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- What is metoprolol (Lopressor, Toprol XL)?
- What brand names are available for metoprolol?
- Is metoprolol (Lopressor, Toprol XL) available as a generic drug?
- Do I need a prescription for metoprolol (Lopressor, Toprol XL)?
- Why is metoprolol (Lopressor, Toprol XL) prescribed to patients?
- What are the side effects of metoprolol (Lopressor, Toprol XL)?
- What is the dosage for metoprolol (Lopressor, Toprol XL)?
- Which drugs or supplements interact with metoprolol (Lopressor, Toprol XL)?
- Is metoprolol (Lopressor, Toprol XL) safe to use during pregnancy or while breastfeeding?
- What else should I know about metoprolol (Lopressor, Toprol XL)?
What is metoprolol (Lopressor, Toprol XL)?
- Metoprolol is a beta-adrenergic blocking agent that is used for treating high blood pressure, heart pain, abnormal rhythms of the heart, and some neurologic conditions. Examples of beta-adrenergic blockers include propanolol (Inderal, Inderal LA, Innopran XL), atenolol (Tenormin), and timolol (Blocadren).
What brand names are available for metoprolol?
- Lopressor and Toprol XL are brand names available for metoprolol in the US.
Quick GuideHow to Lower Blood Pressure: Exercise Tips
Why is metoprolol (Lopressor, Toprol XL) prescribed to patients?
- Metoprolol is prescribed for patients with high blood pressure (hypertension).
- It also is used to treat congestive heart failure and angina pectoris (heart pain) related to coronary artery disease.
- Metoprolol also is useful in slowing and regulating certain types of abnormally rapid heart rates (tachycardias).
- Other uses for metoprolol include the
What are the side effects of metoprolol (Lopressor, Toprol XL)?
Metoprolol is generally well tolerated. Side effects include
- abdominal cramps,
- memory loss,
- low blood pressure,
- cold extremities,
- sore throat, and
- shortness of breath or wheezing.
Possible serious adverse effects include
- In patients with existing slow heart rates (bradycardias) and heart blocks (defects in the electrical conduction of the heart), metoprolol can cause dangerously slow heart rates, and even shock. Metoprolol reduces the force of heart muscle contraction and can aggravate symptoms of heart failure. In patients with coronary artery disease, abruptly stopping metoprolol can suddenly worsen angina, and occasionally precipitate heart attacks. If it is necessary to discontinue metoprolol, its dosage should be reduced gradually over several weeks.
- Initiation of high-dose extended release metoprolol in patients undergoing non-cardiac surgery is associated with bradycardia (slow heart rate), hypotension, stroke, and death. However, long-term therapy with metoprolol should not be routinely withdrawn prior to major surgery. Impaired ability of the heart to respond to reflex adrenergic stimuli may increase the risks of general anesthesia and surgery.
What is the dosage for metoprolol (Lopressor, Toprol XL)?
- Metoprolol should be taken before meals or at bedtime.
- The dose for treating hypertension is 100-450 mg daily in single or divided doses.
- Angina is treated with 100-400 mg daily in two divided doses.
- Heart attack (acute myocardial infarction) is treated with three 5 mg injections administered 2 minutes apart followed by treatment with 50 mg oral metoprolol every 6 hours for 48 hours. After 48 hours, patients should receive 100 mg orally twice daily for at least 3 months.
- The dose for congestive heart failure is 25 mg/daily initially. Then the dose is increased every 2 weeks to reach a target dose of 200 mg/daily orally.
- Hyperthyroidism is treated with 25 to 30 mg by mouth every 6 hours.
Which drugs or supplements interact with metoprolol (Lopressor, Toprol XL)?name="interact">
Which drugs or supplements interact with metoprolol (Lopressor, Toprol XL)?
- Calcium channel blockers and digoxin (Lanoxin) can lower blood pressure and heart rate to dangerous levels when administered together with metoprolol.
- Metoprolol can mask the early warning symptoms of low blood sugar (hypoglycemia) and should be used with caution in patients receiving treatment for diabetes.
- Fluoxetine (Prozac) can increase blood levels of metopropol by reducing breakdown of metoprolol, and increase the side effects from metoprolol.
Is metoprolol (Lopressor, Toprol XL) safe to use during pregnancy or while breastfeeding?
Safe use of metoprolol during pregnancy has not been established.
Small quantities of metoprolol are excreted in breast milk and may potentially cause adverse effects in the infant.
What else should I know about metoprolol (Lopressor, Toprol XL)?
What preparations of metoprolol (Lopressor, Toprol XL) are available?
- Tablets: 25, 50, and 100 mg.
- Tablets (extended release): 25, 50, 100, and 200 mg.
- Injection: 1 mg/ml
How should I keep metoprolol (Lopressor, Toprol XL) stored?
- Tablets should be stored between 15 C and 30 C (59 F and 86 F).
- They should be protected from moisture and dispensed in tight, light-resistant containers.
How does metoprolol (Lopressor, Toprol XL) work?
- Metoprolol blocks the action of the sympathetic nervous system, a portion of the involuntary nervous system, by blocking beta receptors on sympathetic nerves. Since the sympathetic nervous system is responsible for increasing the rate with which the heart beats, by blocking the action of these nerves metoprolol reduces the heart rate and is useful in treating abnormally rapid heart rhythms.
- Metoprolol also reduces the force of contraction of heart muscle and thereby lowers blood pressure. By reducing the heart rate and the force of muscle contraction, metoprolol reduces the need for oxygen by heart muscle. Since heart pain (angina pectoris) occurs when oxygen demand of the heart muscle exceeds the supply of oxygen, metoprolol, by reducing the demand for oxygen, is helpful in treating heart pain.
When was metoprolol approved by the FDA?
- The FDA approved metoprolol in August 1978.
Reference: FDA Prescribing Information
Quick GuideHow to Lower Blood Pressure: Exercise Tips
Metoprolol (Lopressor, Toprol XL) is a beta-adrenergic blocking agent drug, which blocks the action of the sympathetic nervous system (a portion of the involuntary nervous system). Metoprolol is prescribed to treat high blood pressure (hypertension), heart pain (angina), heart rhythm disorders, and some neurological conditions. Side effects include:
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FaintingFainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Heart Disease (Coronary Artery Disease)
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include:
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- Family history
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Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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