Metoprolol tartrate is di(?)-1-(isopropylamino)-3-[p-(2-methoxyethyl)phenoxy]-2-propanol.
Indications / Uses :
Treatment of hypertension and chronic angina pectoris.
May be taken with or without food.
Heart block, greater than 1st-degree atrioventricular (AV) block II and III degree, cardiogenic shock, overt cardiac failure and sinus bradycardia. Abrupt withdrawal of Neobloc should be avoided and it should not be used by patients who have bronchospastic disease unless the patient does not respond to, or cannot tolerate other antihypertensive drugs. In such cases, the lowest dose possible should be used, and a ?2-agonist should be administered concomitantly.
Special Precautions :
The management of patients on ?-blockers undergoing surgery should be discussed with an anesthetist.
Diabetes: In patients with diabetes, especially labile diabetes, or with a history of episodes of spontaneous hypoglycemia, Neobloc should be given with caution, since ?-blockade may mask some important premonitory signs of acute hypoglycemia eg, tachycardia.
Other Metabolic Effects: ?-Adrenergic receptors are involved in the regulation of lipid, as well as carbohydrate metabolism. While some ?-blockers have been found to cause increased plasma levels of triglycerides, there are conflicting data on the other effects of a ?-blockade on lipid metabolism. The long-term clinical significance of the effect of ?-blockers on lipid metabolism is not known.
Hyperthyroidism: Neobloc is effective in reducing the clinical manifestation of developing or continuing hyperthyroidism, resulting in symptomatic improvement without producing any change in thyroid status. Therefore, special care should be exercised in hyperthyroid patients who are also receiving ?-blockers.