Side effects of metoprolol – NHS

Like all medicines, metoprolol can cause side effects, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects of metoprolol happen in more than 1 in 100 people. There are things you can do to help cope with them:

Headaches

Make sure you rest and drink plenty of fluids. It’s best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches usually go away after the first week of taking metoprolol. Talk to your doctor if the headaches are severe or last longer than a week.

Feeling tired, dizzy or weak

If metoprolol makes you feel dizzy or weak, stop what you’re doing, and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you’re feeling tired. Try not to drink alcohol, as it may make your symptoms worse.

Cold hands or feet

Put your hands or feet under warm running water, massage them, and wiggle your fingers and toes. Try not to smoke or have drinks with caffeine in – these can make your blood vessels narrower and restrict your blood flow. Smoking also makes your skin colder. Try wearing mittens (they’re warmer than gloves) and warm socks. Do not wear tight watches or bracelets.

Feeling sick (nausea)

Stick to simple meals and avoid rich or spicy food. It might help to take your metoprolol after you have eaten.

Stomach pain

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.

If you’re in a lot of pain, speak to your pharmacist or doctor.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.

Serious side effects

It’s rare, but some people have serious side effects when taking metoprolol.

Call a doctor or call 111 straight away if:

• you get shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
• you get shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
• you have a fast heart rate, high temperature, trembling and confusion – these are signs of too much thyroid hormone in the blood
• the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – these can be signs of liver problems
• you get unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

Immediate action required: Go to A&E or call 999 now if:

• you have any heavy bleeding or bleeding that you cannot stop, such as cuts or nosebleeds that do not stop within 10 minutes

Immediate action required: Call 999 now if:

• you get chest pain that does not stop after a few minutes or is new or worse if you already have angina

Chest pain is a possible sign of a heart attack and needs to be checked out as soon as possible.

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to metoprolol.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of metoprolol. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 9 March 2022

Next review due: 9 March 2025

Metoprolol – StatPearls – NCBI Bookshelf

Continuing Education Activity

Metoprolol is FDA-approved to treat angina, heart failure, myocardial infarction, atrial fibrillation/flutter, and hypertension. Off-label uses include supraventricular tachycardia and thyroid storm. Both oral and intravenous preparations are available. There are immediate and extended-release preparations available orally. There is controversy regarding the selection of beta-blockers in the management of the above conditions. There is also conflicting evidence regarding the optimal choice of a particular beta-blocker in treating each specific disease. This activity will highlight the mechanism of action, adverse event profile, pharmacology, monitoring, and relevant interactions of metoprolol, pertinent for members of the interprofessional team in the treatment of patients with conditions where it is of clinical value.

Objectives:

• Identify the mechanism of action of metoprolol.

• Describe the adverse effects of metoprolol.

• Summarize the contraindications of metoprolol.

• Employ interprofessional team strategies for enhancing care coordination and communication to advance the safe use of metoprolol and improve outcomes.

Access free multiple choice questions on this topic.

Indications

Metoprolol is FDA-approved to treat angina, heart failure, myocardial infarction, atrial fibrillation/flutter, and hypertension. Off-label uses include supraventricular tachycardia and thyroid storm. Both oral and intravenous preparations are available. There are immediate and extended-release preparations available orally.  There is controversy regarding the selection of beta-blockers in the management of the above conditions. There is also conflicting evidence regarding the optimal selection of a particular beta-blocker in treating each specific disease.[1] The role of beta-blockers as initial therapy for hypertension, particularly in the absence of compelling indications, has been questioned.[2][3] 

Several randomized trials in the 1980s showed a mortality benefit for beta-blockers in acute myocardial infarction.[4][5][6] The Metoprolol Atherosclerosis Prevention in Hypertensives (MAPHY) trial specifically showed a benefit of metoprolol over diuretics regarding sudden cardiac death as well as myocardial infarction.[7] A large randomized trial of over 50,000 patients in the 1990s showed metoprolol to reduce mortality and re-infarction when used chronically after myocardial infarction.[8] Beta-blockers have demonstrated prognostic benefit and reduce mortality in the treatment of chronic heart failure. The carvedilol or metoprolol European trial (COMET) enrolled patients with stable heart failure and compared each drug head-to-head. Carvedilol was associated with a statistically significantly lower risk of all-cause death.[9] However, recent trials have had conflicting evidence on whether selective beta-1 blockers such as metoprolol have any benefit over other beta-blockers like carvedilol.[1]

Mechanism of Action

Metoprolol is a cardioselective beta-1-adrenergic receptor inhibitor that competitively blocks beta1-receptors with minimal or no effects on beta-2 receptors at oral doses of less than 100 mg in adults. It decreases cardiac output by negative inotropic and chronotropic effects. Metoprolol does not exhibit membrane stabilizing or intrinsic sympathomimetic activity. Administration of metoprolol to normal subjects results in a reduction in heart rate and cardiac output; this appears to be related to the dose and concentration of the drug. Metoprolol is mainly lipophilic, and distribution is typical of a basic lipophilic drug. Based on animal studies, it appears to be almost completely absorbed from the gastrointestinal (GI) tract when taken orally.

There is significant hepatic first-pass elimination, which results in around 50% of the oral dose reaching the systemic circulation. It is 11% bound to serum albumin. The half-life of metoprolol is about 3 to 4 hours in most patients for non-extended release tabs. Metoprolol excretion principally occurs via the kidneys.[10] Metoprolol succinate produces more level drug concentrations as compared to metoprolol tartrate, which has more peak-to-trough variation. However, despite these differences in pharmacokinetics, studies have concluded that both agents produce similar clinical effects, both acute and chronic.[11]

Administration

Metoprolol may administration can be either oral or intravenous. The immediate-release oral formulation is to be administered with or immediately following food intake. The administration of the short-acting formulation of metoprolol tartrate is usually twice daily. It may be effective for hypertension when taken once per day; however, lower doses may not control blood pressure for 24 hours. Patients may take the extended-release metoprolol succinate formulation without regard to meals.[12]

Adverse Effects

The primary adverse effects of metoprolol include heart failure exacerbation, fatigue, depression, bradycardia or heart block, hypotension, bronchospasm, cold extremities, dizziness, decreased libido, diarrhea, tinnitus, decreased exercise tolerance, glucose intolerance, and may mask hypoglycemia. Abrupt cessation of the drug may lead to a withdrawal syndrome that could cause angina or myocardial infarction. Tachycardia and hypertension are both common in withdrawal syndrome.[13]

Contraindications

Metoprolol is contraindicated in patients with sick sinus syndrome, second or third-degree heart block (in the absence of pacemaker),  decompensated heart failure, hypotension, and documented hypersensitivity to the drug or components. Also, caution is necessary for patients with a history of noncompliance as the abrupt cessation of the drug can lead to withdrawal syndromes, including angina and myocardial infarction. Patients who have ingested cocaine or methamphetamine have traditionally had a contraindication to the use of selective beta-blocker such as metoprolol. This observation has its basis on case reports, and there is no strong evidence that they cause any deleterious effects. Regardless, agents such as labetalol, which have alpha and beta activity, or calcium channel blockers should be used in these cases. Metoprolol is a pregnancy risk factor Category C drug.[14]

Monitoring

The onset of action for oral immediate-release tablets is within 1 hour, with a duration of effect variable depending on the dose given. The extended-release preparation has a similar onset of action and a duration of up to 24 hours. Metabolism of metoprolol is hepatic with excretion in the urine. If there is renal impairment, there is no dosage adjustment necessary. If there is a history of hepatic impairment, slowly increasing titrated doses to effect should be used. With the use of intravenous (IV) administration, cardiac monitor, including ECG heart rate and blood pressure, should be constant. Oral administration heart rate rhythm and blood pressure require monitoring.[14]

Toxicity

Treatment will vary based on the amount of metoprolol amount taken, comorbidities, age, and other co-investments. On arrival, assess ABCs and monitor appropriate blood work, including coingestants, ECG, large-bore IVs, and pregnancy status if female. Consult poison control/toxicology early in the course. Treatment choices include volume resuscitation, activated charcoal, whole bowel irrigation, nasogastric lavage, atropine, glucagon, calcium gluconate/calcium chloride, high-dose insulin, vasopressors, Intralipid, transcutaneous, or transvenous pacemaker. Cardiac status and a current fluid balance will guide volume resuscitation. Activated charcoal is typically given 1 g/kg and usually only has efficacy if dosed within 1 to 2 hours of ingestion. [15] If the patient has any altered mentation, caution is necessary to the possibility of aspiration. Whole bowel irrigation should be a consideration for extended-release preparations or large quantity ingestion.

Nasogastric lavage is usually ineffective, except for large quantity ingestions. The clinician may consider atropine use, although it is typically ineffective in moderate-to-severe overdoses. Calcium administration to increase intracellular calcium at a dose of 60 mg/kg over 5 to 10 minutes of calcium gluconate. Calcium chloride at a dose of 10 to 20 mL of a 10% solution is an option if central access is obtained. Glucagon dosing is 50 mcg/kg as a bolus with titration of drip. High-dose insulin at a dose of 1 unit per kilogram bolus followed by 1 unit per kilogram per hour drip.[16]

Administration with dextrose with a drip titrating to euglycemia as well as potassium repletion as needed. Vasopressors with epinephrine or norepinephrine titrated rate and blood pressure. Intralipid IV lipid emulsion therapy can serve as a lipid sink that extracts the drug from the myocyte. It may also provide free fatty acids as a substrate. It should be noted that the use of this medication will affect some laboratory monitoring.[17] Consider a transcutaneous or transvenous pacemaker. Extracorporeal membrane oxygenation (ECMO) should be considered for refractory cases.[18] If the clinician is concerned about intentional overdose, they should order a mandatory psychiatric evaluation. There may also be a need for the possibility of co-ingestants and treatment of those as well. For non-extended or non-sustained-release preparations, 4 to 6 hours of observation without any derangement of mental status or vital signs is sufficient. Any extended-release or sustained-release preparation requires 12 to 24 hours of telemetry observation, depending on the preparation. Extra caution should be considered in the pediatric population as very low amounts, including one pill or even one-half pill, which can cause cardiovascular collapse and death. [19]

Enhancing Healthcare Team Outcomes

Metoprolol is an effective beta-blocker for many cardiac disorders. However, prescribers of this drug should be aware that specific indications for this drug are still lacking. While research has shown the drug to lower mortality in CHF patients, the same applies to several other beta-blockers. To ensure the safe use of the drug, all members of the interprofessional healthcare team, including clinicians (MDs, DOs, NPs, and PAs), specialists, nurses, and pharmacists, should be very familiar with the indications, administration, and potential adverse effects and drug interactions of metoprolol, as well as all members of the beta-blocker drug classification, including which agents are specific vs. beta-1 specific. This will result in improved patient outcomes with fewer adverse events. [Level 5]

Metoprolol can be administered orally or IV and works quickly. 

Review Questions

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References

1.

Fröhlich H, Zhao J, Täger T, Cebola R, Schellberg D, Katus HA, Grundtvig M, Hole T, Atar D, Agewall S, Frankenstein L. Carvedilol Compared With Metoprolol Succinate in the Treatment and Prognosis of Patients With Stable Chronic Heart Failure: Carvedilol or Metoprolol Evaluation Study. Circ Heart Fail. 2015 Sep;8(5):887-96. [PubMed: 26175538]

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Lindholm LH, Carlberg B, Samuelsson O. Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. 2005 Oct 29-Nov 4Lancet. 366(9496):1545-53. [PubMed: 16257341]

3.

Khan N, McAlister FA. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis. CMAJ. 2006 Jun 06;174(12):1737-42. [PMC free article: PMC1471831] [PubMed: 16754904]

4.

Hjalmarson A, Herlitz J, Holmberg S, Rydén L, Swedberg K, Vedin A, Waagstein F, Waldenström A, Waldenström J, Wedel H, Wilhelmsen L, Wilhelmsson C. The Göteborg metoprolol trial. Effects on mortality and morbidity in acute myocardial infarction. Circulation. 1983 Jun;67(6 Pt 2):I26-32. [PubMed: 6342837]

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Intravenous beta-blockade during acute myocardial infarction. Lancet. 1986 Jul 12;2(8498):79-80. [PubMed: 2873383]

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Sleight P. Use of beta adrenoceptor blockade during and after acute myocardial infarction. Annu Rev Med. 1986;37:415-25. [PubMed: 2871805]

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Wikstrand J, Warnold I, Tuomilehto J, Olsson G, Barber HJ, Eliasson K, Elmfeldt D, Jastrup B, Karatzas NB, Leer J. Metoprolol versus thiazide diuretics in hypertension. Morbidity results from the MAPHY Study. Hypertension. 1991 Apr;17(4):579-88. [PubMed: 2013485]

8.

Freemantle N, Cleland J, Young P, Mason J, Harrison J. beta Blockade after myocardial infarction: systematic review and meta regression analysis. BMJ. 1999 Jun 26;318(7200):1730-7. [PMC free article: PMC31101] [PubMed: 10381708]

9.

Remme WJ, Cleland JG, Erhardt L, Spark P, Torp-Pedersen C, Metra M, Komajda M, Moullet C, Lukas MA, Poole-Wilson P, Di Lenarda A, Swedberg K. Effect of carvedilol and metoprolol on the mode of death in patients with heart failure. Eur J Heart Fail. 2007 Nov;9(11):1128-35. [PubMed: 17716943]

10.

Brogden RN, Heel RC, Speight TM, Avery GS. Metoprolol: a review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris. Drugs. 1977 Nov;14(5):321-48. [PubMed: 201441]

11.

Kukin ML, Mannino MM, Freudenberger RS, Kalman J, Buchholz-Varley C, Ocampo O. Hemodynamic comparison of twice daily metoprolol tartrate with once daily metoprolol succinate in congestive heart failure. J Am Coll Cardiol. 2000 Jan;35(1):45-50. [PubMed: 10636257]

12.

Wikstrand J, Hjalmarson A, Waagstein F, Fagerberg B, Goldstein S, Kjekshus J, Wedel H., MERIT-HF Study Group. Dose of metoprolol CR/XL and clinical outcomes in patients with heart failure: analysis of the experience in metoprolol CR/XL randomized intervention trial in chronic heart failure (MERIT-HF). J Am Coll Cardiol. 2002 Aug 07;40(3):491-8. [PubMed: 12142116]

13.

Helfand M, Peterson K, Christensen V, Dana T, Thakurta S. Drug Class Review: Beta Adrenergic Blockers: Final Report Update 4 [Internet]. Oregon Health & Science University; Portland (OR): Jul, 2009. [PubMed: 21089245]

14.

Ripley TL, Saseen JJ. β-blockers: a review of their pharmacological and physiological diversity in hypertension. Ann Pharmacother. 2014 Jun;48(6):723-33. [PubMed: 24687542]

15.

Graudins A, Lee HM, Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol. 2016 Mar;81(3):453-61. [PMC free article: PMC4767195] [PubMed: 26344579]

16.

Stellpflug SJ, Harris CR, Engebretsen KM, Cole JB, Holger JS. Intentional overdose with cardiac arrest treated with intravenous fat emulsion and high-dose insulin. Clin Toxicol (Phila). 2010 Mar;48(3):227-9. [PubMed: 20141425]

17.

Walter E, McKinlay J, Corbett J, Kirk-Bayley J. Review of management in cardiotoxic overdose and efficacy of delayed intralipid use. J Intensive Care Soc. 2018 Feb;19(1):50-55. [PMC free article: PMC5810865] [PubMed: 29456602]

18.

Chenoweth JA, Colby DK, Sutter ME, Radke JB, Ford JB, Nilas Young J, Richards JR. Massive diltiazem and metoprolol overdose rescued with extracorporeal life support. Am J Emerg Med. 2017 Oct;35(10):1581.e3-1581.e5. [PubMed: 28705745]

19.

Euwema MS, Swanson TJ. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 1, 2022. Deadly Single Dose Agents. [PubMed: 28722879]

Disclosure: Jason Morris declares no relevant financial relationships with ineligible companies.

Disclosure: Alexis Dunham declares no relevant financial relationships with ineligible companies.

What helps, analogs, prescription, dosage, mechanism of action

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. CONSULTATION OF A SPECIALIST IS REQUIRED. 0005

Podoinitsyna Alena Andreevna,

Diploma of Pharmaceutical Education: 105924 3510722 reg. number 31917

All authors

Contents of the article

• Metoprolol: mechanism of action
• Metoprolol: from what
• Metoprolol: prescription
• Metoprolol: dosage
• Metoprolol: analogues
• Metoprolol or Egilok: which is better
• Anaprilin or Metoprolol: what is better
• Summary
• Ask an expert on the topic of the article

Hypertension is a chronic disease, the main manifestation of which is an increase in blood pressure. High blood pressure is responsible for 10 million deaths and 200 million disabilities worldwide. Symptoms of hypertension are either absent or nonspecific: headache, dizziness, palpitations.

Hypertension can and should be treated and controlled with medicines. We asked the pharmacist Alena Podoinitsyna to tell us about the drug Metoprolol: what it is prescribed for, in what dosages it is produced and what is the mechanism of action of the drug. They gave several examples of analogues of Metoprolol, and also compared it with Egilok and Anaprilin.

All products Metoprolol

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Metoprolol: mechanism of action

Metoprolol is a medicine that is taken for high blood pressure. The drug blocks beta-adrenergic receptors. Blockade of beta-adrenergic receptors leads to a decrease in the number of heart contractions, contractility and speed of contraction of the heart muscle, while reducing myocardial oxygen demand.

Metoprolol: from what

We understand what Metoprolol tablets are from. The drug has antihypertensive, antianginal and antiarrhythmic effects. Metoprolol is a beta-blocker. It helps to reduce pressure at rest, during stress and physical exertion.

Antianginal effect is manifested in a decrease in heart rate and a decrease in the heart’s need for oxygen. The antiarrhythmic effect is expressed in the elimination of tachycardia, a decrease in the excitability of the heart and the conduction of nerve impulses in its tissues.

Metoprolol: indications for use

• high blood pressure
• angina pectoris
• complex therapy after a heart attack
• arrhythmia, tachycardia
• migraine prophylaxis
• hyperthyroidism

Prescription metoprolol

Metoprolol is a prescription drug. When buying it, a pharmacy employee will ask you to provide a prescription from a doctor. The drug is available by prescription, as when used in recommended doses, the patient can harm himself.

Metoprolol has side effects and contraindications. Only a doctor can evaluate the benefit-risk ratio of the drug. Therefore, the decision on the need for his appointment is also made by the doctor.

Metoprolol: contraindications for use

• hypersensitivity to any component of the preparation
• atrioventricular block II and III degree
• heart failure in the stage of decompensation
• patient therapy with nootropics acting on beta-adrenergic receptors
• decrease in heart rate below 60 beats per minute
• cardiogenic shock
• circulatory disorders in the organs, or the threat of gangrene
• low blood pressure
• acute myocardial infarction
• lactose intolerance, glucose-galactose malabsorption
• children under 18 years of age
• severe form of bronchial asthma and chronic obstructive pulmonary disease.
• concomitant use of certain groups of drugs
• lactation

Metoprolol: dosage

Metoprolol contains the active ingredient: metoprolol tartrate, at a dosage of 100 mg per 1 tablet. But we note that Metoprolol is produced on the basis of 2 active ingredients, or rather, salts. Each of them carries an action peculiar only to it.

• Metoprolol tartrate – the substance is contained in tablets of immediate action, these tablets must be taken several times a day.
• Metoprolol succinate – the substance is contained in tablets with a delayed release, respectively, such tablets are drunk 1 time per day.

Metoprolol: analogues

In order to choose metoprolol analogues and substitutes, a specialist consultation is necessary. Egilok, Serdol, Metocard, Betalok, Betalok ZOK contain metoprolol as an active substance. Metoprolol can be replaced with them without consulting a doctor. We recommend that you consult with a pharmacy employee or a pharmacist in the chat on our service. The specialist will help you choose the right dosage and dosage form.

The need to change to drugs with a different active substance is determined by the doctor. Metoprolol is part of the combined preparations. For example, Logimax, Implicor, Hypotef. They, in addition to metoprolol, contain other active ingredients. You can not replace them with a simple Metoprolol.

Do you want to understand the analogues of drugs in order to skillfully select drugs for your budget? Our manual from expert pharmacists “Analogues of popular drugs” will help you with this! Getting a training manual is easy: subscribe to our social networks and write “analogues” in the messages.

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Metoprolol or Egilok: which is better

When choosing the best drug, you should first consult with your doctor. There are practically no differences between Metoprolol and Egilok. Preparations differ by manufacturers:

• Metoprolol is produced in Russia, Slovenia, Israel, Slovakia and Germany
• Egilok is produced only in Hungary.

Other characteristics, such as: mechanism of action, indications for use, contraindications, side effects and other special indications, are the same for both drugs. All characteristics depend on the active substance. In both preparations, it is metoprolol tartrate. Therefore, Egilok is a substitute for Metoprolol.

Anaprilin or Metoprolol: which is better

Both drugs belong to the same group of drugs – beta-blockers. But the active ingredients are different. Anaprilin contains propranolol hydrochloride.

The difference between active substances lies in the mechanism of their action.

• Metoprolol is a non-selective adrenoblocker and acts on beta1-adrenergic receptors
• Anaprilin is selective and acts on beta1- and beta2-adrenergic receptors.

Thus, Anaprilin has more side effects and contraindications than Metoprolol. For example: both drugs should be taken with caution in diabetes mellitus. Metoprolol is also with caution in: chronic obstructive pulmonary disease and bronchial asthma, and Anaprilin is completely contraindicated.

Preparations and manufacturers differ.

• Anaprilin is produced by Russia and Ukraine
• Metoprolol is produced by Russia and 4 other countries.

Follow your doctor’s advice to select the best drug.

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Summary

• Metoprolol is an antihypertensive drug that is often prescribed for the treatment of hypertension, coronary heart disease and arrhythmias.
• Metoprolol is a prescription drug and is available only on prescription.
• The active substance of metoprolol is the salt of metoprolol succinate or tartrate.
• Metoprolol lowers blood pressure by reducing the heart’s need for oxygen and reducing the heart rate.
• Metoprolol has 4 analogues with which it can be substituted.
• When comparing Metoprolol with Egilok, differences were found only in manufacturers.
• Anaprilin differs from Metoprolol not only in producing companies, but also in the active substance.

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Still have questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets.

Managing editor

Zotina Natalya Igorevna,

Expert pharmacist

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Alternatives to bisoprolol: how to replace the drug?

What to choose instead of bisoprolol: analogues and other medicines for lowering blood pressure and treating cardiovascular diseases. Description of the effect, side effects and method of application.

Bisoprolol is a beta-blocker used to treat various diseases of the cardiovascular system. However, like any other drug, bisoprolol has its own side effects, which may be the reason for the need to replace this supplement.

There are alternatives to bisoprolol that can treat heart disease and rhythm disturbances without the risk of side effects. But before replacing the drug, it is necessary to consult a qualified doctor and not make a decision on your own in order to avoid negative health consequences.

Another drug may be prescribed to replace bisoprolol, for example, arbidol, valsartan, losartan, amladipine, convertal, etc. The use of alternative therapies, such as cardiac therapy, physiotherapy, massage, and others, may also be suggested.

What is bisoprolol?

Bisoprolol is a drug that primarily belongs to the group of beta-blockers.

It has the ability to slow down the heartbeat, regulate blood pressure and reduce the risk of developing cardiovascular disease.

Bisoprolol is prescribed according to individual patient indications, usually in the treatment of arrhythmias and tonsillitis, as well as in the treatment of a number of other diseases. It comes in a variety of forms, including tablets, injections, and solutions.

If you want to replace bisoprolol with another medicine, be sure to consult your doctor and follow all his recommendations.

When is bisoprolol prescribed?

Bisoprolol is a beta-blocker used to treat a variety of cardiovascular conditions.

The main indication for the appointment of bisoprolol is arterial hypertension. It lowers blood pressure levels by reducing heart rate and cardiac concentration power. In addition, bisoprolol is used for coronary heart disease, angina pectoris and control of arrhythmias.

Also, bisoprolol can be used as a prophylaxis for migraine, as well as to reduce the risk of complications after myocardial infarction. In some cases, bisoprolol may be used in the treatment of asthma and chronic obstructive pulmonary disease.

Only a doctor can prescribe bisoprolol, who will determine the dose and duration of treatment, depending on the individual characteristics of the patient and the nature of the disease.

How does bisoprolol work?

Bisoprolol is a selective beta-adrenergic antagonist. This means that it blocks the action of certain hormones that can lead to high blood pressure and heart rate.

Bisoprolol reduces the contractility of the heart and relaxes the blood vessels, which helps to reduce pressure and reduce the workload on the heart. This makes it effective for treating hypertension and preventing recurrent heart attacks.

Bisoprolol reduces the heart rate, reduces the force of contraction of the heart and reduces the heart’s need for oxygen. Also, this drug can improve blood flow to the heart and reduce the likelihood of arrhythmias.

Despite the effectiveness of bisoprolol, it can have side effects such as dizziness, sleep disturbances, depression and others. If these symptoms appear, you should consult a doctor.

What problems can occur when taking bisoprolol?

Bisoprolol is a drug often prescribed for the treatment of hypertension, angina pectoris, and other cardiovascular conditions. However, some patients may have problems taking this drug.

• Lowering blood pressure: bisoprolol is a beta-blocker that can cause a decrease in blood pressure. Therefore, patients suffering from hypotension may experience an increase in the symptoms of this disease, such as dizziness, weakness, nausea, and even loss of consciousness.
• Dyspepsia: Some patients may experience dyspepsia, which is an indigestion that can manifest as nausea, vomiting, gas, abdominal pain, and tremors in the abdomen.
• Drowsiness and fatigue: bisoprolol may cause drowsiness and fatigue in patients, especially at the beginning of treatment or when the dose is increased. Therefore, it is not recommended to drive vehicles and engage in other hazardous activities that require increased attention until it is clear how the drug affects the patient’s body.
• Bronchospasm: Beta-blockers such as bisoprolol may cause bronchial constriction and worsen asthma symptoms. The use of bisoprolol is not recommended in patients with chronic obstructive pulmonary disease or other respiratory diseases.

If you experience any of the problems listed above, be sure to tell your doctor about your symptoms and do not take bisoprolol unless advised to do so.

What alternatives to bisoprolol are available?

Bisoprolol is a beta-blocker used to treat hypertension, angina, and cardiac arrhythmias. However, if you have a contraindication to taking bisoprolol or if this drug is not effective, you have alternatives.

The doctor may prescribe other drugs instead of bisoprolol, including other beta-blockers, ACE inhibitors, calcium antagonists, etc. However, when taking a new drug, it is necessary to take into account the individual characteristics of the patient and contraindications, so the choice of a substitute should be made only by a doctor.

It is also possible to resort to alternative medicine methods, such as a nutritious diet combined with relaxation exercises, massage and yoga. But it should be remembered that these methods will not replace drug therapy and must be agreed with the doctor.

It is important to note that in no case should you cancel bisoprolol yourself and start taking a substitute, as this can lead to a deterioration in the condition and serious consequences. Only an experienced specialist will be able to choose the right replacement and control the treatment process.

What is carvedilol?

Carvedilol is a medicine used in cardiac practice to treat cardiovascular disease. It belongs to the group of beta-blockers with antioxidant activity and alpha-blocking properties.

Carvedilol acts on the heart by decreasing the heart rate, decreasing the force of the heart contraction, dilating the blood vessels. As a result, the load on the heart decreases and the pressure in the vessels decreases. This leads to an improvement in the blood supply to organs and tissues, a decrease in the manifestations of heart failure and arrhythmia.

Carvedilol is indicated for the treatment of various conditions such as:

• heart failure
• hypertension (high blood pressure)
• angina pectoris (chest pain on exertion)
• arrhythmias

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Carvedilol is effective and safe, but its use may be accompanied by some side effects such as dizziness, drowsiness, nausea and abdominal pain. Before you start taking carvedilol, be sure to consult your doctor and follow his recommendations.

When is carvedilol prescribed?

Carvedilol is a drug that belongs to the group of beta-blockers. It is used to treat cardiovascular diseases that are associated with an increase in the load on the heart, for example, in arterial hypertension, angina pectoris, chronic heart failure.

Carvedilol is indicated for:

• arterial hypertension;
• chronic heart failure;
• angina;
• myocardial infarction;
• cardiac arrhythmias.

The drug may be prescribed when other methods of treatment have not given sufficient results, or if there are contraindications to the use of other drugs.

Carvedilol helps to restore a normal heart rhythm, reduce the workload on the heart, stabilize blood pressure and improve the general well-being of the patient.

How does carvedilol work?

Carvedilol is a beta-blocker used to treat cardiovascular conditions such as hypertension and angina pectoris. It works by blocking the action of adrenaline on β-receptors, which are found in the heart and blood vessels.

This mechanism of action reduces the strength and frequency of heart contractions, resulting in lower blood pressure and reduced workload on the heart. In addition, blockade of β-receptors reduces the contractile ability of the smooth muscle of blood vessels, which leads to their expansion and improved blood flow.

Carvedilol also has antioxidant properties and may improve vascular endothelial function, which reduces the risk of cardiovascular disease.

Carvedilol has a broader spectrum of action than many other beta-blockers as it also blocks α1 receptors that are involved in the regulation of vascular tone. This mechanism of action reduces peripheral vascular resistance and reduces the workload on the heart.

Carvedilol is often prescribed as a substitute for bisoprolol when its use is contraindicated. It can also be used in combination with other drugs to achieve the best treatment effect.

What problems can occur when taking carvedilol?

1. Pressure reduction. Carvedilol is a drug that can lower blood pressure. When it is taken, dizziness, weakness, or even loss of consciousness may occur. Therefore, it is important to monitor the value of blood pressure and contact a doctor immediately if such symptoms occur.

2. Deterioration of heart function. Possible deterioration in cardiac function may occur in patients with heart failure. Such patients should regularly visit a doctor and take the necessary tests. Also, with a decrease in vitality and weakness, it is recommended to stop taking carvedilol.

3. Refusal to take medication. Carvedilol must be taken daily and regularly without missing doses. Refusal to take the medicine can lead to a worsening of the condition and even to the development of serious complications. If you have problems taking the medicine, you should consult a doctor and find an alternative.

4. Negative interaction with other drugs. Some medicines may interfere with the effectiveness of carvedilol or cause it to be actively withdrawn from the body. Therefore, before taking other medicines, it is necessary to discuss this with your doctor and inform you that you are taking carvedilol.

5. Allergic reactions. Some patients may experience an allergic reaction to carvedilol. Symptoms may include hives, itching, swelling of the throat and face, respiratory problems, etc. In case of allergic reactions, you should stop taking carvedilol and consult a doctor.

What is metoprolol?

Metoprolol is a beta-blocker drug used to treat various diseases of the heart and blood vessels. Beta-blockers block the action of epinephrine and norepinephrine on the beta-adrenergic receptors of the heart, which can reduce the heart rate, reduce the strength and speed of the heart rate, and reduce the oxygen demand of the heart.

Metoprolol is often used to treat hypertension, angina pectoris, myocardial infarction and heart failure. It can be used as monotherapy or in combination with other drugs.

Metoprolol is available in various forms: tablets, injection, long-acting tablets. The dosage and regimen of the drug should be prescribed by a doctor, based on the health status of a particular patient.

Before you start taking metoprolol, you need to consult a doctor who will determine the optimal dose and choose an individual treatment regimen. Self-medication can be harmful to health and worsen the course of diseases of the cardiovascular system.

When is metoprolol prescribed?

Metoprolol is a drug that belongs to the group of beta-blockers. It is used to treat various diseases and conditions related to the cardiovascular system.

Metoprolol can be prescribed for:

• hypertension;
• angina;
• cardiac arrhythmias;
• myocarditis;
• myocardial infarction;
• prevention of recurrent myocardial infarction;
• chronic heart failure;
• other cardiovascular diseases.

The drug reduces the heart rate, reduces the force of contraction of the heart muscle and lowers blood pressure. This helps to improve the functioning of the cardiovascular system and reduce the risk of complications.

As with any drug, metoprolol should only be prescribed after a doctor’s examination and diagnostic measures.

There are various contraindications for which metoprolol should not be used. It is important to discuss all the risks and side effects of the drug with your doctor before starting treatment.

How does metoprolol work?

Metoprolol is a beta-blocker used to treat a variety of heart and blood vessel conditions. Its action is based on the fact that it blocks the action of adrenaline on the heart muscle and blood vessels.

The action of metoprolol is to reduce heart rate and blood pressure. Due to this, it reduces the load on the heart and vascular system.

Metoprolol benefits:

• decreased heart rate;
• lowering blood pressure;
• reducing the load on the heart and vascular system;
• improving the quality of life in patients with diseases of the heart and blood vessels.

How to take metoprolol:

1. The dosage of metoprolol depends on the patient’s condition and is recommended to be prescribed by a doctor.
2. It is recommended to take metoprolol after meals and drink plenty of water.
3. It is not recommended to take metoprolol in the evening as it may cause insomnia.

Contraindications:

• Allergic reaction to metoprolol;
• Bronchial asthma;
• Arterial hypotension;
• Severe cardiovascular insufficiency.

What problems can occur when taking metoprolol?

Metoprolol is a beta-blocker used to treat high blood pressure, angina pectoris, myocardial infarction and other cardiovascular conditions. However, there may be some problems with its use that need to be taken into account.

Side effects: when taking metoprolol, various side effects may occur, such as dizziness, fatigue, drowsiness, sleep disturbance, insomnia, depression, bradycardia, bronchospasm and others.

Contraindications: metoprolol is contraindicated in individual intolerance, heart failure, bronchial asthma, low blood pressure, diabetes and other diseases. Before you start taking the drug, be sure to consult your doctor and read the instructions.

Interaction with other drugs: metoprolol can increase the toxicity of other drugs, such as antibiotics, antidepressants, anticancer drugs, etc. Therefore, before taking metoprolol, you should read the instructions in detail and consult your doctor.

Cancellation of the drug: when metoprolol is discontinued, the dosage should be gradually reduced to avoid lowering blood pressure, increasing heart rate, dizziness and other unpleasant symptoms.

In general, metoprolol is an effective drug for the treatment of cardiovascular diseases, however, before starting its use, it is necessary to consult a doctor and study the instructions in order to avoid problems.

What is enalapril?

Enalapril is a drug from the group of angiotensin converting enzyme inhibitors (ACE inhibitors). It is used to treat high blood pressure (hypertension), heart failure, and to prevent cardiovascular disease.

The drug is an effective means for lowering blood pressure, which helps to reduce the load on the heart muscle and improve blood circulation in the body. In addition to this, enalapril reduces the risk of developing cardiovascular diseases such as myocardial infarction and stroke.

The drug is available as tablets to be taken by mouth once or twice a day, usually with meals.

Important to know:

• Never take enalapril without a doctor’s prescription.
• Taking the drug requires regular monitoring of blood pressure and kidney function.
• Enalapril can interact with some drugs, so always tell your doctor about all the medicines you are taking.

When is enalapril prescribed?

Enalapril is a drug belonging to the group of ACE (angiotensin converting enzyme) inhibitors.

It is used to treat various diseases of the cardiovascular system:

• hypertension;
• chronic heart failure;
• after myocardial infarction;
• for kidney protection in diabetic nephropathy.

Enalapril can also be used as a prophylactic agent to prevent the development of cardiovascular diseases, especially in the presence of risk factors such as:

• obesity;
• alcohol abuse;
• diabetes mellitus;
• hereditary predisposition.

Enalapril may be given in combination with other drugs such as diuretics or beta-blockers to achieve the best therapeutic effect.

However, self-medication can lead to serious consequences, so the appointment of this drug should be carried out only under the supervision of a physician.

How does enalapril work?

Enalapril is a drug belonging to the group of angiotensin-converting enzyme inhibitors (ACE inhibitors). It acts on the renin-angiotensin-aldosterone system, which regulates blood pressure and is involved in the development of cardiovascular diseases.

The main action of enalapril is to block ACE inhibitors, which leads to a decrease in the conversion of angiotensin I to angiotensin II. Angiotensin II promotes vasoconstriction and increases blood pressure. Blocking its synthesis allows you to expand blood vessels and reduce the load on the heart.

In addition, enalapril reduces the release of aldosterone and reduces cardiac muscle remodeling. As a result, the likelihood of developing complications of the cardiovascular system, such as myocardial infarction, heart failure and mortality from cardiovascular diseases, is reduced.

Enalapril is used to treat hypertension, chronic heart failure, after myocardial infarction, to prevent cardiovascular complications in patients at increased risk and other conditions.

What problems can occur when taking enalapril?

Occurrence of side effects: Side effects may occur when taking enalapril, including dry mouth, dizziness, weakness, fatigue, loss of appetite, nausea, stomach pain, and problems with the absorption and excretion of fluids from the body. To prevent these side effects, it is important to take the drug exactly as directed by your doctor.

Contraindications: Enalapril is contraindicated in the presence of an allergy to this drug, as well as in certain heart conditions such as angina pectoris, heart attack and circulatory disorders in the brain.

Interactions with other drugs: Enalapril may interact with some other drugs, including pain medications, aseptic agents, furosemide, lithium, etc. It is important to tell your doctor about all the drugs you are taking.

Pressure change: Taking enalapril can lead to a decrease in blood pressure, so you should not stop the drug yourself. Be sure to tell your doctor about your blood pressure and health status.

Long-term use: Enalapril is taken for a long time as prescribed by a doctor. It is necessary to regularly undergo examinations and monitor pressure indicators and the effect of the drug on the body.

Edema: The use of enalapril may cause edema, especially in people with impaired renal function and a high salt diet. If swelling occurs, you should immediately consult a doctor.

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Q&A:

What are the alternatives to bisoprolol?

There are various alternatives: metoprolol, carvedilol, nebivolol, esmolol and other beta-blockers, as well as other classes of antihypertensive drugs such as ACE inhibitors (lisinopril, ramipril), calcium antagonists (amlodipine, nifedipine) and diuretics (indapamide, furosemide).

How to choose the right alternative?

The choice of an appropriate alternative depends on many factors such as disease stage, comorbidities, side effects, cost, etc. It is better to discuss this issue with a doctor who will tell you the most appropriate drug in each case.

What are the side effects of alternative drugs?

Side effects may vary depending on the drug. For example, ACE inhibitors may have cough, calcium antagonists may have edema, and diuretics may have electrolyte disturbances. In any case, the doctor should warn the patient about possible side effects and monitor their manifestation while taking the drug.

Can bisoprolol be changed to another drug without consulting a doctor?

No, the replacement of the drug should take place only on the prescription of a doctor who takes into account the individual characteristics of the patient and additionally conducts an examination. Independent choice of drugs can lead to negative health consequences.