A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Lopressor Side Effects, and Drug Interactions - Metoprolol Tartrate
Lopressor Side Effects, and Drug Interactions - Metoprolol Tartrate
SIDE EFFECTS
Hypertension and Angina
Most adverse effects have been mild and transient.
Central Nervous System: Tiredness and dizziness
have occurred in about 10 of 100 patients. Depression has been reported
in about 5 of 100 patients. Mental confusion
and short-term memory loss
have been reported. Headache, nightmares, and insomnia
have also been reported.
Cardiovascular: Shortness of breath
and bradycardia
have occurred in approximately 3 of 100 patients. Cold extremities;
arterial insufficiency, usually of the Raynaud type; palpitations;
congestive heart failure; peripheral
edema; and hypotension
have been reported in about 1 of 100 patients. (See CONTRAINDICATIONS,
WARNINGS, and PRECAUTIONS.)
Respiratory: Wheezing (bronchospasm) and dyspnea
have been reported in about 1 of 100 patients (see WARNINGS).
Gastrointestinal: Diarrhea has occurred in about
5 of 100 patients. Nausea, dry mouth, gastric
pain, constipation, flatulence, and heartburn
have been reported in about 1 of 100 patients.
Hypersensitive Reactions: Pruritus or rash
have occurred in about 5 of 100 patients. Worsening of psoriasis
has also been reported.
Miscellaneous: Peyronie's disease
has been reported in fewer than 1 of 100,000 patients. Musculoskeletal
pain, blurred vision, and tinnitus
have also been reported.
There have been rare reports of reversible
alopecia, agranulocytosis, and dry eyes. Discontinuation of the
drug should be considered
if any such reaction is not otherwise explicable.
The oculomucocutaneous syndrome
associated with the beta
blocker practolol has
not been reported with metoprolol tartrate.
Myocardial Infarction
Central Nervous System: Tiredness has been reported
in about 1 of 100 patients. Vertigo, sleep
disturbances, hallucinations, headache, dizziness, visual
disturbances, confusion, and reduced libido
have also been reported, but a drug
relationship is not clear.
Cardiovascular: In
the randomized comparison of metoprolol tartrate and placebo
described in CLINICAL PHARMACOLOGY,
the adverse reactions shown in TABLE 1 were reported.
| TABLE 1 |
| |
Metoprolol tartrate |
Placebo |
| Hypotension (systolic BP <90 mmHg) |
27.4% |
23.2% |
| Bradycardia (heart rate
<40 beats/min) |
15.9% |
6.7% |
| Second- or third-degree heart
block |
4.7% |
4.7% |
| First-degree heart
block (P-R ³
0.26 sec) |
5.3% |
1.9% |
| "Heart failure |
27.5% |
29.6% |
Respiratory: Dyspnea of pulmonary origin
has been reported in fewer than 1 of 100 patients.
Gastrointestinal: Nausea and abdominal
pain have been reported
in fewer than 1 of 100 patients.
Dermatologic: Rash and worsened psoriasis
have been reported, but a drug
relationship is not clear.
Miscellaneous: Unstable diabetes
and claudication
have been reported, but a drug
relationship is not clear.
Potential Adverse REACTIONS
A variety of adverse reactions not listed above have been reported
with other beta-adrenergic blocking
agents and should be considered potential adverse reactions to metoprolol
tartrate.
Central Nervous System: Reversible mental
depression progressing
to catatonia; an acute
reversible syndrome
characterized by disorientation for time
and place, short-term memory loss, emotional lability, slightly
clouded sensorium, and decreased performance
on neuropsychometrics.
Cardiovascular: Intensification of AV block
(see CONTRAINDICATIONS).
Hematologic: Agranulocytosis, nonthrombocytopenic
purpura, thrombocytopenic purpura.
Hypersensitive Reactions: Fever combined with aching
and sore throat, laryngospasm, and respiratory distress.
DRUG INTERACTIONS
Catecholamine-depleting drugs (e.g., reserpine) may have
an additive effect when given with beta-blocking agents. Patients
treated with metoprolol tartrate plus a catecholamine
depletor should, therefore, be closely observed for evidence
of hypotension or
marked bradycardia, which may produce vertigo, syncope, or postural
hypotension.
While taking beta-blockers, patients with a history of severe anaphylactic
reaction to a variety of allergens may be more reactive to repeated
challenge, either accidental, diagnostic, or therapeutic. Such patients
may be unresponsive to the usual doses of epinephrine
used to treat allergic
reaction.
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