Metoprolol Tartrate

💊 What is Metoprolol Tartrate used for?

• •The label says it is used to treat a heart attack (definite or suspected acute myocardial infarction) in patients whose condition is hemodynamically stable. It is meant to reduce deaths from heart and blood vessel problems when it is used together with oral metoprolol (taken by mouth) afterward.

How it works

The label describes metoprolol as a beta-1 blocker. It blocks certain receptors, mainly in the heart, which the label associates with the medicine's effect on heart rate and heart function.

How it is usually taken

• •The label says it is given into a vein by a healthcare team in a coronary care unit or similar setting, after the patient's condition has become stable. It is given as several small injections spaced a short time apart, and blood pressure, heart rate, and electrocardiogram (ECG) are watched during the injections. After the injections, the label says patients are changed over to an oral (by mouth) form of metoprolol. The label says the solution should be checked visually for particles and discoloration before it is given.

Comes as

• •Injection: 5 mg of metoprolol tartrate as a clear liquid in 5 mL clear vials

⚠️ Metoprolol Tartrate side effects

🛑 Who should not take Metoprolol Tartrate, and who should be careful

The label says not to take it if

• 🚨The label says it should not be used if you have had a hypersensitivity (allergic reaction) to metoprolol, related derivatives, or any of its ingredients.
• 🚨The label says it should not be used if you have had a hypersensitivity to other beta blockers.
• 🚨The label says it is contraindicated in patients with a very slow heart rate, second- or third-degree heart block (unless a working pacemaker is present), significant first-degree heart block, or sick sinus syndrome without a pacemaker.
• 🚨The label says it is contraindicated in patients with low systolic blood pressure, cardiogenic shock, or decompensated heart failure.

Tell your doctor before taking it if

• •The label says patients should avoid driving or operating machinery, or doing other tasks that need alertness, until their response to the medicine has been determined.
• •Tell your doctor or dentist before any type of surgery that you are taking this medicine.
• •Contact your doctor if you have any difficulty breathing.
• •The label notes a risk of low blood sugar (hypoglycemia) when the medicine is given to people who are fasting or vomiting, and says to monitor for signs of it.
• •The label says beta blockers should generally not be given to people with bronchospastic diseases (such as asthma). It notes that metoprolol may be used in these patients for initial treatment of a heart attack, and that bronchodilators should be readily available.
• •The label says that in pheochromocytoma, metoprolol should be given together with an alpha blocker, and only after the alpha blocker has been started.
• •The label notes that beta blockers may worsen heart failure, and that symptoms of peripheral vascular disease may be made worse.
• •The label notes that patients with diabetes may be at higher risk of low blood sugar.

🔀 Metoprolol Tartrate with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Catecholamine-depleting drugs (such as reserpine) and MAO inhibitors may have an additive effect with beta blockers. The label says to watch for low blood pressure or a very slow heart rate, which may cause dizziness, fainting, or low blood pressure on standing.
• •The label says patients with a history of severe allergic reactions may be more reactive to repeated exposure and may not respond to the usual doses of epinephrine used for an allergic reaction.
• •Strong CYP2D6 inhibitors, such as quinidine, fluoxetine, paroxetine, and propafenone, were shown to double metoprolol concentrations. The label says moderate or weak inhibitors are likely to increase concentrations too, and that the combination should be monitored closely if it cannot be avoided.
• •Digitalis glycosides, clonidine, diltiazem, and verapamil may increase the risk of a slow heart rate when combined with beta blockers.
• •The label says beta blockers may worsen rebound high blood pressure that can follow the withdrawal of clonidine.

Alcohol and food

The label does not say.

🤰 Metoprolol Tartrate in pregnancy and breastfeeding

Pregnancy

The label says available published observational studies have not shown an association of adverse developmental outcomes with maternal use of metoprolol during pregnancy. It also says untreated high blood pressure and heart failure during pregnancy can lead to adverse outcomes for both mother and fetus. Animal studies at very high oral doses showed effects on post-implantation loss and neonatal survival. The label says the background risk of birth defects and miscarriage in the general population is unknown for the indicated population.

Breastfeeding

The label does not say.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20°C to 25°C (68°F to 77°F), with excursions permitted to 15°C to 30°C (59°F to 86°F). Do not freeze. Protect from light and heat.

If a dose is missed

The label does not say.

If too much is taken

The label says overdose may lead to severe slow heartbeat, low blood pressure, and cardiogenic shock. Other possible signs include heart block, heart failure, bronchospasm, low oxygen, reduced consciousness or coma, nausea, and vomiting. The label says treatment should consider intensive care, and that hemodialysis is unlikely to help remove metoprolol.

🗒️ Questions to ask about Metoprolol Tartrate

• Why is this medicine given into a vein rather than by mouth, and when will I switch to the oral form?
• What signs will the care team watch for during and after the injections?
• Should I avoid driving until my response to the medicine is known?
• How could this medicine interact with my other medicines, such as clonidine, diltiazem, or verapamil?
• Does my asthma or other breathing condition affect whether this medicine is appropriate for me?
• What should I do if I notice signs of low blood sugar?

❓ Metoprolol Tartrate: frequently asked questions