The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. The dilutions listed are conservative guidelines that can be used in non-acute conditions. The infusion times were formulated to mimic the onset of an oral formulation. Oral to IV conversion (2.5 to 1) : eg 50mg oral=20mg IV (equivalent beta-blockade). Lopressor may be given by IV bolus (HR, BP, and EKG should be carefully monitored). IV therapy permits rapid control of HR and contractility. Post MI (early tx): 5 mg IV bolus x 3 doses q2 minutes. In patients who tolerate full 15 mg dose, oral lopressor 50mg po q6h should be started 15 min after last IV dose x 48 hours. Unstable angina: 5 mg IV bolus x3 q2min f/b 2 to 5 mg hourly titrated to min HR of 55 to 60 BPM or min systolic BP of 80 . METOPROLOL TARTRATE IMMEDIATE RELEASE TABLETS: Initial dose: 100 mg orally per day in single or divided doses Maintenance dose: 100 to 450 mg orally per day Comments: -May increase dose at weekly, or longer, intervals. -Lower once-daily doses may not maintain full effect at the end of the 24-hour period; larger or more frequent daily doses may be required. Beta-1 selectivity diminishes as the dose is increased. METOPROLOL SUCCINATE EXTENDED RELEASE TABLETS: Initial dose: 25 to 100 mg orally once a day Maintenance dose: 100 to 400 mg orally once a day Comments: -May increase dose at weekly, or longer, intervals. Initial dose: -Metoprolol tartrate immediate release tablets: 50 mg orally twice a day -Metoprolol succinate extended release tablets: 100 mg orally once a day Maintenance dose: 100 to 400 mg per day Comments: -Increase dose at weekly intervals until optimum clinical response has been obtained or pronounced slowing of heart rate occurs. METOPROLOL TARTRATE: Early Treatment: Initial dose: 5 mg IV every 2 minutes as tolerated for 3 doses -Patients tolerant of full IV dose (15 mg): 50 mg orally every 6 hours starting 15 minutes after the last IV dose and continued for 48 hours -Patients intolerant of full IV dose (15 mg): 25 or 50 mg orally every 6 hours depending on the degree of intolerance starting 15 minutes after the last IV dose or as soon as their clinical condition allows Late Treatment: Maintenance dose: 100 mg orally twice a day Comments: -Patients with contraindications to treatment during the early phase of suspected or definite myocardial infarction, patients who appear not to tolerate the full early treatment, and patients in whom the physician wishes to delay therapy for any other reason should be started on 100 mg orally twice a day as soon as their clinical condition allows. -Continue therapy for at least 3 months; efficacy beyond 3 months has not been conclusively established; data from studies with other beta blockers suggest a treatment duration of 1 to 3 years. Use: Treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality. Treatment with the IV formulation can be initiated as soon as the patient's clinical condition allows. Alternatively, treatment can begin within 3 to 10 days of the acute event. Metformin synthesis Xanax 300 mg Sildenafil high blood pressure Patients who fail to tolerate the full intravenous dose should be given half the suggested oral dose. Renal impairment. agents but should have little influence on the bronchodilator effects of beta 2-agonists at normal therapeutic doses. Metoprolol may impair the elimination of lidocaine. Detailed Metoprolol dosage information for adults and children. -Patients tolerant of full IV dose 15 mg 50 mg orally every 6 hours starting. Metoprolol IV Mylan 5 mg/5 mL injection solution vial contains 5 mg of. In therapeutic doses, metoprolol tartrate has less effect on the. Whether a rate control or rhythm control strategy is chosen is very specific to each individual patient. Factors to consider are: ability to tolerate medications, degree of symptoms, degree of functional limitation, occupation, age, and other co-morbidities. While many practitioners may have preferences for a particular strategy, the ACC recommends following the guidelines referenced below hypotension, heart block, sinus bradycardia, bronchospasm, HF, pulmonary toxicity, s kin discoloration, hypothyroidism, hyperthyroidism, corneal deposits, optic neuropathy, warfarin interaction See black box warnings for this drug hypotension, bradycardia, QT prolongation, torsades de pointes (rare), GI upset, constipation, phlebitis (IV), photosensitivity, pulmonary toxicity, polyneuropathy, hepatic toxicity, thyroid dysfunction, eye complications See black box warnings for this drug *Drugs are listed alphabetically. † Dosages given in the table may differ from those re commended by the manufacturers. **Refer to prescribing information for more complete information. § Amiodarone can be useful to control heart rate in patients with atrial fibrillation when other measures are unsuccessful or c ontraindicated Notes: AF = atria l fibrillation; BID = twice a day; GI = gastrointestinal; IV = intravenous; HR = heart rate; HF = heart failure; N/A = not ap plicable. Click on drug names in table for more detailed usage information for each drug. 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: 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. Metoprolol iv dose Metoprolol Tartrate metoprolol tartrate dose., Metoprolol Dosage Guide with Precautions - Anyone buy propecia online Metoprolol 1,2 IV 2.5-5 mg bolus over 2 min, up to 3 doses N/A hypotension, heart block, bradycardia, bronchospasm, HF. 25-100 mg twice daily. May use metoprolol succinate ER 25-200 mg daily Same as starting dose Verapamil 1,2,4 IV 0.075-0.15 mg/kg over 2 mins. 2 nd bolus can be given in 15-30 mins if. American College of. Recommended Therapies for Heart Rate and Rhythm Control in.. Metoprolol iv mylan - au. UpToDate. Post MI early tx 5 mg IV bolus x 3 doses q2 minutes. In patients who tolerate full 15 mg dose, oral lopressor 50mg po q6h should be started 15 min after last IV. Metoprolol, marketed under the tradename Lopressor among others, is a medication of the selective β 1 receptor blocker type. It is used to treat high blood pressure, chest pain due to poor blood flow to the heart, and a number of conditions involving an abnormally fast heart rate. 3 Intravenous administration of metoprolol is more effective than oral administration in the. Dosage of metoprolol was adjusted according to heart rate.