Metoprolol

Uses	High Blood Pressure, Angina (Chest Pain), Prevent Heart Attack and Migraine
Therapy	Anti-Anginal, Anti-Hypertensive
Side Effects	Nausea, Vomiting, Dizziness, Headache, Low Blood Pressure

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Molecule Description

Metoprolol belongs to the class of medicine are called beta-blockers.

Uses

It is used to treat chest pain (angina), heart failure and high blood pressure. Lowering high blood pressure helps kidney problems, prevent strokes, heart attacks. It is also used to avoid migraine.

Contraindications

When should one not use Metoprolol

It is not recommended in patients with severe liver disease, asthma, allergic reactions
You have heart problems like heart blocks
Untreated heart failure
Slow heart rate or low blood pressure

Side effects

Common side effects of this drug are:

Side effects of Metoprolol with higher doses include dizziness, drowsiness, fatigue and diarrhea, stomach pain, constipation, headache, shortness of breath
Can cause certain neuropsychological disturbances like unusual dreams, ataxia (loss of full control over body movements), sleeplessness, depression and vision problem
Serious side effects include worsening of heart failure itself and excessive slowing of heart rate. Hence, the dosage has to be adjusted by the physician
It can worsen diabetes
Sexual dysfunction has been reported in a few cases

Precautions and Warnings

Pregnancy

During pregnancy, this medication should not be used unless prescribed by the physician. Discuss the risks and benefits with your doctor.

Breast Feeding

It is excreted into the mother’s milk. Hence, it is not safe during breastfeeding. Again, your doctor will prescribe it only if its benefit outweighs risk during breastfeeding.The infant needs close monitoring in such cases.

Driving

Be cautious while driving as it can cause dizziness and sleepiness.

Alcohol

Do not drink alcohol while taking this medication as it may cause increased sleepiness or a drop in blood pressure.

Other General Warnings

Talk to your doctor if

You get allergic reactions
If you have diabetes, caution is required
Metoprolol may cause low blood sugar levels and also change the body’s response to low blood sugar. You may not experience warning signs of low blood sugar such as an increase in heart rate, sweating, hunger pangs, headache, etc.
You have any heart problems or suffer from muscle weakness (myasthenia gravis), talk to the doctor before starting any dose of Propranolol
You have kidney or liver problems (including cirrhosis of the liver)
You have asthma or COPD
You suffer from a heart conduction disorder (AV block)
You have a type of chest pain (Prinzmetal’s angina)

Mode of Action

How Does It Work?

They work by slowing the heart rate and relaxing blood vessels. Due to this, the heart doesn’t have to work hard to pump blood.

Interactions

Interactions with other medicines

Used to treat fits like Phenobarbital
Used to treat heart problems like Amlodipine
Medicines used to treat pain, fever-like Diclofenac
Antidepressants like Fluoxetine
Antipsychotic medicine
Antiretroviral like Ritonavir
Antihistamine like Diphenhydramine
Medicine used in malaria such as Hydroxychloroquine
Medicine used to treat any fungal infection

Interactions with food items

It has interactions with apple, grapefruit and orange juice; the usage of these fruits should be avoided.

Dosage

Overdose

You must strictly avoid overdose as it may lead to fatal consequences. The immediate symptoms of overdose are lethargy, breathing disorders, wheezing (whistle-like sound from the chest), missing heartbeat, excessive slowing of pulses, swelling of the hands, feet, ankles or lower legs, shakiness, dizziness, sweating or confusion, blurred vision, headache, pale color, numbness or tingling of the mouth etc. Immediately seek emergency medical attention.

Missed a Dose

You missed any dose take it as soon as you remember. If it is time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose of medicine to compensate for a missed one.

Frequently Asked Questions (FAQs)

Do not suddenly discontinue taking a beta-blocker without talking to your doctor. If you stop a beta-blocker suddenly, you can suffer from chest pain, irregular heartbeat or heart attack. Your doctor might instruct you to decrease your dose gradually.

You experience any symptoms of dizziness, syncope, vision problems, sexual dysfunction, slowing of heart rate, etc. then immediately report to your doctor. The doctor can adjust your dose depending on your blood pressure, heart rate, level of the medicine in your serum and other such relevant factors.

You should give an account of your past or present diseases like liver, kidney or heart-related disorders, diabetes mellitus and thyroid disorders if any. You must inform your doctor about your ongoing prescription and non-prescription medicines, nutritional supplements, vitamins, herbal medicines, etc. Women should share information about pregnancy status, use of oral birth control pills and other vital information like history of pregnancy-induced high blood pressure, if any.

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