Metoprolol

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Morris J, Dunham A

Metoprolol

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Abstract

Metoprolol is FDA-approved for the treatment of 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 also is conflicting evidence regarding the optimal selection of a particular beta blocker in the treatment of 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] In a large randomized trial of over 50,000 patients in the 1990's, Metoprolol was shown to reduce mortality and re-infarction when used chronically after myocardial infarction.[8] Beta blockers have been shown to exert 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]

DrugBank Data that Cites this Article

Drugs

Metoprolol

Drug Carriers

Drug	Carrier	Kind	Organism	Pharmacological Action	Actions
Metoprolol	Serum albumin	Protein	Humans	No	Binder	Details