Drug Cards

Metoprolol

Lopressor
Class:
Beta Blocker
Mechanism of Action:
Selective inhibitor of beta1-adrenergic receptors; completely blocks beta 1 receptors, with little or no effect on Beta 2 receptors at doses <100 mg.
Indications:
  • Atrial fibrillation
  • Atrial flutter
Contraindications:
  • Hypersensitivity to metoprolol or any component of the formulation
  • Sinus bradycardia
  • Heart block greater than first degree (except in patients with a functioning artificial pacemaker)
  • Cardiogenic shock
  • Uncompensated cardiac failure
  • Pregnancy (2nd and 3rd trimesters)
Adverse reactions:
  • Respiratory: Bronchospasm.
  • Cardiovascular: Bradycardia, palpitations, edema, congestive heart failure, reduced peripheral circulation.
  • Central nervous system: Drowsiness, insomnia.
Drug Interactions
  • Drugs with slow AV conduction (digoxin): effects may be additive with beta-blockers.
  • Glucagon: Metoprolol may blunt the hypoglycemic action of glucagon.
  • Verapamil or Diltiazem may have synergistic or additive pharmacological effects when taken concurrently with beta-blockers; avoid concurrent IV use.
Adult Dosage and Administration
5 mg over 1-2 minutes slow IVP (Medical Control Option). May repeat every 5 minutes to a maximum of 15mg.
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Pediatric Dosage and Administration
Not recommended in pediatric population.
The safety and effectiveness of Metoprolol has not been established in children.
Special Considerations:
  • Pregnancy safety (manufacturer): Category C
  • Pregnancy safety (expert analysis): Category D (2nd and 3rd trimesters)