Lopressor injection

Lopressor injection®
Black Box Warning
Adult Indications and Dosage
Pediatric Indications and Dosage
Contraindications
Warnings
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration and Monitoring
IV Compatibility
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient information
Precautions with Alcohol
Look-Alike Drug Names
Drug Shortage Status
Price

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

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Black Box Warning

FDA Package Insert for Lopressor injection contains no information regarding Black Box Warning.

Overview

Lopressor injection is a anti-anginal, anti-arrhythmic, beta-adrenergic blocker drug that is FDA approved for the treatment of acute myocardial infarction (AMI). There is a Black Box Warning for this drug as shown here. Common adverse reactions include bradyarrhythmia, constipation, depression, diarrhea, dizziness, dyspnea, fatigue, headache, heart block, heart failure, hypotension, indigestion, nausea, pruritus, rash, and wheezing.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Acute Myocaridal Infarction

• Dosing Information

• Upon patient presentation: Lopressor injection 5 mg IV x 3 boluses at 2-min intervals

• 15 minutes after the full IV dose: Lopressor tablet 50 mg PO q6h for 2 days followed by Lopressor tablet 100 mg PO q12h (or Lopressor tablet 25—50 mg PO q6h for 2 days if intolerable to the full IV dose; discontinue Lopressor in patients with severe intolerance.)

Lopressor injection is indicated in the treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality when used in conjunction with oral Lopressor maintenance therapy. Treatment with Lopressor injection can be initiated as soon as the patient’s clinical condition allows.

Early Treatment: During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor injection as soon as possible after the patient’s arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient’s hemodynamic condition has stabilized. Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor injection each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor blood pressure, heart rate, and electrocardiogram.

In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see Warnings).

Off-Label Use and Dosage (Adult)

Cardiac Dysrhythmia

Lopressor injection (range: 2—15 mg) has been shown to be effective in the treatment of atrial flutter, atrial fibrillation, multifocal atrial tachycardia, and supraventricular tachycardia.

Injection Site Pain Associated with Propofol

Pretreatment with Lopressor injection (2 mg IV) was shown to be equally as effective as lidocaine in reducing the pain associated with propofol injection.

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Condition 2

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Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition 1

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• Strength of Evidence: (Category A/B/C) (Link)

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Non–Guideline-Supported Use

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Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

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Condition 2

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Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition 1

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• Class of Recommendation: (Class) (Link)

• Strength of Evidence: (Category A/B/C) (Link)

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(Dosage)

Condition 2

• Developed by: (Organisation)

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Non–Guideline-Supported Use

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Contraindications

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Warnings

Conidition 1

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Conidition 2

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Conidition 3

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Adverse Reactions

Clinical Trials Experience

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Cardiovascular

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Gastrointestinal

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Miscellaneous

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Cardiovascular

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Respiratory

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Gastrointestinal

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Hypersensitive Reactions

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Miscellaneous

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Postmarketing Experience

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Drug Interactions

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Use in Specific Populations

Pregnancy

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Pregnancy Category (AUS): X

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Labor and Delivery

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Nursing Mothers

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Pediatric Use

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Geriatric Use

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Race

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Renal Impairment

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Hepatic Impairment

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Females of Reproductive Potential and Males

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Immunocompromised Patients

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Administration and Monitoring

Administration

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Monitoring

Condition 1

(Description regarding monitoring, from Warnings section)

Condition 2

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Condition 3

(Description regarding monitoring, from Warnings section)

IV Compatibility

Solution

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Not Tested

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Variable

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Incompatible

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Y-Site

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Variable

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Incompatible

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Admixture

Compatible

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Not Tested

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Variable

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Incompatible

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Syringe

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Incompatible

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TPN/TNA

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Not Tested

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Variable

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Incompatible

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Overdosage

Acute Overdose

Signs and Symptoms

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Management

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Chronic Overdose

Signs and Symptoms

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Management

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Pharmacology

Lopressor injection
Systematic (IUPAC) name
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Mechanism of Action

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Structure

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Pharmacodynamics

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Pharmacokinetics

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Nonclinical Toxicology

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Clinical Studies

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How Supplied

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Images

Drug Images

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Package and Label Display Panel

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Patient Information

Patient Information from FDA

(Patient Counseling Information)

Patient Information from NLM

(Link to patient information page)

Precautions with Alcohol

Alcohol-Lopressor injection interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Look-Alike Drug Names

• (Paired Confused Name 1a) — (Paired Confused Name 1b)
• (Paired Confused Name 2a) — (Paired Confused Name 2b)
• (Paired Confused Name 3a) — (Paired Confused Name 3b)

Drug Shortage Status

Price

References