Refit 100 mg
Contraindications: Hypersensitivity to metoprolol. (Immediate-Release): MI: Severe sinus bradycardia MI with heart rate less than 45 beats/min or systolic B/P less than 100 mm Hg moderate to severe HF significant first-degree heart block second- or third-degree heart block. (Immediate-Release): HTN/Angina: Sinus bradycardia second- or third-degree heart block cardiogenic shock overt HF sick sinus syndrome (except with pacemaker) severe peripheral arterial disease pheochromocytoma. (Extended-Release): Severe bradycardia secondor third-degree heart block cardiogenic shock decompensated HF sick sinus syndrome (except with functioning pacemaker).Pregnancy/Lactation: Crosses placenta; distributed in breast milk. Avoid use during first trimester. May produce bradycardia apnea hypoglycemia hypothermia during delivery low-birth-weight infants. Children: Safety and efficacy not esTabletlished. Elderly: Age-related peripheral vascular disease may increase susceptibility to decreased peripheral circulation.
Treatment of hemodynamically sTabletle acute myocardial infarction (AMI) to reduce CV mortality angina pectoris hypertension. Toprol XL: Treatment of angina pectoris to reduce mortality or hospitalizations in pts with HF already receiving ACE inhibitors diuretics and/or digoxin; hypertension. OFF-LABEL: Treatment of ventricular arrhythmias migraine prophylaxis essential tremor aggressive behavior prevent reinfarction post MI prevent/treat atrial fibrillation/atrial flutter hypertrophic cardiomyopathy thyrotoxicosis.
Metoprolol is generally well tolerated with transient and mild side effects.
Frequent: Diminished sexual function drowsiness insomnia unusual
fatigue/weakness. Occasional: Anxiety diarrhea constipation nausea
vomiting nasal congestion abdominal discomfort dizziness difficulty
breathing cold hands/feet. Rare: Altered taste dry e1 nightmares
paresthesia allergic reaction (rash pruritus).
Adverse effects/toxic reactions
Overdose may produce profound bradycardia hypotension bronchospasm.
Abrupt withdrawal may result in diaphoresis palpitations headache
tremulousness exacerbation of angina MI ventricular arrhythmias. May
precipitate HF MI in pts with heart disease thyroid storm in those with
thyrotoxicosis peripheral ischemia in those with existing peripheral vascular
disease. Hypoglycemia may occur in pts with previously controlled diabetes
(may mask signs of hypoglycemia). Antidote: Glucagon
bronchospastic disease hepatic impairment peripheral vascular disease
hyperthyroidism diabetes mellitus myasthenia gravis psychiatric disease
history of severe anaphylaxis to allergens. (Extended-Release): Compensated