Generic Name and Formulations:
Metoprolol tartrate 5mg; soln for IV inj.
Novartis Pharmaceuticals Corp
In stabilized patients after MI, to reduce mortality.
See literature. Early treatment: initially administer three 5mg IV bolus inj given at approximately 2-minute intervals; monitor BP, HR, ECG. If full IV dose (15mg) tolerable, give 50mg (tab) every 6 hours starting 15 mins after the last IV dose and continue for 48 hours, thereafter, give maintenance dose of 100mg (tab) twice daily; if full IV dose not tolerable, give 25–50mg (tab) every 6 hours starting 15 mins after the last IV dose or as soon as clinical condition allows; if severe intolerance: discontinue treatment. Late treatment: if early phase treatment is contraindicated, intolerable or delayed therapy needed, start with 100mg (tab) twice daily for at least three months.
Significant 1st degree heart block. 2nd- or 3rd-degree AV block. Systolic pressure<100mmHg or heart rate <45 beats/min. Moderate-to-severe cardiac failure.
CHF. Monitor heart rate and rhythm; reduce or stop treatment if severe bradycardia develops. Bronchospastic disease. Hepatic dysfunction. Diabetes. Pheochromocytoma. Hyperthyroidism. Surgery. Avoid abrupt cessation. Pregnancy (Cat.C). Nursing mothers.
Bradycardia with catecholamine-depleting drugs. May be potentiated by potent CYP2D6 inhibitors (eg, fluoxetine, paroxetine, bupropion, thioridazine, quinidine, propafenone, ritonavir, diphenhydramine, hydroxychloroquine, terbinafine, cimetidine), hydralazine, inhalation anesthetics. Increased risk of bradycardia with concomitant digitalis. May block epinephrine. Increased rebound hypertension with clonidine withdrawal. May enhance vasoconstrictive action of ergots. Withhold before dipyridamole testing.
Fatigue, dizziness, depression, hypotension (discontinue if occurs), diarrhea, rash, dyspnea, bradycardia, cold extremities, palpitations, CHF, peripheral edema, bronchospasm, heart block.
Tabs—100; Ampuls (5mL)—10
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