Metoprololsuccinat Teva (Metoprolol Tartrate)

Metoprolol is indicated for several cardiovascular conditions that involve excessive sympathetic stimulation.

• Hypertension: reduces systemic vascular resistance and cardiac output, helping to achieve target blood pressure levels.
• Angina pectoris: decreases myocardial oxygen demand, relieving chest pain during exertion.
• Post‑myocardial infarction: lowers the risk of recurrent ischemic events and improves survival.
• Chronic heart failure: improves left‑ventricular function and reduces hospitalisation rates.
• Cardiac arrhythmias: controls heart rate in atrial fibrillation and other supraventricular tachyarrhythmias.

• Metoprolol selectively blocks β1‑adrenergic receptors in cardiac tissue, inhibiting the action of endogenous catecholamines such as norepinephrine. This antagonism reduces heart rate, myocardial contractility, and renin release, leading to decreased cardiac output and lower arterial pressure. By attenuating sympathetic drive, the drug also diminishes myocardial oxygen consumption, contributing to its anti‑anginal and anti‑arrhythmic effects.

Metoprolol may be associated with a range of adverse reactions, varying in frequency and severity.

Common Side Effects

• Fatigue or tiredness
• Dizziness, especially on standing
• Cold extremities or reduced peripheral circulation
• Gastrointestinal discomfort such as nausea or abdominal pain
• Sleep disturbances or vivid dreams

Serious or Rare Side Effects

• Bradycardia (significantly low heart rate)
• Severe hypotension (dangerously low blood pressure)
• Heart block or worsening heart failure
• Bronchospasm in patients with asthma or COPD
• Depression or mood changes

When prescribing Metoprolol, clinicians should consider several precautionary measures to ensure safe use.

• Assess cardiovascular status: evaluate heart rate, blood pressure, and signs of heart failure before initiation.
• Review respiratory history: avoid use in patients with uncontrolled asthma or severe chronic obstructive pulmonary disease.
• Monitor renal and hepatic function: dose adjustments may be required in impairment.
• Caution in diabetes: may mask hypoglycaemia symptoms; monitor glucose levels closely.
• Discontinue gradually: abrupt cessation can precipitate rebound tachycardia or hypertension.
• Store at ambient temperature: keep below 25 °C in the original container, protected from moisture and light.

Metoprolol can interact with other medicines, altering its effectiveness or increasing risk of adverse events.

Major Interactions (Avoid)

• Non‑selective β‑blockers: concurrent use can cause excessive β‑blockade and severe bradycardia.
• Calcium channel blockers (verapamil, diltiazem): may lead to profound heart block or hypotension.
• Antidiabetic agents (insulin, sulfonylureas): increased risk of unnoticed hypoglycaemia.

Moderate Interactions (Monitor Closely)

• Antihypertensives (ACE inhibitors, diuretics): additive blood‑pressure lowering effect; monitor for hypotension.
• Antidepressants (SSRIs, tricyclics): may enhance bradycardic response.
• NSAIDs: can reduce antihypertensive efficacy; watch blood pressure.