Lopresor
Generic Name
Metoprolol
Manufacturer
Novartis
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lopresor 50 mg tablet | ৳ 1.30 | N/A |
Description
Overview of the medicine
Lopresor is a beta-adrenergic receptor blocker (beta-blocker) primarily used to treat high blood pressure, angina (chest pain), and to prevent heart attacks. It can also be used to manage certain heart rhythm disorders and heart failure.
Uses & Indications
Dosage
Adults
Hypertension: Initially 100 mg daily in single or divided doses; maintenance 100-400 mg daily. Angina: Initially 100 mg daily; maintenance 100-400 mg daily. Post-MI: 50 mg every 6 hours, then 100 mg twice daily. Heart failure: Individualized, usually starting with low doses (e.g., 12.5-25 mg daily) and gradually titrated upwards.
Elderly
Consider starting with lower doses and titrating cautiously, especially in patients with impaired liver function.
Renal_impairment
No dose adjustment is usually necessary for patients with impaired renal function.
How to Take
Oral tablets should be taken with or immediately after meals to ensure consistent absorption. Extended-release tablets should be swallowed whole; do not crush or chew. Intravenous injection is administered by healthcare professionals.
Mechanism of Action
Metoprolol selectively blocks beta-1 adrenergic receptors, primarily found in the heart. This reduces heart rate, myocardial contractility, and cardiac output, leading to decreased blood pressure and oxygen demand by the heart.
Pharmacokinetics
Onset
Oral: 15-60 minutes (anti-hypertensive effect). IV: 5-20 minutes.
Excretion
Primarily excreted by the kidneys, mostly as metabolites (about 95%). Less than 5% is excreted unchanged in urine.
Half life
Approximately 3-7 hours.
Absorption
Rapid and complete absorption from the gastrointestinal tract, but undergoes significant first-pass metabolism, resulting in approximately 50% bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6. Active metabolites are formed but are generally of minor clinical significance.
Side Effects
Contraindications
- •Known hypersensitivity to metoprolol or other beta-blockers
- •Second or third-degree heart block (without a pacemaker)
- •Sick sinus syndrome (without a pacemaker)
- •Severe bradycardia (heart rate less than 45-50 bpm)
- •Decompensated heart failure
- •Cardiogenic shock
- •Severe peripheral arterial disease
Drug Interactions
Clonidine
If clonidine is discontinued while on metoprolol, the metoprolol should be tapered first.
MAO inhibitors
May enhance hypotensive effects and increase the risk of bradycardia.
Digitalis glycosides
Increased risk of bradycardia and AV block.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
May reduce the antihypertensive effects of metoprolol.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and atrioventricular block.
Storage
Store below 30°C (86°F) in a dry place. Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, cardiac insufficiency, bronchospasm, and possibly cardiac arrest. Management is symptomatic and supportive, including atropine for bradycardia, glucagon for severe heart failure, and vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit outweighs the potential risk to the fetus. Metoprolol is excreted in breast milk; observe infants for signs of beta-blockade.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Expired
WHO Essential Medicine
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Global Brand Names
International brand names for this medicine
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