Metoprolol

Metoprolol is a prescription medication used to treat the symptoms of Hypertension, Acute Myocardial Infarction, Congestive Heart Failure, Angina.

• Metoprolol is available under the following different brand names: Lopressor, Toprol XL, Kapspargo Sprinkle

Dosages of Metoprolol:

Adult and Pediatric dosage

Injectable solution (as tartrate)

• 1mg/1mL

Tablet (as tartrate)

• 25mg (generic)
• 50mg (generic, Lopressor)
• 100mg (generic, Lopressor)

Tablet, extended-release (Toprol XL [as succinate])

• 25mg
• 50mg
• 100mg
• 200mg

Capsule, extended-release (Kapspargo Sprinkle [as succinate])

• 25mg
• 50mg
• 100mg
• 200mg

Hypertension

Lopressor

Adults

• 100 mg/day orally initially in a single dose or divided every 12 hours; may be increased at intervals of 1 week or longer; not to exceed 450 mg/day

Pediatric

• Children 1-17 years: 1-2 mg/kg/day orally divided twice daily; not to exceed 6 mg/kg/day not to exceed 200 mg/day

Toprol XL

Adults

• 25-100 mg orally once daily initially; may be increased at intervals of 1 week or longer; usual range, 50-100 mg/day; not to exceed 400 mg/day

Pediatric

• Children 6 years of age or older: 1 mg/kg orally daily; not to exceed 50 mg/day initially; adjusted on basis of patient response; not to exceed 2 mg/kg/day not to exceed 200 mg/day

Kapspargo Sprinkles

Adults 

• Initial dose: 25-100 mg orally once daily in a single dose; adjust dosage at weekly (or longer) intervals until optimum blood pressure reduction is achieved
• Dosage above 400 mg/day not studied

Pediatric

• Children younger than 6 years of age: safety and efficacy not established
• Children 6 years of age or older: 1 mg/kg orally once daily, do not exceed 50 mg daily; adjust dosage according to blood pressure response
• Doses over 2 mg/kg (or over 200 mg) every day not studied 

Acute Myocardial Infarction

Early treatment

Lopressor

• 5 mg rapid IV every 2 minutes, up to 3 doses; then, 15 minutes after the last IV, 50 mg orally every 6 hours for 48 hours; then 50-100 mg orally every 12 hours
• If full IV dose is not tolerated: 25-50 mg orally every 6 hours after the last IV

Congestive Heart Failure

Toprol XL

• 25 mg orally once per day initially; increased every 2 weeks as needed; target dosage 200 mg/day
• New York Heart Association (NYHA) greater than class II: Reduce dosage 12.5 mg/day

Kapspargo Sprinkle

• Before initiation, stabilize dose of other heart failure drug therapy and ensure the patient is not fluidly overloaded
• Initial dose: 25 mg orally once daily for 2 weeks
• Not suitable for initial therapy in patients who are expected to require a starting dose of less than 25 mg/day
• Individualized dose and closely monitor during up-titration; double dose every 2 weeks to the highest dose level tolerated or up to 200 mg

Angina

Lopressor

• 100 mg/day orally initially divided every 12 hours; may be increased at intervals of 1 week or longer; not to exceed 400 mg/day

Toprol XL

• 100 mg/day orally initially; may be increased at intervals of 1 week or longer; not to exceed 400 mg/day

Kapspargo Sprinkle

• Usual initial dose: 100 mg orally once a day, given in a single dose; gradually increase the dose at weekly intervals until an optimum clinical response is achieved or there is a pronounced slowing of the heart rate
• Dosages above 400 mg/day have not been studied
• If treatment is to be discontinued, gradually reduce the dose over a period of 1-2 weeks

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.