Metoprolol Tartrate

Metoprolol tartrate injection is indicated in the treatment of definite or suspected acute myocardial infarction in hemodynamically stable patients to reduce cardiovascular mortality when used in conjunction with oral metoprolol maintenance therapy. Metoprolol is a beta-adrenergic receptor inhibitor indicated for the treatment of definite or suspected acute myocardial infarction in hemodynamically stable patients to reduce cardiovascular mortality when used in conjunction with oral metoprolol maintenance therapy ( 1 ).

Hypersensitivity to metoprolol and related derivatives, or to any of the excipients; hypersensitivity to other beta blockers (cross sensitivity between beta blockers can occur). Metoprolol is contraindicated in patients with a heart rate <45 beats/min; second-and third-degree heart block (unless a functioning pacemaker is present); significant first-degree heart block (P-R interval ≥0.24 sec); systolic blood pressure <100 mmHg; or decompensated cardiac failure.

• Known hypersensitivity to product components. ( 4 )
• Severe bradycardia, greater than first degree heart block, or sick sinus syndrome without a pacemaker. ( 4 )
• Cardiogenic shock or decompensated heart failure. ( 4 )

• Worsening cardiac failure may occur. ( 5.1 )
• Bronchospastic Disease: Avoid beta blockers. ( 5.2 )
• Pheochromocytoma: First initiate therapy with an alpha blocker. ( 5.3 )
• May aggravate symptoms of arterial insufficiency. ( 5.4 )

5.1Bradycardia

Bradycardia, including sinus pause, heart block, and cardiac arrest have occurred with the use of metoprolol. Patients with first-degree atrioventricular block, sinus node dysfunction, or conduction disorders may be at increased risk. Monitor heart rate and rhythm in patients receiving metoprolol. If severe bradycardia develops, reduce or stop metoprolol.

5.2Heart Failure

Worsening cardiac failure may occur during metoprolol use. If such symptoms occur, increase diuretics and restore clinical stability before administering the next dose of metoprolol [see Dosage and Administration (2) ]. Such episodes do not preclude subsequent successful titration of oral metoprolol.