Metoprolol is a drug used in the treatment of chest pain resulting from poor blood flow to the heart (angina) and also the treatment of high blood pressure. Matter of fact, it has been found to be effective in treating a number of conditions characterised by an unusually rapid heart rate. It is a selective β1 receptor blocker type medication (it is a beta blocker) and is commonly marketed under the trade names, Lopressor, Metolar XR and Toprol XL.

Metoprolol could be used to prevent headaches in those who have a history with migraine headaches. Another key function is that it prevents aggravation of cardiac-related problems after the occurrence of myocardial infarction. Its preferred route of administration is orally but it could also be administered intravenously. It has a chemical formula of C15H25NO3. By way of summary, it could be said that Metoprolol functions by inhibiting the actions of certain chemicals that have an effect on the heart and blood vessels such as epinephrine. It comes for consumption in three forms:

  • The extended-release capsule
  • The immediate release tablet and
  • The extended-release tablet.

Although it is available in form of injection, this can only be administered personally by the healthcare provider. Generally, Metoprolol is a prescription drug. Its generic form usually cost more than the brand name versions but they do not have as many variations in strengths or forms as the brand name versions.

The two major brand names are Lopressor and Toprol- XL. Although they are both forms of Metoprolol, they have one major difference. This major difference is they contain different salt forms. Lopressor is known as Metoprolol tartrate, while Toprol- XL is known as metoprolol succinate. But these variation is not a disadvantage, on the contrary, it is this variation that enables these various combinations of the drug (Metoprolol) to treat various diseases and their related conditions. Usually, 100 mg of Metoprolol is equivalent to 95 ml metoprolol succinate. But metoprolol could also be given in combinations such as combinations with chlorthalidone and those with hydrochlorothiazide.

As a beta blocker, metoprolol functions by blocking the action of norepinephrine or adrenalin on beta receptors in the blood vessels and in the heart. During periods of high blood pressure, it is due to the fact that the blood vessels are constricted. This tightens the vessels hence making the demand for blood and oxygen by the body more pertinent. In a bid to meet up with this blood and oxygen requirement, the blood vessels and heart is put under stress. Beta blockers are vital because they inhibit norepinephrine which acts upon beta receptors in the heart to cause constrictions. This blocking effect would, in turn, relax the blood vessels.

Metoprolol Medical Actions

Metoprolol is fairly aquaphobic (lipophilic) and naturally, it has no sympathomimetic activity. It has a fast half-life of 3 to 7 hours. Usually, it is used for a number of conditions such as ventricular tarchycardia, supraventricular tarchycardia, angina, acute myocardial infarction, hypertension, prevention of migraine headaches, and even treatment of congestive heart failure. It serves as an adjunct in the treatment of hyperthyroidism (excess thyroid hormone by the corresponding gland).

Moreover, it helps in the treatment of reflex syncope or vasovagal syncope which refers to a brief loss of consciousness. It is induced neurologically due to a drop in blood pressure. It is usually preceded by a ringing sensation in the ear. Another interesting condition that metoprolol treats is the relapse into arterial fibrillation. Due to its nature as a beta blocker, it is used as an off label prescription in the treatment of anxiety, social anxiety disorders among other known anxiety disorders. Before accepting a prescription containing metoprolol, it would be better to inform your physician if you have any of the following conditions: any lung condition (asthma inclusive), congestive heart failure, hyperthyroidism and conditions of unusual heartbeats.

The use of metoprolol for anxiety treatment is a given, seeing as it is a beta blocker. Of course, it will not cure the major cause of the anxious state but it could assist the body in managing some physical reactions to said anxious state. Since metoprolol is recommended off label by your physician, there is no given dosage that would be appropriate in the treatment of anxiety (as individuals are different). It would be recommended to simply stick to the dosage plan prepared by your physician.

When considering metoprolol for anxiety treatment, it would be wise to also consider the downside to this treatment. The metoprolol side effects when used for the treatment of anxiety include headache, fatigue, vomiting, constipation, etc.

Earlier a few forms of metoprolol were mentioned, we will now consider them.

Metoprolol Tartrate

This is an oral drug to be ingested during or after a meal. The dosage depends on your condition and how you are currently responding to treatment. Your physician would be in the perfect position to recommend the appropriate dosage for you. While starting the intake of metoprolol tartrate initially, the physician starts off slow at low dosages while increasing the dosage slowly as time goes by. To maximize benefits from metoprolol tartrate, it is advisable to stick strictly to your doses. The sudden termination of this drug is not proper at all. This is because some conditions might severely aggravate if the supply of the drug is suddenly cut off. It would be better to just stick to the drug as long as your physician prescribed it, even if you feel that you are completely fit.

This drug is useful in preventing another heart attack, chest pains or migraine headaches, but only as prescribed. So, it would be wrong to take the drug whenever chest pains or migraine headaches occur. We could ask the physician for a drug that could be taken for sudden bouts of migraine headaches and chest pains. For instance, sumatripan could be used for the migraines and nitroglycerin for the chest pain.

In order to be on the safer side, inform your physician if you are allergic to metoprolol or any other beta blocker before the drug is prescribed for you. This is because the tablet could contain other ingredients that you are not aware of, so full disclosure concerning your allergies would enable your physician to make better choices for you.

For diabetic individuals, this particular drug could cover up the rapid heart rate that follows the reduction of blood sugar to extreme levels. But it would also make it more difficult to control your blood sugar levels.

Before surgery, inform your physician about all the drugs you are using in that period of time. This drug may induce drowsiness, so do not operate heavy machinery after intake of the drug. Most especially, do not mix the drug with alcohols or other drugs (marijuana).

In case of an overdose locate the closest medical center to you as soon as possible.

Metoprolol Succinate

Metoprolol succinate is an oral medication. It is to be taken as the physician instructs, either before, after or during meals. It is usually taken once daily. For extended-release tablets, it would be most unwise to crush or chew them. These drugs are meant to be gradually broken down in the body, but when they are crushed all the medicinal efficacy would be released at the same time. This would then increase the chances of side effect occurrence.

Do not split open extended-release capsules unless a score line exists and you have been permitted to do so by your physician. If the capsule has been prescribed to you and you are having issues swallowing the drug, you could open the capsule and sprinkle the enclosed package (the drug) onto a spoonful of semiliquid or soft food. You could choose to use pudding, yoghurt or even applesauce. Then make sure you swallow the drug/food mixture without chewing. The mixture should not be exposed to open air for extended periods and should be used within a time frame of about 60 minutes. To minimize the chances of a severe side effect, the physician could instruct that you start from low doses and proceed to higher doses (based on your response to the current treatment regimen).

Endeavour to take the metoprolol succinate at the correct times. This would help you benefit maximally from the drug. Similar to metoprolol tartrate, this drug (metoprolol succinate) also demands that you follow through to the very last drug no matter how much better you feel you are. Some certain conditions have the tendency to suddenly deteriorate and become worse than they were original if the drug were to be suddenly stopped. If you are truly better, after necessary check-ups, the physician would slowly reduce your dose until you no longer need to take the drug without eliciting any adverse effects.

Before accepting to take metoprolol succinate, give a full detail of your medical history to your physician, especially the allergies. This would make sure there is no component of the drug that you could react to. Note that not all the accompanying components are listed and you may neglect the ones you are unaware of. But the physician is there for a reason.

Prior to starting surgery, the physician should be aware of all the drug products you use. Ranging from all the prescription drugs to over the counter drugs and even herbal drugs). This product causes dizziness when ingested. So do not handle any heavy machinery surrounding the period of drug consumption. Put a limit on the intake of alcoholic beverages and totally stop drinking if you can, at least for the duration of drug intake.

During pregnancy, this medication should be taken only when absolutely necessary. This is because the drug could seep into the breast milk.

In the event of an overdose, the patient should be rushed to the nearest hospital. This overdosing would usually be characterised by fainting, trouble breathing, very slow heartbeat and extreme dizziness.

One major difference between the metoprolol tartrate and the metoprolol succinate is that the former uses an immediate release formulation while the latter fancies the extended release system.

Of particular importance is the metoprolol 25 mg tablet. It reduces high blood pressure (BP) while also taking care of chest pains that occur as a result of blood flow to the heart. It plays a key part in the treatment of heart and blood vessels. It effects can be noticed within an hour of consumption (onset of action after oral administration is within an hour). But if administered intravenously, then the onset of action could be brought down to about 20 minutes. The average duration of effect lasts longer when administered intravenously than when taken orally (gastric juices would have acted on some part of the drug after oral consumption). The drug` effect could last anywhere from 3 hours to 6 hours for oral ingestion. While the intravenous administration leaves the drug active in the system anywhere from 5 hours to 6 hours.

Metoprolol 25 mg is also not recommended in cases of pregnancy, unless absolutely necessary. The physician should discuss all the risks and benefits with the individual. The physician would gladly provide the necessary information. The same thing applies to breastfeeding mothers.

In some cases, metoprolol 25 mg could be substituted by other drugs such as Meto 25 mg tablet, Betaloc 25 mg tablet among a few others.

Metoprolol 25 mg shares the same side effects as any other metoprolol, they include:

  • Dizziness
  • Reduced heart rate
  • Decreased blood pressure
  • Shortness of breath
  • Blurred vision

The above mentioned are the severe side effects. The more common side effects include nausea, vomiting and skin rash.