Lopressor/use in specific populations: Difference between revisions

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__NOTOC__
__NOTOC__
{{Metoprolol}}
{{Metoprolol}}
{{CMG}}; {{AE}} {{AZ}}
{{CMG}}


==Pharmacokinetics Special populations==
==Pharmacokinetics Special populations==
===Geriatric patients===
===Geriatric patients===
The geriatric population may show slightly higher plasma concentrations of metoprolol as a combined result of a decreased metabolism of the drug in elderly population and a decreased hepatic blood flow. However, this increase is not clinically significant or therapeutically relevant.
The geriatric population may show slightly higher plasma concentrations of metoprolol as a combined result of a decreased metabolism of the drug in elderly population and a decreased hepatic blood flow. However, this increase is not clinically significant or therapeutically relevant.
===Renal impairment===
===Renal impairment===
The systemic availability and half-life of Lopressor in patients with renal failure do not differ to a clinically significant degree from those in normal subjects.
The systemic availability and half-life of Lopressor in patients with renal failure do not differ to a clinically significant degree from those in normal subjects.
===Hepatic Impairment===
===Hepatic Impairment===
Since the drug is primarily eliminated by hepatic metabolism, hepatic impairment may impact the pharmacokinetics of metoprolol. The elimination half-life of metoprolol is considerably prolonged, depending on severity (up to 7.2 h).
Since the drug is primarily eliminated by hepatic metabolism, hepatic impairment may impact the pharmacokinetics of metoprolol. The elimination half-life of metoprolol is considerably prolonged, depending on severity (up to 7.2 h).


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===Pediatric patients===
===Pediatric patients===
No pediatric studies have been performed. The safety and efficacy of Lopressor in pediatric patients have not been established.
No pediatric studies have been performed. The safety and efficacy of Lopressor in pediatric patients have not been established.
===Renal impairment===
===Renal impairment===
No dose adjustment of Lopressor is required in patients with renal impairment.
No dose adjustment of Lopressor is required in patients with renal impairment.
===Hepatic impairment===
===Hepatic impairment===
Lopressor blood levels are likely to increase substantially in patients with hepatic impairment. Therefore, Lopressor should be initiated at low doses with cautious gradual dose titration according to clinical response.
Lopressor blood levels are likely to increase substantially in patients with hepatic impairment. Therefore, Lopressor should be initiated at low doses with cautious gradual dose titration according to clinical response.
===Geriatric patients (>65 years)===
===Geriatric patients (>65 years)===
In general, use a low initial starting dose in elderly patients given their greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = LOPRESSOR (METOPROLOL TARTRATE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION] | url =http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bb05420c-fd24-4672-9f62-fdd313819287 | publisher =  | date =  | accessdate = }}</ref>
In general, use a low initial starting dose in elderly patients given their greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = LOPRESSOR (METOPROLOL TARTRATE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION] | url =http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bb05420c-fd24-4672-9f62-fdd313819287 | publisher =  | date =  | accessdate = }}</ref>
==References==
==References==
{{Reflist}}
{{Reflist}}


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[[Category:Drugs]]
[[Category:Drugs]]
[[Category:Cardiovascular Drugs]]
[[Category:Beta blockers]]

Revision as of 17:39, 9 February 2014

Metoprolol
Clinical data
Trade namesLopressor, Toprol-xl
AHFS/Drugs.comMonograph
MedlinePlusa682864
[[Regulation of therapeutic goods |Template:Engvar data]]
Pregnancy
category
  • AU: C
  • US: C (Risk not ruled out)
Routes of
administration		Oral, IV
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability12%
MetabolismHepatic via CYP2D6, CYP3A4
Elimination half-life3-7 hours
ExcretionRenal
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
E number{{#property:P628}}
ECHA InfoCard{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
FormulaC15H25NO3
Molar mass267.364 g/mol
3D model (JSmol)
Melting point120 °C (248 °F)
  (verify)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pharmacokinetics Special populations

Geriatric patients

The geriatric population may show slightly higher plasma concentrations of metoprolol as a combined result of a decreased metabolism of the drug in elderly population and a decreased hepatic blood flow. However, this increase is not clinically significant or therapeutically relevant.

Renal impairment

The systemic availability and half-life of Lopressor in patients with renal failure do not differ to a clinically significant degree from those in normal subjects.

Hepatic Impairment

Since the drug is primarily eliminated by hepatic metabolism, hepatic impairment may impact the pharmacokinetics of metoprolol. The elimination half-life of metoprolol is considerably prolonged, depending on severity (up to 7.2 h).

Uses in Special Population

Pediatric patients

No pediatric studies have been performed. The safety and efficacy of Lopressor in pediatric patients have not been established.

Renal impairment

No dose adjustment of Lopressor is required in patients with renal impairment.

Hepatic impairment

Lopressor blood levels are likely to increase substantially in patients with hepatic impairment. Therefore, Lopressor should be initiated at low doses with cautious gradual dose titration according to clinical response.

Geriatric patients (>65 years)

In general, use a low initial starting dose in elderly patients given their greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.[1]

References

  1. ↑ "LOPRESSOR (METOPROLOL TARTRATE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION]".

Adapted from the FDA Package Insert.

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