Metoprolol

Indications.

Apart from indications for cardiac purposes, Metoprolol 200 LP is indicated in the long-term treatment of migraine.

Contraindications.

• Asthma and chronic obstructive pulmonary disease, in their severe forms.


• Heart failure not controlled by treatment.


• Cardiogenic shock.


• Unpaired second and third degree atrioventricular blocks.


• Prinzmetal's angina (in pure forms and as monotherapy).


• Sinus disease (including sinoatrial block).


• Bradycardia (<45 to 50 beats per minute).


• Raynaud's phenomenon and peripheral arterial disorders, in their severe forms.


• Untreated pheochromocytoma.


• Hypotension.


• Hypersensitivity to metoprolol.


• History of anaphylactic reaction.

This medication is generally not recommended during breast-feeding.

Side effects.

• Very common: Asthenia.


• Common:
  
  
  
  • Dizziness,
  
  
  • headache,
  
  
  • nausea, abdominal pain, diarrhea, constipation,
  
  
  • bradycardia, severe if applicable, postural hypotension, palpitations,
  
  
  • cold extremity,
  
  
  • dyspnea on exertion.
  
  
  
  


• Uncommon:
  
  
  
  • Vomiting,
  
  
  • heart failure, drop in blood pressure, precordial pain, cardiogenic shock in patients with myocardial infarction,
  
  
  • edema,
  
  
  • depression, concentration disturbance, drowsiness, insomnia, nightmare,
  
  
  • bronchospasm,
  
  
  • hypoglycemia,
  
  
  • increased weight.
  
  
  
  


• Rare:
  
  
  
  • Paresthesia,
  
  
  • dry mouth,
  
  
  • slowed atrioventricular conduction or worsening of existing atrioventricular block, arrhythmia,
  
  
  • Raynaud's syndrome,
  
  
  • worsening of existing intermittent claudication,
  
  
  • nervousness, anxiety,
  
  
  • impotence,
  
  
  • alopecia,
  
  
  • rhinitis,
  
  
  • visual defects, dryness or eye irritation, conjunctivitis,
  
  
  • antinuclear antibodies exceptionally accompanied by clinical manifestations like lupus syndrome and leading to discontinuation of treatment.
  
  
  
  


• Very rare:
  
  
  
  • Arthralgia,
  
  
  • dysgeusia,
  
  
  • retroperitoneal fibrosis,
  
  
  • hepatitis,
  
  
  • gangrene in patients with severe peripheral circulatory disorders,
  
  
  • stroke, amnesia, memory impairment, confusion, hallucination,
  
  
  • Peyronie's disease,
  
  
  • Exacerbation of psoriasis,
  
  
  • reaction photosensitivity,
  
  
  • thrombocytopenia.
  
  
  
  

Overdose.

Like all beta blockers, extreme bradycardia, hypotension, bronchospasm with respiratory failure, heart failure can occur justifying the use of dobutamine, glucagon or even an external pace maker, bronchodilator.