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Beta-Blocker

Metoprolol (IV/Oral — Cardiology)

Brand names: Betaloc, Lopresor

Metoprolol is a beta-1-selective beta-blocker used for angina, hypertension and arrhythmias, and, as a modified-release formulation, as an adjunct in stable chronic heart failure.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Administer once daily with food or after a meal. Titrate at weekly or longer intervals as needed and tolerated. ( 2 ) Hypertension: Recommended starting dosage is 100 mg daily, in single or divided doses. ( 2.1 ) Angina Pectoris: Recommended starting dosage is 100 mg daily, given as two divided doses. ( 2.2 ) Myocardial Infarction: The starting dosage depends upon tolerance of intravenous metoprolol, see full prescribing information. ( 2.3 ) 2.1 Hypertension Individualize the dosage of metoprolol tartrate tablets. Metoprolol tartrate tablets should be taken with or immediately following meals. The usual initial dosage is 100 mg daily in single or divided doses. Adjust dosage at weekly (or …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-06-10. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It selectively blocks beta-1 adrenoceptors, lowering heart rate, myocardial contractility and renin release, thereby reducing myocardial oxygen demand and blood pressure.

Prescribing in practice

  • Do not withdraw abruptly, especially in ischaemic heart disease, as rebound angina, hypertension or arrhythmia may occur; reduce the dose gradually.
  • Avoid in asthma and reversible obstructive airways disease, and in significant bradycardia, heart block or decompensated heart failure.
  • May mask the warning signs of hypoglycaemia, such as tachycardia, in patients with diabetes.

Monitoring

Monitor heart rate and blood pressure; in heart failure use the modified-release formulation, titrate slowly and review clinical status, watching for worsening symptoms or fluid retention.

Counselling the patient

  • Do not stop the medicine suddenly without medical advice.
  • It may cause tiredness, cold hands and feet, or dizziness.
  • If you have diabetes, note it can mask the early warning signs of a low blood sugar.

Evidence & guidelines

Established beta-blocker for ischaemic heart disease, hypertension, arrhythmia and (modified-release) heart failure (NICE NG106; NICE NG185).

Reference: MERIT-HF Trial (Lancet 1999); COMMIT Trial (Chen et al. Lancet 2005); ESC HF Guidelines 2021; SPC Betaloc; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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