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Metoprolol (Intravenous route)

Pronunciation:

met-oh-PROE-lol

Brand Names:

  • Lopressor

Dosage Forms:

  • Solution

Warnings:

Intravenous route(Solution)

Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred. The dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored when discontinuing chronic therapy. If angina markedly worsens or acute coronary insufficiency develops, metoprolol tartrate administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician's advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue metoprolol tartrate therapy abruptly even in patients treated only for hypertension .

Classifications:

Therapeutic—

Cardiovascular Agent

Pharmacologic—

Beta-Adrenergic Blocker, Cardioselective

Uses of This Medicine:

Metoprolol injection is used to reduce the risk of death from an acute heart attack. It is given to people who have already had a heart attack.

This medicine is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of metoprolol injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metoprolol injection in the elderly. However, elderly patients may be more sensitive to the effects of metoprolol injection than younger adults and are more likely to have age-related liver or heart problems, which may require caution and an adjustment in the dose for patients receiving metoprolol injection.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Albuterol
  • Amiodarone
  • Arformoterol
  • Bambuterol
  • Clenbuterol
  • Clonidine
  • Colterol
  • Crizotinib
  • Diltiazem
  • Dronedarone
  • Fenoldopam
  • Fenoterol
  • Fingolimod
  • Formoterol
  • Hexoprenaline
  • Indacaterol
  • Isoetharine
  • Lacosamide
  • Levalbuterol
  • Lidocaine
  • Metaproterenol
  • Olodaterol
  • Pirbuterol
  • Procaterol
  • Reproterol
  • Ritodrine
  • Salmeterol
  • Terbutaline
  • Tretoquinol
  • Tulobuterol
  • Verapamil
  • Vilanterol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acetohexamide
  • Acetyldigoxin
  • Alfuzosin
  • Amlodipine
  • Amtolmetin Guacil
  • Arbutamine
  • Aspirin
  • Benfluorex
  • Bromfenac
  • Bufexamac
  • Bunazosin
  • Celecoxib
  • Chlorpropamide
  • Choline Salicylate
  • Citalopram
  • Clonixin
  • Deslanoside
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digitoxin
  • Digoxin
  • Dipyrone
  • Doxazosin
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Felodipine
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Guar Gum
  • Ibuprofen
  • Ibuprofen Lysine
  • Indomethacin
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Ketoprofen
  • Ketorolac
  • Lacidipine
  • Lercanidipine
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Manidipine
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Metildigoxin
  • Mibefradil
  • Miglitol
  • Mirabegron
  • Morniflumate
  • Moxisylyte
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Nicardipine
  • Nifedipine
  • Niflumic Acid
  • Nilvadipine
  • Nimesulide
  • Nimodipine
  • Nisoldipine
  • Nitrendipine
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenelzine
  • Phenobarbital
  • Phenoxybenzamine
  • Phentolamine
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Pranidipine
  • Pranoprofen
  • Prazosin
  • Proglumetacin
  • Propoxyphene
  • Propyphenazone
  • Proquazone
  • Repaglinide
  • Rifampin
  • Rifapentine
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • St John's Wort
  • Sulindac
  • Tamsulosin
  • Telithromycin
  • Tenoxicam
  • Terazosin
  • Tiaprofenic Acid
  • Tolazamide
  • Tolbutamide
  • Tolfenamic Acid
  • Tolmetin
  • Trimazosin
  • Troglitazone
  • Urapidil
  • Valdecoxib
  • Venlafaxine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood circulation problems or
  • Bradycardia (slow heartbeat) or
  • Heart block or
  • Heart failure, moderate to severe or
  • Sick-sinus syndrome (heart rhythm problem)—Should not be used in patients with these conditions.
  • Diabetes or
  • Hyperthyroidism (overactive thyroid) or
  • Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat.
  • Hypotension (low blood pressure) or
  • Ischemic heart disease or
  • Lung disease (eg, asthma, bronchitis, emphysema) or
  • Pheochromocytoma (adrenal gland tumor)—Use with caution. May make these conditions worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Your doctor will only give you a few doses of this medicine until your condition improves, and then you will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check you closely to make sure this medicine is working properly and to check for unwanted effects.

Metoprolol injection may worsen the symptoms of heart failure in some patients. Tell your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop receiving this medicine several days before having surgery.

This medicine may cause some people to become less alert than they are normally. if this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while using metoprolol injection.

Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Blurred vision
chest pain or discomfort
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
shortness of breath
slow or irregular heartbeat
sweating
unusual tiredness or weakness
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
cough
decreased urine output
difficult or labored breathing
dilated neck veins
disturbed color perception
double vision
extreme fatigue
fast, pounding, or racing heartbeat or pulse
halos around lights
irregular breathing
loss of vision
mental confusion
night blindness
noisy breathing
overbright appearance of lights
pain, tension, and weakness upon walking that subsides during periods of rest
paleness or cold feeling in the fingertips and toes
rapid weight gain
seeing, hearing, or feeling things that are not there
short-term memory loss
swelling of the face, fingers, feet, or lower legs
tightness in the chest
tingling of the hands or feet
tingling or pain in the fingers or toes when exposed to cold
troubled breathing
tunnel vision
unusual weight gain or loss
Rare
Bluish color skin of the fingers or toes
chills
clay-colored stools
continuing loss of appetite
continuing or severe abdominal or stomach pain
continuing or severe nausea and vomiting
dark urine
difficulty with moving
fever
general tiredness and weakness
headache
hoarseness
increased frequency of urination
itching skin
light-colored stools
lower back or side pain
muscle pain or stiffness
numbness of the fingers or toes
pain, swelling, or redness in the joints
painful or difficult urination
rash
sore throat
sores, ulcers, or white spots on the lips or in the mouth
unpleasant breath odor
unusual bleeding or bruising
upper right abdominal or stomach pain
vomiting of blood
weakness
yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Bluish color of the fingernails, lips, skin, palms, or nail beds
change in consciousness
loss of consciousness
no blood pressure or pulse
stopping of heart
unconsciousness
very drowsy or sleepy

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Belching
bloated
decreased interest in sexual intercourse
difficulty having a bowel movement (stool)
discouragement
dry mouth
excess air or gas in the stomach or intestines
feeling of constant movement of self or surroundings
feeling of indigestion
feeling sad or empty
full feeling
inability to have or keep an erection
irritability
loss in sexual ability, desire, drive, or performance
loss of interest or pleasure
nightmares
pain in the chest below the breastbone
passing gas
redness or other discoloration of the skin
sensation of spinning
tiredness
trouble concentrating
trouble sleeping
Rare
Bone pain
continuing ringing or buzzing or other unexplained noise in the ears
hearing loss
increased sensitivity of the skin to sunlight
pain of penis on erection
severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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