Does metoprolol cause edema
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Metoprolol and Edema: Analyzing the Evidence
Introduction to Metoprolol and Edema
Metoprolol, a beta-1 selective adrenergic receptor blocker, is commonly prescribed for conditions such as hypertension, angina, and heart failure. However, its potential side effects, including the risk of edema, are a concern for both patients and healthcare providers. This article synthesizes research findings to determine whether metoprolol causes edema.
Angioedema and Metoprolol
Case Study of Severe Angioedema
A notable case involved a 72-year-old woman who developed severe angioedema after receiving intravenous metoprolol. The patient had a history of angioedema from lisinopril but no prior exposure to beta-blockers. The angioedema resolved with intravenous steroids and diphenhydramine hydrochloride 1. This case highlights that metoprolol can cause severe angioedema in certain individuals, although such reactions are rare.
Pulmonary Edema and Metoprolol
Protective Role in Tocolytic Therapy
Research involving anesthetized dogs indicated that metoprolol might prevent fluid displacement into the lung interstitium, which is a precursor to pulmonary edema. The study showed that metoprolol counteracted the hemodynamic changes and increased pulmonary capillary permeability induced by beta-sympathicomimetics, suggesting a protective role against pulmonary edema in this context 2. This finding implies that metoprolol may reduce the risk of pulmonary edema when used alongside beta-sympathicomimetics.
Peripheral Edema and Metoprolol
Comparative Study with Nebivolol
A study comparing nebivolol and metoprolol in patients with hypertension found that both drugs, when combined with amlodipine, resulted in some cases of peripheral edema. Specifically, 5.9% of patients on the metoprolol and amlodipine combination experienced swelling of the legs and feet 3. This suggests that while metoprolol can cause peripheral edema, the incidence is relatively low and comparable to other beta-blockers.
Conclusion
The evidence indicates that metoprolol can cause different types of edema, including angioedema and peripheral edema, although these occurrences are relatively rare. In specific therapeutic contexts, such as tocolytic therapy, metoprolol may even have a protective effect against pulmonary edema. Patients and healthcare providers should be aware of these potential side effects and monitor for symptoms of edema during metoprolol therapy.
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