Lopressor injection
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
For information about metoprolol, click here.
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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).[1]
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
Condition 1
- Developed by: (Organisation)
- Class of Recommendation: (Class) (Link)
- Strength of Evidence: (Category A/B/C) (Link)
- Dosing Information
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Condition 2
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- Strength of Evidence: (Category A/B/C) (Link)
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Non–Guideline-Supported Use
Atrial flutter
- Dosing Information
- Lopressor injection dose range: 2—15 mg[2]
Atrial fibrillation
- Dosing Information
- Lopressor injection dose range: 2—15 mg[2]
Multifocal atrial tachycardia
- Dosing Information
- Lopressor injection dose range: 2—15 mg[2]
Supraventricular tachycardia
- Dosing Information
- Lopressor injection dose range: 2—15 mg[2]
Injection Site Pain Associated with Propofol Use
- Dosing Information
- Pretreatment with Lopressor injection 2 mg.[3]
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
Condition 1
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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)
- Dosing Information
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Condition 2
- Developed by: (Organisation)
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- Strength of Evidence: (Category A/B/C) (Link)
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Non–Guideline-Supported Use
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Condition 3
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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
Condition 1
Central Nervous System
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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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Condition 1
Central Nervous System
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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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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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Gender
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Race
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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
(Oral/Intravenous/etc)
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
Compatible
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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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Variable
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Incompatible
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Syringe
Compatible
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Variable
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Incompatible
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TPN/TNA
Compatible
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Variable
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Incompatible
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Overdosage
Acute Overdose
Signs and Symptoms
(Description)
Management
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Chronic Overdose
Signs and Symptoms
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Management
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Pharmacology
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Lopressor injection
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Mechanism of Action
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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
- ↑ "LOPRESSOR (METOPROLOL TARTRATE) INJECTION, SOLUTION [NOVARTIS PHARMACEUTICALS CORPORATION]".
- ↑ 2.0 2.1 2.2 2.3 Amsterdam, EA.; Kulcyski, J.; Ridgeway, MG. (1991). "Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias". J Clin Pharmacol. 31 (8): 714–8. PMID 1880230. Unknown parameter
|month=ignored (help) - ↑ Aşik, I.; Yörükoğlu, D.; Gülay, I.; Tulunay, M. (2003). "Pain on injection of propofol: comparison of metoprolol with lidocaine". Eur J Anaesthesiol. 20 (6): 487–9. PMID 12803269. Unknown parameter
|month=ignored (help)