed that metoprolol is being taken.
Beta-blockers mask some of the clinical signs of thyrotoxicosis. Therefore, Metoprolol should be administered with caution to patients having, or suspected of developing, thyrotoxicosis, and both thyroid and cardiac function should be monitored closely.
Metoprolol may induce or aggravate bradycardia, symptoms of peripheral arterial circulatory disorders and anaphylactic shock.
Metoprolol may be administered when heart failure has been controlled. Digitalisation and/or diuretic therapy should also be considered for patients with a history of heart failure or patients known to have a poor cardiac reserve.
Metoprolol may reduce the effect of diabetes treatment and mask the symptoms of hypoglycaemia.
In patients with significant hepatic dysfunction it may be necessary to adjust the dosage because metoprolol undergoes biotransformation in the liver. Patients with hepatic or renal insufficiency may need a lower dosage, and metoprolol is contraindicated in patients with hepatic or renal disease/failure.
Patients with anamnestically known psoriasis should take beta-blockers only after careful consideration as the medicine may cause aggravation of psoriasis.
Beta blockers may increase both the sensitivity towards allergens and the seriousness of anaphylactic reactions.
Beta blockers may unmask myasthenia gravis.
In the presence of liver cirrhosis, the bioavailability of metoprolol may be increased, and dosage should be adjusted accordingly.
Store below 30°C and protect from light and moisture.
Keep out of reach of children.
1 x10 Alu/PVC blister
Metoprolol Tartrate Tablets BP 100 mg are available in an Alu/PVC blister of 10 tablets. Such 01 blister in a carton with pack insert.
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