Lopressor (Intravenous)

Metoprolol injection is used to lower the risk of death after an acute heart attack. It is given to people who have already experienced a heart attack.

This medicine is a beta-blocker. It works by changing how the body responds to nerve signals in certain areas, such as the heart. This causes the heart to beat more slowly and lowers blood pressure. When blood pressure goes down, more blood and oxygen flow to the heart.

This medicine is available only with your doctor's prescription.

It is very important that your doctor checks you closely to ensure this medicine is working properly and to monitor for unwanted effects.

Metoprolol injection may make heart failure symptoms worse in some patients. Tell your doctor right away if you experience chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.

This medicine may cause changes in your blood sugar levels. It may also hide signs of low blood sugar, like a rapid pulse rate. Check with your doctor if you have these issues or if you notice a change in your blood or urine sugar test results.

Make sure any doctor or dentist treating you knows that you are using this medicine. You may need to stop using this medicine several days before surgery.

This medicine may cause some people to feel less alert than usual. If this happens, do not drive, use machines, or do anything else that could be dangerous if you are not alert while using metoprolol injection.

Dizziness, lightheadedness, or even fainting may happen when you get up suddenly from lying or sitting down. Getting up slowly may help reduce this issue. Also, lying down for a while may relieve dizziness or lightheadedness.

Do not take other medicines unless your doctor has discussed them with you. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, it's important to consider the risks of taking it against the benefits it may provide. This is a decision you and your doctor will make together. For this medicine, you should think about the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, inform your healthcare professional about any other allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies have not been done to understand how metoprolol injection affects children. Safety and effectiveness have not been established.

Geriatric

Studies so far have not shown any specific problems for elderly patients that would limit the use of metoprolol injection in this age group. However, older patients may be more sensitive to metoprolol injection than younger adults and are more likely to have age-related liver or heart issues, which may require caution and possibly a dose adjustment.

Breast Feeding

Research in women suggests that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others can be used together even if there may be an interaction. In such cases, your doctor may want to adjust the dose or take other precautions. It is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential importance and are not necessarily a complete list.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abiraterone Acetate
• Adagrasib
• Albuterol
• Ceritinib
• Clonidine
• Cobicistat
• Crizotinib
• Darunavir
• Desvenlafaxine
• Diltiazem
• Dronedarone
• Duloxetine
• Escitalopram
• Fedratinib
• Fenoldopam
• Fexinidazole
• Fingolimod
• Formoterol
• Givosiran
• Indacaterol
• Iohexol
• Lacosamide
• Lercanidipine
• Levalbuterol
• Lidocaine
• Olodaterol
• Panobinostat
• Ponesimod
• Rifampin
• Rivastigmine
• Salmeterol
• Sertraline
• Siponimod
• Terbinafine
• Terbutaline
• Tocilizumab
• Verapamil
• Vilanterol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but it might be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Alfuzosin
• Alogliptin
• Amtolmetin Guacil
• Aspirin
• Bromfenac
• Bufexamac
• Bunazosin
• Bupropion
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Dapagliflozin
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Digoxin
• Dipyrone
• Doxazosin
• Droxicam
• Dulaglutide
• Empagliflozin
• Ertugliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin Aspart, Recombinant
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Human Inhaled
• Insulin Human Isophane (NPH)
• Insulin Human Regular
• Insulin Lispro, Recombinant
• Ketoprofen
• Ketorolac
• Linagliptin
• Liraglutide
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metformin
• Metildigoxin
• Miglitol
• Mirabegron
• Morniflumate
• Moxisylyte
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Paroxetine
• Phenelzine
• Phenobarbital
• Phenoxybenzamine
• Phentolamine
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Pramlintide
• Pranoprofen
• Prazosin
• Proglumetacin
• Propafenone
• Propoxyphene
• Propyphenazone
• Proquazone
• Quinidine
• Repaglinide
• Rifapentine
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• St John's Wort
• Sulindac
• Tamsulosin
• Telithromycin
• Tenoxicam
• Terazosin
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Trimazosin
• Urapidil
• Valdecoxib
• Venlafaxine
• Vildagliptin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at the same time as eating food or certain types of food because interactions may happen. Using alcohol or tobacco with certain medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect how this medicine works. Make sure to inform your doctor if you have any other medical problems, especially:

• Blood circulation problems or
• Bradycardia (slow heartbeat) or
• Heart block or
• Heart failure, moderate to severe or
• Sick-sinus syndrome (heart rhythm problem)—This medicine should not be used in patients with these conditions.

• Diabetes or
• Hyperthyroidism (overactive thyroid) or
• Hypoglycemia (low blood sugar)—It may hide some signs and symptoms of these conditions, like a fast heartbeat.

• Hypotension (low blood pressure) or
• Ischemic heart disease or
• Lung disease (e.g., asthma, bronchitis, emphysema) or
• Pheochromocytoma (adrenal gland tumor)—Use with caution. It may worsen these conditions.

• Liver disease—Use with caution. The effects may be stronger due to slower removal of the medicine from the body.

Along with its necessary effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

More common

• Blurred vision
• chest pain or discomfort
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from lying down or sitting
• shortness of breath
• slow or irregular heartbeat
• sweating
• unusual tiredness or weakness

Less common

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• cough
• decreased urine output
• difficult or labored breathing
• dilated neck veins
• disturbed color perception
• double vision
• extreme fatigue
• fast, pounding, or racing heartbeat or pulse
• halos around lights
• irregular breathing
• loss of vision
• mental confusion
• night blindness
• noisy breathing
• overbright appearance of lights
• pain, tension, and weakness upon walking that goes away during rest
• paleness or cold feeling in the fingertips and toes
• rapid weight gain
• seeing, hearing, or feeling things that are not real
• short-term memory loss
• swelling of the face, fingers, feet, or lower legs
• tightness in the chest
• tingling of the hands or feet
• tingling or pain in the fingers or toes when cold
• troubled breathing
• tunnel vision
• unusual weight gain or loss

Rare

• Bluish color of the skin on the fingers or toes
• chills
• clay-colored stools
• ongoing loss of appetite
• ongoing or severe abdominal or stomach pain
• ongoing or severe nausea and vomiting
• dark urine
• difficulty moving
• fever
• general tiredness and weakness
• headache
• hoarseness
• increased frequency of urination
• itchy skin
• light-colored stools
• lower back or side pain
• muscle pain or stiffness
• numbness of the fingers or toes
• pain, swelling, or redness in the joints
• painful or difficult urination
• rash
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• unpleasant breath odor
• unusual bleeding or bruising
• upper right abdominal or stomach pain
• vomiting blood
• weakness
• yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Bluish color of the fingernails, lips, skin, palms, or nail beds
• change in consciousness
• loss of consciousness
• no blood pressure or pulse
• stopping of the heart
• unconsciousness
• very drowsy or sleepy

Some side effects may happen that usually do not need medical attention. These side effects may go away as your body adjusts to the medicine. Your health care professional may also have ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Less common

• Belching
• bloated
• decreased interest in sexual intercourse
• difficulty having a bowel movement (stool)
• discouragement
• dry mouth
• excess air or gas in the stomach or intestines
• feeling of constant movement of self or surroundings
• feeling of indigestion
• feeling sad or empty
• full feeling
• inability to have or keep an erection
• irritability
• loss in sexual ability, desire, drive, or performance
• loss of interest or pleasure
• nightmares
• pain in the chest below the breastbone
• passing gas
• redness or other discoloration of the skin
• sensation of spinning
• tiredness
• trouble concentrating
• trouble sleeping

Rare

• Bone pain
• ongoing ringing, buzzing, or other unexplained noise in the ears
• hearing loss
• increased sensitivity of the skin to sunlight
• pain of the penis on erection
• severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Lopressor

Available Dosage Forms:

• Solution

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Beta-Adrenergic Blocker, Cardioselective

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Your doctor will only give you a few doses of this medicine until your condition improves, and then you will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

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