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


  • 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.


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.


Post operative chronic pain