Metoprolol

Dosage forms available

• Metoprolol is available in tablet form, including immediate-release and extended-release. It may also be given intravenously (IV) in hospital settings.

Age and dose restrictions

• Metoprolol is generally prescribed to adults and children above 6 years.

Contraindications

• This medicine is contraindicated in individuals with severe bradycardia, heart block greater than first degree, cardiogenic shock, overt heart failure, and a known allergy to Metoprolol or other beta-blockers. Patients with asthma or severe chronic obstructive pulmonary disease (COPD) should avoid Metoprolol unless deemed necessary by a healthcare professional.

Other medications to avoid

• Concurrent use of calcium channel blockers (verapamil, diltiazem), antidepressants (fluoxetine), antiarrhythmic medicines (amiodarone), antihypertensives (clonidine), and MAO inhibitors can enhance the blood pressure-lowering and heart rate-slowing effects of Metoprolol, increasing the risk of adverse outcomes. 

Overdose and missed dose

• Overdose symptoms include extreme dizziness, slow heartbeat, fainting, and difficulty breathing. In such cases, seek emergency medical attention.
• If a dose is missed, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose—do not double dose to catch up.

Management of side effects

• Fatigue and dizziness are common, especially at the start of treatment. Resting and avoiding sudden posture changes can help manage dizziness. If cold extremities or bradycardia occur, inform your doctor. Severe side effects like shortness of breath, swelling of hands or feet, or persistent fatigue require medical attention and possible adjustment of the dosage.

Use in driving and operating machinery

• Metoprolol can cause drowsiness and dizziness. Avoid driving, operating machinery, or performing tasks that require alertness until you know how this medicine affects you.

Use in pregnancy and lactation

• This medicine should be used during pregnancy only if needed, as it may affect fetal growth. It can pass into breast milk, so lactating mothers should consult their healthcare provider before using this medicine.

Caution in other conditions

• Caution is advised in patients with diabetes (as it may mask hypoglycemia symptoms), thyroid disorders, kidney or liver impairment, circulatory disorders, and respiratory conditions like asthma. Monitoring is essential in elderly patients due to increased sensitivity to blood pressure changes.

Special dietary and lifestyle recommendations

• Maintain a low-sodium, heart-healthy diet with plenty of fruits, vegetables, and whole grains. Avoid high-fat, high-cholesterol foods. 
• Limit caffeine and alcohol intake, and do not smoke. 
• Regular exercise, such as walking or yoga, can help manage blood pressure and heart health, but consult your doctor before starting any new physical activity.