Drugs Q & A

What If You Accidentally Took Double Dose of Metoprolol?

Metoprolol, sold under the brand name Lopressor, among others, is a selective β₁ receptor blocker medication. 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.

Metoprolol was approved for use in the United States in 1978 and is still widely used in the therapy of hypertension and angina pectoris, with more than 27 million prescriptions filled yearly. Metoprolol is also used to reduce the risk of cardiovascular mortality after acute myocardial infarction.

How should you take metoprolol?

Take metoprolol exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Metoprolol should be taken with a meal or just after a meal.

Take the medicine at the same time each day.

Swallow the capsule whole and do not crush, chew, break, or open it.

A Toprol XL tablet can be divided in half if your doctor has told you to do so. Swallow the half-tablet whole, without chewing or crushing.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You will need frequent medical tests, and your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using this medicine.

You should not stop using this medicine suddenly. Stopping suddenly may make your condition worse.

If you have high blood pressure, keep using metoprolol even if you feel well. High blood pressure often has no symptoms. You may need to use this medicine for the rest of your life.

Store at room temperature away from moisture and heat.

Metoprolol injection is given as an infusion into a vein. A healthcare provider will give you this injection in a medical setting where your heart and blood pressure can be monitored. Metoprolol injections are given for only a short time before switching you to the oral form of this medicine.

What to do if you accidentally took double dose of metoprolol?

When metoprolol is administered orally, it is almost completely absorbed in the gastrointestinal tract. The maximum serum concentration is achieved 20 min after intravenous administration and 1-2 hours after oral administration. The bioavailability of metoprolol is of 100% when administered intravenously and when administered orally, it presents about 50% for the tartrate derivative and 40% for the succinate derivative.

Metoprolol is a moderately lipophilic β-blocker that in overdose causes direct myocardial depression leading to bradycardia, hypotension, and the potential for cardiovascular collapse. Taking double dose metoprolol can cause dizziness, trembling and also make it difficult to breathe. The amount of metoprolol that can lead to an overdose varies from person to person.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Metoprolol Safety Information

You should not use metoprolol if you have a serious heart problem (heart block, sick sinus syndrome, slow heart rate), severe circulation problems, severe heart failure, or a history of slow heart beats that caused fainting.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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