$Unique_ID{BRK02034}
$Pretitle{}
$Title{METOPROLOL}
$Subject{Lopressor (Geigy)}
$Volume{}
$Log{
Lopressor 50*0203401.scf
Lopressor 100*0203402.scf}

Copyright (C) 1991 Publications International, Ltd.


METOPROLOL
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BRAND NAME (Manufacturer):
     Lopressor (Geigy)
TYPE OF DRUG:
     Beta-adrenergic blocking agent
INGREDIENT:
     metoprolol
DOSAGE FORM:
     Tablets (50 mg and 100 mg)
STORAGE:
     Metoprolol should be stored at room temperature in a tightly closed,
       light-resistant container.

USES

     Metoprolol is used to treat high blood pressure and angina (chest pain)
and to prevent additional heart attacks in heart attack patients.  Metoprolol
belongs to a group of medicines known as beta-adrenergic blocking agents or,
more commonly, beta blockers.  These drugs work by controlling nerve impulses
along certain nerve pathways.

TREATMENT

     Metoprolol can be taken with a glass of water, with meals, immediately
following meals, or on an empty stomach, depending on your doctor's
instructions.  Try to take the medication at the same time(s) each day.
     Try not to miss any doses of this medicine.  If you do miss a dose of the
medication, take the missed dose as soon as possible.  However, if the next
scheduled dose is within eight hours (if you are taking this medicine only
once a day) or within four hours (if you are taking this medicine more than
once a day), do not take the missed dose of the medication at all; just return
to your regular dosing schedule.  Do not double the next dose of the
medication.
     It is important to remember that metoprolol does not cure high blood
pressure, but it will help to control the condition as long as you continue to
take it.

SIDE EFFECTS

     Minor.

     Anxiety; cold hands or feet (due to decreased blood circulation to the
skin, fingers, and toes); constipation; decreased sexual ability; diarrhea;
difficulty in sleeping; drowsiness; dryness of the eyes, mouth, and skin;
headache; nausea; nervousness; stomach discomfort; tiredness; or weakness.
These side effects should disappear during treatment, as your body adjusts to
the medicine.
     If you are extra-sensitive to the cold, be sure to dress warmly during
cold weather.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads) and exercise more
(unless your doctor directs you to do otherwise).
     Plain, nonmedicated eye drops (artificial tears) may help to relieve eye
dryness.
     If you experience mouth or throat dryness, you may want to chew sugarless
gum or suck on ice chips or a piece of hard candy.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
breathing difficulty or wheezing, confusion, dizziness, fever and sore throat,
hair loss, hallucinations, light-headedness, mental depression, nightmares,
numbness or tingling of the fingers or toes, rapid weight gain (three to five
pounds within a week), reduced alertness, skin rash, swelling, or unusual
bleeding or bruising.

INTERACTIONS

     Metoprolol interacts with several other types of medications:
     1. Indomethacin, aspirin, or other salicylates may decrease the
blood-pressure-lowering effects of beta blockers.
     2. Concurrent use of beta blockers and calcium channel blockers
(diltiazem, nifedipine, verapamil) or disopyramide can lead to heart failure
or very low blood pressure.
     3. Cimetidine and oral contraceptives (birth control pills) can increase
the blood concentrations of metoprolol, which can result in greater side
effects.
     4. Alcohol, barbiturates, and rifampin can decrease the blood
concentrations of metoprolol, which can result in a decrease of effectiveness.
     5. Side effects may be increased if beta blockers are taken with
clonidine, digoxin, epinephrine, phenylephrine, phenylpropanolamine,
phenothiazine tranquilizers, prazosin, or monoamine oxidase (MAO) inhibitors.
At least 14 days should separate the use of a beta blocker and the use of an
MAO inhibitor.
     6. Beta blockers may antagonize (work against) the effects of
theophylline, aminophylline, albuterol, isoproterenol, metaproterenol, and
terbutaline.
     7. Beta blockers can also interact with insulin or oral antidiabetic
agents, raising or lowering blood sugar levels and masking the symptoms of low
blood sugar.
     8. The action of beta blockers may be increased if they are used with
chlorpromazine, furosemide, or hydralazine, which may have a negative effect.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any listed above.

WARNINGS

     * Tell your doctor if you have ever had unusual or allergic reactions to
any medications, especially to metoprolol or any other beta blocker
(acebutolol, atenolol, carteolol, esmolol, labetalol, nadolol, penbutolol,
pindolol, propranolol, or timolol).
     * Tell your doctor if you now have or have ever had allergies, asthma,
hay fever, eczema, slow heartbeat, bronchitis, diabetes mellitus, emphysema,
heart or blood vessel disease, kidney disease, liver disease, thyroid disease,
or poor circulation in the fingers or toes.
     * You may want to check your pulse while taking this medication.  If your
pulse is much slower than your usual rate (or if it is less than 50 beats per
minute), check with your doctor.  A pulse rate that is too slow may cause
circulation problems.
     * This medicine may affect your body's response to exercise.  Make sure
you discuss with your doctor a safe amount of exercise for your medical
condition.
     * It is important that you do not stop taking this medicine without first
checking with your doctor.  Some conditions may become worse when the medicine
is stopped suddenly, and the danger of a heart attack is increased in some
patients.  Your doctor may want you to reduce gradually the amount of medicine
you take before stopping completely to minimize the potential risks.  Make
sure that you have enough medicine on hand to last through vacations,
holidays, and weekends.
     * Before having surgery or any other medical or dental treatment, tell
your doctor or dentist that you are taking metoprolol.  Often, this medication
will be discontinued 48 hours prior to any major surgery.
     * Metoprolol can cause dizziness, drowsiness, light-headedness, or
decreased alertness.  Exercise caution while driving a car or using any
potentially dangerous machinery.
     * While taking this medicine, do not use any over-the-counter
(nonprescription) allergy, asthma, cough, cold, sinus, or diet preparation
without first checking with your pharmacist or doctor.  Some of these
medicines can result in high blood pressure when taken at the same time as a
beta blocker.
     * Be sure to tell your doctor if you are pregnant.  Animal studies have
shown that some beta blockers, when used in very high doses, can cause
problems in pregnancy.  Adequate studies have not been conducted in humans,
but there has been some association between beta blockers used during
pregnancy and low birth weight, as well as breathing problems and slow heart
rate in newborn infants.  However, other reports have shown no effects on
newborn infants.  Also, tell your doctor if you are breast-feeding an infant.
Although this medicine has not been shown to cause problems in breast-fed
infants, some of the medicine may pass into breast milk, so caution is
warranted.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
