Metoprolol Tartrate (Antihypertensive)

Question 1

What is the brand name of Metoprolol Tartrate?

Answer 1

Lopressor

Question 2

What is the available tablet strengths of Lopressor?

Answer 2

25mg, 50mg, & 100mg tabs

Question 3

What is the available Injection strength of Lopressor?

Answer 3

5mg/5mL

Question 4

What are the two FDA indications for Metoprolol Tartrate & the recommended dosages?

Answer 4

Management of hypertension

• Initial: 100mg/day in a single or divided dose. May increase dose at weekly (or longer) intervals
• Maintenance: 100mg to 450mg/day in a single or divided dose

Acute Myocardial Infarction:

• Early treatment: three 5mg IV bolus doses at approx. 2 minute intervals. 15 minute after last IV dose, start 25mg to 50mg PO Q6H
• Late treatment: 100mg BID for at least 3 months. Start maintenance dose 48 hours after last IV dose

Question 5

What is the mechanism of action for Lopressor?

Answer 5

Metoprolol is a relatively cardioselective beta-1 adrenergic receptor blocker a.k.a. beta-blocker

Question 6

What are the drug interactions for metoprolol tartrate?

Answer 6

• May decrease affects of feel fine lines barbiturates or right stamping may decrease affects
• Cimetidine may increase serum levels
• Hydralazine, propafenone or thioamines may increase effects.
• Non-steroidal anti-inflammatory agents may decrease affects.
• Toxic affects may be increased with verapamil.
• May increase toxic effects of lidocaine.
• Use with prazosin may increase postural hypotension.
• Use with digitalis may cause additive bradycardia.

Question 7

What are the contraindications of Lopressor?

Answer 7

• Uses contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, congestive heart failure, overt cardiac failure, and a patient with a heart rate lower than 45 bpm, systolic blood pressure less than 100 mmHg, or moderate to severe cardiac failure.
• Used with caution and pregnancy, and patient with bronchospasmic diseases, diabetes, thyrotoxicosis, and impaired hepatic function.
• Pregnancy Category C.

Question 8

What are the adverse effects of Metoprolol Tartrate?

Answer 8

Dizziness, fatigue, depression, shortness of breath, diarrhea, and bradycardia.

Question 9

What should the RPh tell a patient when counseling for metoprolol tartrate?

Answer 9

• Contacted physician the above side effects are severe or persistent.
• Do not discontinue therapy without first consulting a physician.
• Take with food to increase absorption.
• May cause dizziness. Use caution while operating machinery i.e. forklifts.
• Patients with diabetes need to be aware that this agent can cause masking of hypoglycemic symptoms.
• If you miss a dose, take it as soon as possible. If it is closer to the time of your next dose than the missed dose, skip the missed dose and return your dosing schedule. Do not double doses.