Hypertension The mechanism of the antihypertensive effects of beta-blocking agents has not been fully elucidated. However, several possible mechanisms have been proposed: Angina Pectoris By blocking catecholamine -induced increases in heart rate, in velocity and extent of myocardial contraction, and in blood pressure, Lopressor reduces the oxygen requirements of the heart at any given level of effort, thus making it useful in the long-term management of angina pectoris.
Myocardial Infarction The precise mechanism of action of Lopressor in patients with suspected or definite myocardial infarction is not known. Pharmacodynamics Relative beta1 selectivity is demonstrated by the following: This contrasts with the effect of nonselective beta1 plus beta2 beta blockers , which completely reverse the vasodilating effects of epinephrine. Lopressor has no intrinsic sympathomimetic activity, and membrane-stabilizing activity is detectable only at doses much greater than required for beta blockade.
Animal and human experiments indicate that Lopressor slows the sinus rate and decreases AV nodal conduction. When the drug was infused over a minute period, in normal volunteers, maximum beta blockade was achieved at approximately 20 minutes. Equivalent maximal beta-blocking effect is achieved with oral and intravenous doses in the ratio of approximately 2.
There is a linear relationship between the log of plasma levels and reduction of exercise heart rate. Metoprolol dose reductions may be necessary. Consider therapy modification Diazoxide: Beta-Blockers may enhance the negative inotropic effect of Disopyramide. Dronedarone may increase the serum concentration of Beta-Blockers.
This likely applies only to those agents that are metabolized by CYP2D6. Use lower initial beta-blocker doses; adequate tolerance of the combination, based on ECG findings, should be confirmed prior to any increase in beta-blocker dose.
Consider therapy modification Ergot Derivatives: Beta-Blockers may enhance the vasoconstricting effect of Ergot Derivatives. Consider therapy modification Fingolimod: Beta-Blockers may enhance the bradycardic effect of Fingolimod.
Avoid the concomitant use of fingolimod and beta-blockers if possible. If coadministration is necessary, patients should have overnight continuous ECG monitoring conducted after the first dose of fingolimod. Monitor patients for bradycardia. Consider therapy modification Floctafenine: More specifically, Beta-Blockers may inhibit the ability to effectively treat severe allergic reactions to Grass Pollen Allergen Extract 5 Grass Extract with epinephrine.
Some other effects of epinephrine may be unaffected or even enhanced e. Consider therapy modification Herbs Hypertensive Properties: Monitor therapy Herbs Hypotensive Properties: Monitor therapy Hypotension-Associated Agents: Beta-Blockers may enhance the hypoglycemic effect of Insulins.
Bradycardia-Causing Agents may enhance the bradycardic effect of Ivabradine. May enhance the hypotensive effect of Metoprolol. Metoprolol may decrease the serum concentration of Lercanidipine. Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. Monitor therapy Lidocaine Systemic: Beta-Blockers may increase the serum concentration of Lidocaine Systemic.
Monitor therapy Lidocaine Topical: Beta-Blockers may increase the serum concentration of Lidocaine Topical. Beta-Blockers may increase the serum concentration of Mepivacaine. Beta-Blockers may enhance the bradycardic effect of Midodrine. May diminish the antihypertensive effect of Metoprolol. Mirabegron may increase the serum concentration of Metoprolol. Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside.
Monitor therapy Nonsteroidal Anti-Inflammatory Agents: May diminish the antihypertensive effect of Beta-Blockers. Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion.
Consider therapy modification Opioids Anilidopiperidine: Opioids Anilidopiperidine may enhance the hypotensive effect of Beta-Blockers. Avoid concurrent use of sensitive CYP2D6 substrates when possible, particularly those substrates with a narrow therapeutic index. Consider therapy modification Peginterferon Alfa-2b: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Monitor therapy Phosphodiesterase 5 Inhibitors: May increase the serum concentration of Beta-Blockers.
Propafenone possesses some independent beta blocking activity. Monitor therapy Prostacyclin Analogues: Monitor therapy Rifamycin Derivatives: Ruxolitinib Canadian product labeling recommends avoiding use with bradycardia-causing agents to the extent possible.
Monitor therapy Selective Serotonin Reuptake Inhibitors: Beta-Blockers may enhance the hypoglycemic effect of Sulfonylureas. Cardioselective beta-blockers eg, acebutolol, atenolol, metoprolol, and penbutolol may be safer than nonselective beta-blockers. All beta-blockers appear to mask tachycardia as an initial symptom of hypoglycemia. Ophthalmic beta-blockers are probably associated with lower risk than systemic agents. Monitor therapy Theophylline Derivatives: Monitor for reduced theophylline efficacy during concomitant use with any beta-blocker.
Beta-1 selective agents are less likely to antagonize theophylline than nonselective agents, but selectivity may be lost at higher doses. Monitor therapy Adverse Reactions Frequency not always defined. Decreased libido, unstable diabetes Gastrointestinal: Blurred vision, visual disturbance Otic: What conditions does Metoprolol Succinate treat?
Side Effects Drowsiness, dizziness , tiredness, diarrhea , and slow heartbeat may occur. Decreased sexual ability has been reported rarely. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness , get up slowly when rising from a sitting or lying position. With some brands of this medication , an empty tablet shell may appear in your stool. This drug may reduce blood flow to your hands and feet, causing them to feel cold.
Smoking may worsen this effect. Dress warmly and avoid tobacco use. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction , including: This is not a complete list of possible side effects.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. In Canada - Call your doctor for medical advice about side effects.
You may report side effects to Health Canada at List Metoprolol Succinate side effects by likelihood and severity. Precautions Before taking metoprolol , tell your doctor or pharmacist if you are allergic to it; or to other beta-blockers such as atenolol , propranolol ; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Take metoprolol exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor. The long-acting tablet may be split. Swallow the whole or half tablets whole; do not chew or crush them. Your doctor may start you on a low dose of metoprolol and gradually increase your dose. Metoprolol controls high blood pressure and angina but does not cure them. Extended-release metoprolol controls heart failure but does not cure it.
It may take a few weeks before you feel the full benefit of metoprolol. Continue to take metoprolol even if you feel well.
The most common side effects with metoprolol are lopressor blood pressure; slow heart rate; dizziness; fatigue; depression; itchy skin; rash; and diarrhea. Lopressor metoprolol lopressor be taken at the same time every day, lopressor er 25mg, after a meal. Metoprolol should be taken exactly 25mg prescribed by the doctor at the same lopressor every day. Metoprolol commonly produces mild first-degree heart block. However, if patients feel that the weight gain is affecting their quality of life, it is suggested 25mg they discuss this with their provider and see if there is a comparable alternative. Food in general can lopressor the effectiveness 25mg metoprolol especially meals high in protein. My HR still gets up sometimes to the 90's I also developed pericardial effusion, lopressor er 25mg. Extended release metoprolol Toprol XL is more expensive than immediate release metoprolol Lopressor. Metoprolol is also an 25mg medication categorized as a beta-blocker.
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