Metoprolol: Price, Dosage & Where to Buy

Metoprolol is a beta-adrenergic blocker prescribed to treat hypertension, angina pectoris, and myocardial infarction. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and heart attacks. It requires a prescription in the United Kingdom and has been available as a generic medicine since April 1995.

Metoprolol is indicated for the treatment of hypertension in adult patients, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. It is also used in the long-term treatment of angina pectoris, to reduce angina attacks and to improve exercise tolerance.

In patients with myocardial infarction, metoprolol is indicated for the treatment of haemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality when used alone or in conjunction with intravenous metoprolol. Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake.

The label lists 25 mg, 50 mg, 100 mg, and 200 mg extended-release capsules and tablets, as well as 12.5 mg, 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg immediate-release tablets. The label also lists a 10 mg/mL oral solution and intravenous formulations of 5 mg/5 mL and 1 mg/mL. For hypertension, the usual initial dosage is 100 mg daily in single or divided doses, with adjustment at weekly or longer intervals.

The effective dosage range is 100 mg to 450 mg per day. For angina pectoris, the usual initial dosage is 100 mg daily, given in two divided doses, with gradual increases at weekly intervals.

The effective dosage range is 100 mg to 400 mg per day. For myocardial infarction, the usual starting dose is 50 mg every 6 hours in patients who tolerate intravenous therapy, titrating to a maintenance dosage of 100 mg twice daily.

Metoprolol belongs to a class of medicines called beta-adrenergic blockers, often referred to as beta-blockers. These medicines work by blocking the effects of certain natural chemicals in the body, such as adrenaline, on the heart and blood vessels. This action slows the heart rate, reduces the force of heart contractions, and lowers blood pressure, which decreases the workload on the heart.

By reducing the heart's demand for oxygen, metoprolol helps to relieve angina and protect the heart muscle after a heart attack. The medicine is relatively selective for beta-1 receptors, which are found mainly in the heart, though this selectivity is not absolute.

Available data from published observational studies have not demonstrated an association of adverse developmental outcomes with maternal use of metoprolol during pregnancy. Untreated hypertension and myocardial infarction during pregnancy can lead to adverse outcomes for the mother and the foetus. Metoprolol crosses the placenta, and neonates born to mothers who are receiving metoprolol during pregnancy may be at risk for hypotension, hypoglycaemia, bradycardia, and respiratory depression.

Neonates should be observed and managed accordingly. In animal reproduction studies, metoprolol increased post-implantation loss and decreased neonatal survival in rats at oral dosages of 500 mg/kg/day, approximately 11 times the daily dose of 450 mg in a 60-kg patient. Pregnant women with hypertension should be carefully monitored and managed accordingly.

If a dose is missed, the general approach for beta-blockers is to resume the regular schedule as soon as remembered, unless it is close to the time for the next scheduled dose. In that case, skip the missed dose and continue with the regular dosing schedule.

It is important not to double the dose to make up for a missed one, as this may lead to an excessive drop in heart rate or blood pressure. Patients should speak to their doctor or pharmacist if they have questions about a missed dose.

The label lists storage at 20° to 25°C (68° to 77°F), which corresponds to controlled room temperature. The product should be protected from moisture and dispensed in a tight, light-resistant container using a child-resistant closure to maintain quality.