Metoprolol is indicated for the following conditions-

• Hypertension.
• Angina pectoris.
• Cardiac arrhythmias, especially supraventricular tachyarrhythmias.
• Adjunct to treatment of thyrotoxicosis.

Hypertension (Hight Blood Pressure)

Angina

Arrythmia

Thyrotoxicosis

Hypertension: A daily dose of 100 mg should be administered, either in single or divided doses. Depending on the reaction, the dosage may be increased by 100 mg per day, either in single or divided doses, at weekly intervals until it reaches 200 mg per day.

Angina pectoris: 50-100 mg twice or three times daily.

Cardiac arrhythmias: 50 mg taken twice or three times day is typically enough. If necessary, the dose can be increased to 300 mg per day in divided doses if necessary.

Hyperthyroidism: 50 mg four times a day. As euthyroid status is gradually reached, the dosage should be gradually lowered.

Myocardial infarction: 50 mg every 6 hours for 48 hours, ideally within 12 hours after commencement of chest pain.

Commonly associated side effects include-

• dizziness
• headache
• bradycardia
• orthostatic hypotension (occasionally with syncope)
• dyspnea
• nausea
• abdominal pain
• Asthenia

Dizziness	Headache	Bradycardia
Hypotension	Nausea	Asthenia

• Metoprolol should be used with caution in patients with impaired hepatic function.
• In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent.
• Worsening cardiac failure may occur during up-titration of metoprolol

• Patients should be encouraged to-

  • avoid driving or operating machinery or performing other duties that require alertness until their response to metoprolol has been assessed; and
  • to contact their physician if they experience any trouble breathing.
  • must tell his or her doctor or dentist that he or she is taking metoprolol before undergoing any type of surgery.