Metoprolol

May be taken with or without food.

2nd or 3rd degree atrioventricular block, decompensated cardiac failure, severe bradycardia, sick-sinus syndrome (without pacemaker), untreated phaeochromocytoma, severe peripheral arterial disease, and cardiogenic shock.

Patient with 1st degree atrioventricular block, sinus node dysfunction, or conduction disorders, bronchospastic disease, diabetes mellitus, psoriasis, myasthenia gravis, thyrotoxicosis, peripheral vascular disease. Avoid abrupt withdrawal. Hepatic impairment. Elderly. Pregnancy and lactation. CYP2D6 ultrarapid and poor metabolisers. Patient Counselling This drug may cause dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, heart rate, and ECG.

Significant: Bradycardia, atrioventricular block, hypotension. Cardiac disorders: Dyspnoea, pulmonary oedema, palpitations. Ear and labyrinth disorders: Tinnitus. Eye disorders: Blurred vision, visual disturbances. Gastrointestinal disorders: Nausea, vomiting, abdominal pain, constipation, flatulence, dry mouth, heartburn. General disorders and administration site conditions: Fatigue. Immune system disorders: Psoriasis. Metabolism and nutrition disorders: Peripheral oedema. Musculoskeletal and connective tissue disorders: Musculoskeletal pain. Nervous system disorders: Headache. Psychiatric disorders: Depression, confusion, nightmares, insomnia, hallucinations. Respiratory, thoracic and mediastinal disorders: Bronchospasm. Skin and subcutaneous tissue disorders: Photosensitivity, skin rash. Vascular disorders: Orthostatic hypotension (occasionally with syncope), cold extremities.

May enhance cardiodepressant effect with anaesthetic drugs (e.g. cyclopropane). May enhance hypoglycaemic effects of insulin. Increased serum concentration with CYP2D6 inhibitors (e.g. quinidine, fluoxetine, paroxetine, propafenone). May increase atrioventricular conduction and decrease heart rate with digitalis glycosides, clonidine, diltiazem, verapamil. Additive effects with catecholamine-depleting drugs (e.g. reserpine) and MAO inhibitors. Increased blood pressure lowering effect with TCA, barbiturates, phenothiazines, and other antihypertensive agents. Reduced antihypertensive effects with NSAIDs (e.g. indometacin). May enhance vasoconstrictive action of ergot alkaloids.

Antimigraine Preparations / Beta-Blockers

C07AB02 - metoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.