Metoprolol chemical structure
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Metoprolol

Metoprolol is a selective beta1 receptor blocker used in treatment of several diseases of the cardiovascular system. It is marketed under the brand name Lopressor® by Novartis, and Toprol® (in the USA), Seleken® or Selokeen® (elsewhere) by AstraZeneca and as Corvitol® by Berlin-Chemie AG. more...

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It should be noted that Lopressor® refers to metoprolol tartrate, while Toprol® refers to metoprolol succinate.

Properties:

  • Cardioselective
  • Lipophilic
  • Without intrinsic sympathomimetic activity (ISA)
  • Without membrane stabilizing activity
  • Short half-life must be taken at least twice daily or SR preparations

Indications:

  • Essential hypertension
  • Arrhythmias
  • Coronary heart disease (prevention of angina attacks)
  • Secondary prevention after a myocardial infarction
  • Low dosed treatment of some forms of heart failure (see MERIT-HF study1)
  • Migraine prophylaxis
  • Adjunct in treatment of hyperthyroidism

In the United States and most other countries, this medication is available only by prescription.

Read more at Wikipedia.org


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Metoprolol Is a Safe Treatment in Patients with Severe CHF - congestive heart failure
From American Family Physician, 3/15/02 by Karl E. Miller

Beta-adrenergic receptor blockers have been shown to reduce morbidity and mortality in patients with mild to moderate congestive heart failure (CHF). Beta-blocker therapy has been shown to reduce the symptoms of heart failure and appears to be well tolerated by these patients. Despite this proven benefit, there is still some concern about use of beta blockers in patients with more severe CHF. The concern is that these agents may actually worsen symptoms and increase mortality. Goldstein and colleagues studied the effect of a beta1-selective beta blocker--metoprolol controlled release/extended release--in the treatment of patients with severe CHF.

The study was a subgroup analysis of the larger MERIT-HF study with 795 enrolled participants. The study group consisted of patients with New York Heart Association (NYHA) Functional class III or IV heart failure and an ejection fraction of less than 25 percent. Those who qualified for the study were randomly assigned to receive placebo or metoprolol, with starting dosages of 12.5 or 25 mg once daily. The dosage was doubled every two weeks up to a target of 200 mg per day or the highest tolerated dosage. The study looked at cardiac morbidity and mortality, hospitalizations, and tolerability of treatment.

The yearly mortality rate in the metoprolol group was reduced by 39 percent compared with the placebo group. In addition, sudden deaths were reduced by 45 percent, and the number of deaths secondary to worsening of heart failure was reduced by 55 percent. The metoprolol group also had fewer hospitalizations and showed improvement in NYHA functional classification. Metoprolol was well tolerated, and fewer persons withdrew from the trial group than from the placebo group.

The authors conclude that metoprolol controlled release/extended release can be used in the treatment of severe CHF. This treatment was well tolerated, reduced mortality rates, and improved heart failure symptoms.

COPYRIGHT 2002 American Academy of Family Physicians
COPYRIGHT 2002 Gale Group

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