Pregnancy: Betaloc should not be given during pregnancy and lactation unless its use is considered essential. In general, beta-blockers reduce placental perfusion, which has been associated with growth retardation, intrauterine death, abortion and early labour. It is therefore suggested that appropriate maternofetal monitoring be performed in pregnant women treated with metoprolol.
Beta-receptor blockers may cause bradycardia, in the foetus and in the newborn infant. This should be considered if these drugs are prescribed in the last trimester and in association with delivery.
Betaloc should gradually be withdrawn 48-72 hours before planned childbirth. If this is not possible the newborn infant should be supervised during 48-72 hours postpartum for signs and symptoms of beta blockade (e.g. heart and lung complications).
Lactation: Metoprolol is concentrated in human breast milk in a quantity that corresponds to approximately three times the quantity found in the plasma of the mother. The risk for harmful reactions with respect to the breast-feeding child seems to be low at therapeutic doses of the medicine. The breast-feeding child should however be observed regarding signs of beta blockade.