Pronunciation:

met-oh-PROE-lol

Brand Names:

• Lopressor

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Cardiovascular Agent

Pharmacologic—

Beta-Adrenergic Blocker, Cardioselective

Uses of This Medicine:

Metoprolol injection is used to reduce the risk of death from an acute heart attack. It is given to people who have already had a heart attack.

This medicine is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of metoprolol injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metoprolol injection in the elderly. However, elderly patients may be more sensitive to the effects of metoprolol injection than younger adults and are more likely to have age-related liver or heart problems, which may require caution and an adjustment in the dose for patients receiving metoprolol injection.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Mavorixafor

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abiraterone Acetate
• Abiraterone Acetate, Micronized
• Albuterol
• Ceritinib
• Clonidine
• Cobicistat
• Crizotinib
• Darunavir
• Desvenlafaxine
• Diltiazem
• Dronedarone
• Duloxetine
• Epinephrine
• Escitalopram
• Fedratinib
• Fenoldopam
• Fexinidazole
• Fingolimod
• Formoterol
• Givosiran
• Indacaterol
• Iohexol
• Lacosamide
• Landiolol
• Lercanidipine
• Levalbuterol
• Lidocaine
• Olodaterol
• Panobinostat
• Ponesimod
• Rifampin
• Rivastigmine
• Salmeterol
• Sertraline
• Siponimod
• Terbinafine
• Terbutaline
• Venlafaxine
• Verapamil
• Vilanterol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Alfuzosin
• Alogliptin
• Amtolmetin Guacil
• Aspirin
• Bromfenac
• Bufexamac
• Bunazosin
• Bupropion
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Dapagliflozin
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Digoxin
• Dipyrone
• Doxazosin
• Droxicam
• Dulaglutide
• Empagliflozin
• Ertugliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin Aspart, Recombinant
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Human Inhaled
• Insulin Human Isophane (NPH)
• Insulin Human Regular
• Insulin Lispro, Recombinant
• Ketoprofen
• Ketorolac
• Linagliptin
• Liraglutide
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metformin
• Metildigoxin
• Miglitol
• Mirabegron
• Morniflumate
• Moxisylyte
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Paroxetine
• Phenelzine
• Phenobarbital
• Phenoxybenzamine
• Phentolamine
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Pramlintide
• Pranoprofen
• Prazosin
• Proglumetacin
• Propafenone
• Propoxyphene
• Propyphenazone
• Proquazone
• Quinidine
• Repaglinide
• Rifapentine
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sulindac
• Tamsulosin
• Telithromycin
• Tenoxicam
• Terazosin
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Trimazosin
• Urapidil
• Valdecoxib
• Vildagliptin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood circulation problems or
• Bradycardia (slow heartbeat) or
• Heart block or
• Heart failure, moderate to severe or
• Sick-sinus syndrome (heart rhythm problem)—Should not be used in patients with these conditions.

• Diabetes or
• Hyperthyroidism (overactive thyroid) or
• Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat.

• Hypotension (low blood pressure) or
• Ischemic heart disease or
• Lung disease (eg, asthma, bronchitis, emphysema) or
• Pheochromocytoma (adrenal gland tumor)—Use with caution. May make these conditions worse.

• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Your doctor will only give you a few doses of this medicine until your condition improves, and then you will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check you closely to make sure this medicine is working properly and to check for unwanted effects.

Metoprolol injection may worsen the symptoms of heart failure in some patients. Tell your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop receiving this medicine several days before having surgery.

This medicine may cause some people to become less alert than they are normally. if this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while using metoprolol injection.

Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Blurred vision

chest pain or discomfort

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

shortness of breath

slow or irregular heartbeat

sweating

unusual tiredness or weakness

Less common

Bloating or swelling of the face, arms, hands, lower legs, or feet

cough

decreased urine output

difficult or labored breathing

dilated neck veins

disturbed color perception

double vision

extreme fatigue

fast, pounding, or racing heartbeat or pulse

halos around lights

irregular breathing

loss of vision

mental confusion

night blindness

noisy breathing

overbright appearance of lights

pain, tension, and weakness upon walking that subsides during periods of rest

paleness or cold feeling in the fingertips and toes

rapid weight gain

seeing, hearing, or feeling things that are not there

short-term memory loss

swelling of the face, fingers, feet, or lower legs

tightness in the chest

tingling of the hands or feet

tingling or pain in the fingers or toes when exposed to cold

troubled breathing

tunnel vision

unusual weight gain or loss

Rare

Bluish color skin of the fingers or toes

chills

clay-colored stools

continuing loss of appetite

continuing or severe abdominal or stomach pain

continuing or severe nausea and vomiting

dark urine

difficulty with moving

fever

general tiredness and weakness

headache

hoarseness

increased frequency of urination

itching skin

light-colored stools

lower back or side pain

muscle pain or stiffness

numbness of the fingers or toes

pain, swelling, or redness in the joints

painful or difficult urination

rash

sore throat

sores, ulcers, or white spots on the lips or in the mouth

unpleasant breath odor

unusual bleeding or bruising

upper right abdominal or stomach pain

vomiting of blood

weakness

yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Bluish color of the fingernails, lips, skin, palms, or nail beds

change in consciousness

loss of consciousness

no blood pressure or pulse

stopping of heart

unconsciousness

very drowsy or sleepy

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Belching

bloated

decreased interest in sexual intercourse

difficulty having a bowel movement (stool)

discouragement

dry mouth

excess air or gas in the stomach or intestines

feeling of constant movement of self or surroundings

feeling of indigestion

feeling sad or empty

full feeling

inability to have or keep an erection

irritability

loss in sexual ability, desire, drive, or performance

loss of interest or pleasure

nightmares

pain in the chest below the breastbone

passing gas

redness or other discoloration of the skin

sensation of spinning

tiredness

trouble concentrating

trouble sleeping

Rare

Bone pain

continuing ringing or buzzing or other unexplained noise in the ears

hearing loss

increased sensitivity of the skin to sunlight

pain of penis on erection

severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.