Metoprolol Succinate (Antihypertensive)

Question 1

What is the brand name of Metoprolol Succinate?

Answer 1

Toprol-XL & Kapsargo

Question 2

What strength tablets, XR are available for Metoprolol Succinate?

Answer 2

Tablets, XR

25mg, 50mg, 100mg, 200mg

Question 3

What strength sprinkle capsules are available?

Answer 3

25mg, 50mg, 100mg, & 200mg (Kapsargo)

Question 4

What dose of Toprol-XR is used to manage hypertension?

Answer 4

Start with 25-100 mg/day in a single dose. May increase dose at weekly (or longer) intervals up to a maximum of 400mg/day

Question 5

What dose of Toprol-XR is used for long-term treatment of angina pectoris?

Answer 5

Start with 100mg/day single dose. May increase dose at weekly (or longer) intervals up to a maximum of 400mg/day. If treatment is to be DC, the dosage should be reduced gradually over a period of 1-2 weeks

Question 6

What dose of Toprol-XR is used to treat stable, symptomatic heart failure?

Answer 6

Prior to initiation of therapy, the dosing of diuretics, ACE inhibitors, and digitalis should be stabilized, Start with 12.5mg to 25mg QD. Double the dose every 2 weeks to the highest dose tolerated by the patient, up to a maximum of 200mg/day

Question 7

What should the providers monitor in a patient taking Metoprolol Succinate?

Answer 7

Blood Pressure

Question 8

What is the mechanism of action for Metoprolol succinate?

Answer 8

it is a relatively cardioselective beta-1-adrenergic receptor blocker. (beta blocker)

Question 9

What are the drug interactions of Toprol-XR?

Answer 9

• May decrease effects of theophylline
• Barbiturates or rifampin may decrease Metoprolol plasma levels
• Cimetidine may increase plasma levels
• Hydralazine, propafenone, or thiamin may increase effects
• NSAID agents may decrease effects
• Toxic effects may be increased with verapamil
• May increase toxic effects of lidocaine
• Use with prazosin may increase postural hypotension

Question 10

What are the contraindications for Toprol-XR?

Answer 10

• Use is contraindicated in patients with sinus bradycardia, heart block greater than first-degree, cariogenic shock, decompensated heart failure, and sick sinus syndrome
• When stopping chronically administered therapy, doses should be gradually decreases over a 1-2 week period to avoid angina pectoris and/or myocardial infarction
• Use with caution in pregnancy, in patients with broncho-spastic diseases, diabetes, thyrotoxicosis, and impaired hepatic function
• Pregnancy Category C

Question 11

What are the adverse effects of Metoprolol Succinate?

Answer 11

Sissiness or fatigue, depression, shortness of breath or bradycardia, pruritus, and diarrhea

Question 12

What should the RPh tell the patient when counseling on Metoprolol Succinate?

Answer 12

• Contact physician if adverse effects become severe
• Patients with heart failure should contact their MD if their symptoms worsen
• Do not DC therapy without first consulting MD
• Take food with medicine to increase absorption
• Take whole or halved tablets without crushing chewing
• Patients with diabetes need to be aware that his agent can cause masking of hypoglycemic symptoms
• If a dose is missed, skip it and return to your normal dosing schedule