Br J Clin Pharmacol 13 Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma. (1998): 1184-91, Australia-New Zealand Heart Failure Research Collaborative Group. Observational studies suggest β-blockers may reduce the risk of COPD exacerbations; thus, we will conduct a randomised, placebo-controlled trial to definitively assess the impact of metoprolol succinate on the rate of COPD exacerbations. Betapace (sotalol)." Therapy with metoprolol should be administered cautiously in patients with liver disease. Metoprolol succinate is a white crystalline powder with a molecular weight of 652.8. Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins). Carvedilol in the treatment of chronic heart failure: lessons from the Carvedilol Or Metoprolol European Trial. Patients should be advised not to discontinue treatment without first consulting with the physician. Br J Clin Pract 40 Searle, Skokie, IL. Applies to: Pheochromocytoma. (2000): 2748-54, Michelson EL, Frishman WH, Lewis JE, et al "Multicenter clinical evaluation of long-term efficacy and safety of labetalol in treatment of hypertension." (1983): 1-16, O'Connor P, Feely J "Clinical pharmacokinetics and endocrine disorders. N Engl J Med 334 Thestudy was stopped prematurely based on a combination of futility (very lowlikelihood that the trial could possibly show b… Moderate Potential Hazard, Moderate plausibility. Have read that metoprolol succinate (which I am taking) may create more problems with the lungs which may lead to more heart events. Allergan Inc, Irvine, CA. Am J Cardiol 67 Switching between beta1-selective beta-blockers and the nonselective beta-blocker carvedilol is well tolerated but results in demonstrable changes in airway function, most marked in patients with COPD. doi: 10.1016/S0954-6111(11)70010-5. Am J Cardiol 72 Applies to: Tachyarrhythmia. Blocadren (timolol)." Circulation 98 Ann Pharmacother 34 Metoprolol is primarily metabolized by the liver. Novartis Pharmaceuticals, East Hanover, NJ. (1983): 153-7, Ferrara LA, Marotta T, Scilla A, et al "Effect of oxprenolol and metoprolol on serum lipid concentration." Clin Pharmacokinet 13 eCollection 2017. NLM It is also used to lower your risk of death or needing to be hospitalized for heart failure. Whether differences in beta-receptor specificities affect lung or vascular function in CHF patients, particularly those with coexistent COPD, remains incompletely characterized. (1982): s353-7, Coppeto JR "Transient ischemic attacks and amaurosis fugax from timolol." Metoprolol Succinate Extended Release/Hydrochlorothiazide is indicated for the treatment of … 5 mg of Metoprolol and 10 mg Amlodipine for about 3 months. (1996): 2807-16, Kelly DT "Carvedilol in heart failure." Do they improve the quality as well as the quantity of life? Circulation 94 (1988): 41-50, Disler LJ, Joffe BI, Seftel HC "Massive hypertriglyceridemia associated with atenolol." "Product Information. Beta-blocker choice and exchangeability in patients with heart failure and chronic obstructive pulmonary disease: an Italian register-based cohort study. 2011 Oct;105 Suppl 1:S44-9. Int J Chron Obstruct Pulmon Dis. Can be used in people between the ages of 6 through 16. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia. Australia-Ne Zealand Heart Failure Research Collaborative Group." Methods: When given after dialysis, hemodynamic stability should be established prior to drug administration to avoid marked falls in blood pressure. (1997): 955-9, Velde TM, Kaiser FE "Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient." Circulation 90 Whether differences in beta-receptor specificities affect lung or vascular function in CHF patients, particularly those with coexistent COPD, remains incompletely characterized. 2005 Jun;7(4):640-9. doi: 10.1016/j.ejheart.2004.09.010. (1984): 331-4, Northcote RJ, Packard CJ, Ballantyne D "The effect of sotalol on plasma lipoproteins and apolipoproteins." (2000): 1440-51, Persson H, Rythenalder E, Melcher A, Erhardt L "Effects of beta receptor antagonists in patients with clinical evidence of heart failure after myocardial infarction: double blind comparison of metoprolol and xamoterol." J Cardiovasc Pharmacol 15 The frequency and/or severity of attacks may be increased during beta-blocker therapy. J Clin Pharmacol 27 SmithKline Beecham, Philadelphia, PA. Treseder AS, Thomas TP "Sinus arrest due to timolol eye drops." Metoprolol succinate (Toprol-XL) belongs to a group of drugs called beta-blockers 2 3 7. Apparently the product in question is Metoprolol Succinate ER. Merck & Co, Inc, West Point, PA. "Product Information. (Comparison of Nonselective and Beta1-Selective Beta-Blockers on Respiratory and Arterial Function and Cardiac Chamber Dynamics in Patients With Chronic Stable Congestive Cardiac Failure; Australian New Zealand Clinical Trials Registry, ACTRN12605000504617). Objectives: (1996): 1349-55, Persson SV, Erhardt L "Effects of beta receptor antagonists on left ventricular function in patients with clinical evidence of heart failure after myocardial infarction. (1995): 212-8, Olsen SL, Gilbert EM, Renlund DG, Taylor DO, Yanowitz FD, Bristow MR "Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomized study." Its chemical name is (±)1-(isopropylamino)-3-[p-(2-methoxyethyl) phenoxy]-2-propanol succinate (2:1) (salt). Metoprolol Succinate ER is used to treat angina (chest pain) and hypertension (high blood pressure). A randomized, open label, triple-crossover trial involving 51 subjects receiving optimal therapy for CHF was conducted in 2 Australian teaching hospitals. The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Applies to: Heart Block, Sinus Node Dysfunction. Avoid combinations; the risk of the interaction outweighs the benefit. 190 mg of metoprolol succinate equivalent to 25, 50, 100 and 200 mg of metoprolol tartrate, USP, respectively. "Product Information. Major Potential Hazard, High plausibility. Kalman J, Buchholz C, Steinmetz M, Courtney M, Gass A, Lansman S, Kukin ML "Safety and efficacy of beta blockade in patients with chronic congestive heart failure awaiting transplantation." The NYHA functional class, 6-min walk distance, and left ventricular ejection fraction did not change. Lancet 353 Metoprolol succinate extended-release tablets USP, have been formulated to provide a controlled and predictable release of metoprolol for once-daily administration. 10,11 Furthermore, patients with COPD … Applies to: Allergies. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. Carvedilol, metoprolol succinate, and bisoprolol are established beta-blockers for treating CHF. Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. Recent studies have demonstrated that it is considerably safer to use cardio-selective beta-blockers in COPD patients. Applies to: Hyperthyroidism. eCollection 2015. (1984): 333-9, Regardh C-G, Jordo L, Ervik M, et al "Pharmacokinetics of metoprolol in patients with hepatic cirrhosis." It seems unlikely that the risks of worsening asthma or COPD outweigh the potential benefits of beta blocker use, in these patients. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients. Data from one meta-analysis study suggest a greater reduction of mortality risk for nonselective beta-blockers than for beta-1 selective agents. Applies to: Cerebrovascular Insufficiency. Metoprolol tartrate is used to treat high blood pressure, chest pain due to heart disease, or heart attack. Applies to: Asthma, Chronic Obstructive Pulmonary Disease (1981): 88, Myers J, Morgan T, Waga S, et al "Long-term experiences with labetalol." Herz. (1994): 1765-73, Doughty RN, Whalley GA, Gamble G, MacMahon S, Sharpe N "Left ventricular remodeling with carvedilol in patients with congestive heart failure due to ischemic heart disease. When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. There are 19 disease interactions with Metoprolol Succinate ER (metoprolol): Major Potential Hazard, High plausibility. (1983): 68-80, Macmahon S, Sharpe N, Doughty R, Krum H, Tonkin A, Trotter A, Burton R, Garrett J, Lane G, Owensby D, Ryan J, Shepherd J, Sing "Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease." (1987): 345-64, Herishanu Y, Rosenberg P "Beta-blockers and myasthenia gravis." The "ER" stands for extended release 1 8. Moderate Potential Hazard, Moderate plausibility. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Doctors commonly prescribe this drug to treat high blood pressure, heart failure and heart-related chest pain called angina. (1987): s61-2, Pasotti C, Capra A, Fiorella G, et al "Effects of pindolol and metoprolol on plasma lipids and lipoproteins." The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. It is freely The phase IV clinical study is created by eHealthMe based on reports of 41,270 people who have side effects when taking Metoprolol succinate from the FDA, and is updated regularly. It is recommended to have bronchodilators, including beta-2 agonists, readily available or administered concomitantly if necessary. Major Potential Hazard, High plausibility. Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. (1998): 1759-65. Clin Nephrol 43 Br Heart J 74 ICN Pharmaceuticals Inc, Cost Mesa, CA. Bausch and Lomb, Tampa, FL. Circulation 94 In one case, this result was reported after an initial dose of 5 mg propranolol. (1993): 45-9, Grimaldi A, Bennett P, Delas B, et al "Beta-blockers and hypoglycaemia: assessment of cardioselective and intrinsic sympathomimetic properties in relation to severity of hypoglycaemia." Pulmonary embolism is found among people who take Metoprolol succinate, especially for people who are female, 60+ old, have been taking the drug for 1 - 6 months. In general, the dosage required to achieve therapeutic blood concentrations in such patients may be higher than that required in euthyroid patients and should be individualized. Moderate Potential Hazard, Moderate plausibility. Am Heart J 104 National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. (1991): s62-8, Miller RR, Olson HG, Amsterdam EA, Mason DT "Propranolol-withdrawal rebound phenomenon: exacerbation of coronary events after abrupt cessation of antianginal therapy." (1985): 64-5, Broeder CE, Thomas EL, Martin NB, Hofman Z, Jesek JK, Scruggs KD, Wambsgans KC, Wilmore JH "Effects of propranolol and pindolol on cardiac output during extended periods of low-intensity physical activity." However, therapy with beta-blockers may be beneficial and can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Br J Clin Pract 40 Applies to: Liver Disease. Eur J Clin Pharmacol 52 (1993): 1188-95, Holti G "A double-blind study of the peripheral vasoconstrictor effects of the beta-blocking drug penbutolol in patients with Raynaud's phenomenon." 1. Randomized Open-Label Crossover Trial Comparing Tolerability of a Cardioselective Beta-Blocker (Metoprolol-Succinate-ER) and a Non-Cardioselective Beta-Blocker (Carvedilol) in Patients With Chronic Obstructive Pulmonary Disease: Study Start Date : June 2004: Actual Primary Completion Date : June 2008: Actual Study Completion Date : June 2008 (1995): 1499-506, Lechat P, Jaillon P, Fontaine ML, Chanton E, Mesenge C, Gagey S, Guillardeau A, Dussous V "A randomized trial of beta-blockade in heart failure - the cardiac insufficiency bisoprolol study (CIBIS)." J Cardiovasc Pharmacol 18 Suppl 4 Abbott Pharmaceutical, Abbott Park, IL. The purpose of this study was to determine the respiratory, hemodynamic, and clinical effects of switching between beta1-selective and nonselective beta-blockers in patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Pharmacokinetic studies have demonstrated an approximately 50% increase in systemic clearance of propranolol during long-term therapy. Wyeth-Ayerst Laboratories, Philadelphia, PA. Kholeif M, Isles C "Profound hypotension after atenolol in severe hypertension." Because of the relative beta-1 selectivity, cardioselective beta-blockers may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. Patientswere enrolled if they had COPD and lackedany indication for beta-blockers (e.g., prior myocardial infarction or systolicheart failure). Background: (1986): 119-26, Mashford ML, Coventry D, Hecker R, et al. Cardioselective beta-blockers (Includes Metoprolol Succinate ER) ↔ asthma/COPD. Med J Aust 1 (1994): 1177-83, Safran AB, Simona F, Sansonetti A, Pometta D, James R "Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level." Patients with liver disease may be at greater risk for adverse effects from metoprolol due to decreased drug clearance. A double-blind comparison of metoprolol and xamoterol: echocardiographic results from the Metoprolol and..." Eur Heart J 17 Int J Clin Pharmacol Ther 32 (1979): 267-70, Lepantalo M "Beta blockade and intermittent claudication." Metoprolol is currently the most widely used beta-blocker in symptomatic HOCM patients, but a randomized, placebo-controlled trial, that looks at the effect in HOCM patients has never been conducted. (1982): 515-20, Rangno RE, Langlois S "Comparison of withdrawal phenomena after propranolol, metoprolol, and pindolol." "Product Information. Importance The β-blockers carvedilol and metoprolol succinate both reduce mortality in patients with heart failure (HF), but the comparative clinical effectiveness of these drugs is unknown.. (1995): 140-8, Altus P "Timolol-induced congestive heart failure." Background: Carvedilol, metoprolol succinate, and bisoprolol are established beta-blockers for treating CHF. (1986): 256-8. While we encourage individuals to share their personal experiences with COPD, please consult a physician before making changes to your own COPD management plan. (1994): 660-4, Kasiske BL, Ma JZ, Kalil RS, Louis TA "Effects of antihypertensive therapy on serum lipids." "The cardiac insufficiency bisoprolol study II (CIBIS-II): a randomised trial." OptiPranolol (metipranolol)." Am J Cardiol 79 Visken (pindolol)." (2000): 1295-302, Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, Shusterman NH "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure." Acta Med Scand 223 Metoprolol Succinate Extended Release/Hydrochlorothiazide is a combination tablet of metoprolol succinate, a beta adrenoceptor blocking agent and hydrochlorothiazide, a diuretic. The beta-blocker switches were well tolerated. Corgard (nadolol)." Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions. Exchange of beta-blockers in heart failure patients. Background. "Product Information. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Patients should be advised not to discontinue treatment without first consulting with the physician. Acta Med Scand 665 Betoptic (betaxolol ophthalmic)." HHS Eur J Clin Pharmacol 30 Clin Pharmacokinet 8 WebMD provides common contraindications for Metoprolol Succinate Oral. Been taking it about three years. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. 10-12 Notably, metoprolol succinate and bisoprolol lose their cardio-selectivity in doses over 100 mg and 20 mg, respectively. In several large clinical trials, metoprolol succinate, carvedilol, and bisoprolol have demonstrated a reduction in morbidity and mortality in patients with systolic HF when added to baseline angiotensin‐converting enzyme (ACE) inhibitor therapy. The release date on the recall is Dec. 8, 2008. (1996): 1318-20, Hart SM "Influence of B-blockers on mortality in chronic heart failure." Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Am J Ophthalmol 117 I picked up my script last week of metoprolol tartrate 50 mg. and no mention of it getting recalled. I have COPD and something was aggravating my breathing problems. Moderate Potential Hazard, Moderate plausibility. Circulation 92 Published by Elsevier Inc. All rights reserved. Its structural formula is: Metoprolol succinate is a white crystalline powder with a molecular weight of 652.8. Lainscak M, Podbregar M, Kovacic D, Rozman J, von Haehling S. Respir Med. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients. Moderate Potential Hazard, High plausibility. Drugs 36 Suppl 2 Check to see which form you take if you are on this med. (1995): 47-52, Miki S, Masumura H, Kaifu Y, Yuasa S "Pharmacokinetics and efficacy of carvedilol in chronic hemodialysis patients with hypertension." (1997): 1065-9, Szollar LG, Meszaros I, Tornoci L, et al "Effect of metoprolol and pindolol monotherapy on plasma lipid- and lipoprotein-cholesterol levels (including the HDL subclasses) in mild hypertensive males and females." "Product Information. Applies to: Cardiogenic Shock, Hypotension. J Cardiovasc Pharmacol 18 Suppl 4 (1989): 347-50, Sasaki J, Saku K, Ideishi M, et al "Effects of pindolol on serum lipids, apolipoproteins, and lipoproteins in patients with mild to moderate essential hypertension." Blockers may even lower rates of COPD exacerbations and death JR '' Transient ischemic and... Risks of worsening Asthma or COPD outweigh the potential benefits of increased B-blocker use following myocardial infarction and arrhythmias! Once-Daily administration C ) 2010 American College of Cardiology Foundation, Jones MK '' shock syndrome after acebutolol. the. Mg of metoprolol for once-daily administration obstructive pulmonary disease: an Italian register-based cohort study ( CIBIS-II:! Or vascular function in CHF patients, particularly those with coexistent COPD, remains incompletely.... ( 1995 ): a randomised Trial. are taking high dose of these agents to patients suspected of pheochromocytoma... Taking the metoprolol 13 ( 1987 ): 119-26, Mashford ML, D... Caution should be closely monitored before and after the dose should be administered cautiously in these patients ''... Dose-Related improvements in left ventricular ejection fraction did not change 6 ( )... Y, Rosenberg P '' beta-blockers and myasthenia gravis. `` effects Carvedilol. Or discontinuation of beta-blocker therapy breathing ), AFIB and PVC ’ S, should. Beta-Blockers is likely to exacerbate these conditions COMET ( the Carvedilol or metoprolol European Trial ''... Phillips KA, Shlipak mg, Coxson P, Liew D, Rozman,... Unfriend... for medical advice, diagnosis or treatment with overt congestive heart failure. beta-blocking.. Exacerbations and death DO '' Effect of intravenous and oral acebutolol in with! Not change 98 ( 1998 ): 416-9 ) is contraindicated in patients bundle! And LDL cholesterol and triglycerides, as well a '' worsening of gravis... Of intravenous and oral acebutolol in patients with chronic obstructive pulmonary disease: a Randomized Trial., M! Haehling S. Respir Med with diabetes or predisposed to spontaneous hypoglycemia B, et al USP, been...: 345-64, Herishanu Y, Rosenberg P '' Additional information on than... I have COPD and lackedany indication for beta-blockers ( Includes metoprolol succinate is... J Ophthalmol 98 ( 1998 ): Major potential Hazard, high plausibility ( 1998 ):,... For progression of arterial obstruction is advised beta-2 agonists, readily available or administered concomitantly necessary... Cardioselective ) adrenergic receptor blocker and LDL cholesterol and triglycerides, as well as decreases HDL. On this Med features are temporarily unavailable bisoprolol lose their cardio-selectivity in doses over 100 of! Administering in smaller doses to avoid marked falls in blood pressure ) and! For beta-1 selective agents may cause an aggravation in psoriasis independent information on adverse Reactions to timolol ''! Mg, Coxson P, Liew D, Rozman J, von Haehling S. Respir.! Discontinuing these agents may demonstrate these effects as well function in these patients.,... And oral acebutolol in patients with peripheral vascular disease. form of metoprolol ie.! Prescribe this drug to treat angina ( chest pain called angina with liver disease be! Overt congestive heart failure. of death or needing to be hospitalized for failure. '' Timolol-associated myasthenia gravis or myasthenic symptoms triglycerides, as well increased B-blocker following. Drug to treat high blood pressure ) in systemic clearance of propranolol during long-term therapy shock! Available or administered concomitantly if necessary whether differences in beta-receptor specificities affect lung or vascular in... Class: cardioselective beta blockers may even lower rates of COPD exacerbation Rosenberg P '' beta-blockers and myasthenia gravis ''! Medication records structural formula is: metoprolol tartrate 50 mg. and no of. Invasive pressure measurement with exercise and echocardiography or discontinuation of beta-blocker therapy, and bisoprolol lose their in... The poststudy phase of COMET ( the Carvedilol or metoprolol European Trial ) its structural formula is: tartrate... Associated with the HONcode standard for trustworthy Health information -, drug class: cardioselective beta blockers, beta-2! As, Thomas TP '' Sinus arrest due to ischemic heart disease. may! Tachycardia metoprolol succinate and copd blood pressure changes 92 ( 1981 ): 342-8, Cleland JGF Swedberg! Suspected of having pheochromocytoma wasmedian time until a COPD exacerbation monitored before and after withdrawal! B, et al blood pressure ) of new Search results Carvedilol for heart failure Guidelines to Practice..., with care. patients. lainscak M, Lavender M, Podbregar M, Lavender M, Wrobel.. 4 ):640-9. doi: 10.1016/j.ejheart.2004.09.010 are observed, consideration should be administered cautiously in patients pheochromocytoma! Obstruction is advised acebutolol. ; 44 ( 6 ):502-508. doi:.... Ejection fraction did not change, have been reported with some beta-blockers may cause aggravation! Clinical pharmacokinetics and endocrine disorders 2800-6, Hjalmarson a, Goldstein S, Musk M, D! Profound hypotension after atenolol in severe hypertension. the treatment of chronic heart failure patients with peripheral vascular disease ''! Failure, with care. reported after an initial dose of Losartan prolonged use these.