Metoprolol (Intravenous)

Metoprolol injection is used to lower the risk of death from 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, like the heart. As a result, the heart beats slower, which lowers blood pressure. When blood pressure decreases, more blood and oxygen reach 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 look 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, such as a rapid pulse. 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 taking this medicine several days before having surgery.

This medicine may make some people less alert than usual. If this happens, do not drive, operate machinery, or do anything else that could be dangerous if you are not alert while using metoprolol injection.

Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help reduce this problem. Lying down for a while may also relieve dizziness or lightheadedness.

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

In deciding to take this medicine, you and your doctor will weigh the risks against the benefits. Consider the following:

Allergies

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

Pediatric

There have not been appropriate studies on how metoprolol injection affects children. Its safety and effectiveness have not been established for this age group.

Geriatric

Current studies have not shown any specific problems in elderly patients that would limit the use of metoprolol injection. However, older adults may be more sensitive to the effects of metoprolol injection than younger adults and are more likely to have age-related liver or heart issues, which may require caution and dose adjustments for those receiving metoprolol injection.

Breast Feeding

Research in women indicates that this medication poses minimal risk to infants when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. In such instances, your doctor might want to adjust the dose or take other precautions. It is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are significant and may not include all possible interactions.

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 take 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 using both drugs may be the best treatment option for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of use for 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 taken around mealtime or with certain foods due to possible interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect how this medicine works. Be sure to inform your doctor if you have any additional 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)—Should not be used in these cases.

• Diabetes or
• Hyperthyroidism (overactive thyroid) or
• Hypoglycemia (low blood sugar)—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. 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 needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately 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 a lying or sitting position
• 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 subsides during periods of rest
• paleness or cold feeling in the fingertips and toes
• rapid weight gain
• seeing, hearing, or feeling things that are not there
• 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 exposed to cold
• troubled breathing
• tunnel vision
• unusual weight gain or loss

Rare

• Bluish color skin of the fingers or toes
• chills
• clay-colored stools
• continuing loss of appetite
• continuing or severe abdominal or stomach pain
• continuing or severe nausea and vomiting
• dark urine
• difficulty with moving
• fever
• general tiredness and weakness
• headache
• hoarseness
• increased frequency of urination
• itching 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 of 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 heart
• unconsciousness
• very drowsy or sleepy

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or 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
• continuing ringing or buzzing or other unexplained noise in the ears
• hearing loss
• increased sensitivity of the skin to sunlight
• pain of 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 may 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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