Metoprolol and asthma

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Metoprolol and Asthma: A Comprehensive Review

Introduction to Metoprolol and Asthma

Metoprolol is a beta1-adrenoceptor blocking agent commonly used to manage hypertension and other cardiovascular conditions. However, its use in patients with asthma is controversial due to potential respiratory side effects. This article synthesizes research findings on the effects of metoprolol in asthmatic patients, focusing on lung function, safety, and interactions with bronchodilators.

Effects on Lung Function in Asthmatic Patients

Impact on Forced Expiratory Volume (FEV1)

Several studies have investigated the impact of metoprolol on lung function, particularly FEV1, a critical measure of airway obstruction. At lower doses (100 mg daily), metoprolol does not significantly affect FEV1 in asthmatic patients . However, higher doses (200 mg daily) have been associated with a reduction in FEV1 and exacerbation of asthma symptoms in some patients 156. This suggests that while metoprolol can be used cautiously at lower doses, higher doses pose a risk of bronchoconstriction.

Comparison with Other Beta-Blockers

Metoprolol's effects on lung function have been compared with other beta-blockers. For instance, propranolol, a non-selective beta-blocker, significantly reduces FEV1 and increases airway resistance, making it less suitable for asthmatic patients 47. In contrast, cardioselective beta-blockers like metoprolol and practolol have a lesser impact on FEV1, although metoprolol still shows some degree of bronchoconstriction at higher doses 147.

Safety and Tolerability

Adverse Respiratory Events

The safety profile of metoprolol in asthmatic patients has been a subject of concern. Studies have reported that while lower doses are generally well-tolerated, higher doses can lead to significant bronchoconstriction and asthma exacerbations 125. In one study, seven out of fifteen patients had to discontinue metoprolol due to severe bronchoconstriction . This highlights the importance of careful dose management and monitoring in asthmatic patients.

Comparison with Other Treatments

When compared to other beta-blockers like atenolol and celiprolol, metoprolol tends to cause more respiratory side effects. Atenolol, for instance, has been shown to cause fewer asthma attacks and less bronchospasm, making it a preferred option for asthmatic patients requiring beta-blockade 810. Celiprolol, another cardioselective beta-blocker, has also been found to be safer, causing no significant changes in airway resistance or FEV1 .

Interaction with Bronchodilators

Combined Use with Beta2-Agonists

The interaction between metoprolol and bronchodilators like salbutamol and isoproterenol is crucial for managing asthma symptoms. Studies have shown that metoprolol can blunt the bronchodilatory effects of these agents, particularly at higher doses 567. However, when used in conjunction with optimal bronchodilator therapy, metoprolol at lower doses does not significantly inhibit the bronchodilatory response 139. This indicates that while metoprolol can be used in asthmatic patients, it should be combined with effective bronchodilator therapy to mitigate potential adverse effects.

Conclusion

Metoprolol, a cardioselective beta1-adrenoceptor blocker, can be cautiously used in asthmatic patients at lower doses (up to 100 mg daily) without significantly affecting lung function. However, higher doses pose a risk of bronchoconstriction and asthma exacerbations. Comparatively, atenolol and celiprolol are safer alternatives with fewer respiratory side effects. The combined use of metoprolol with bronchodilators is essential to ensure effective asthma management. Careful dose management and monitoring are crucial when prescribing metoprolol to asthmatic patients.

Sources and full results

Most relevant research papers on this topic

The effect of metoprolol and practolol on lung function and blood pressure in hypertensive asthmatics.

Metoprolol and practolol are equally effective beta1-adrenoceptor blocking drugs for hypertension in asthmatics, with no significant difference in lung function or blood pressure effects.

RCTHighly Cited

1976·

92citations

·H. Formgren

Respiratory and cardiac effects of metoprolol and bevantolol in patients with asthma

Metoprolol and bevantolol both have similar effects on standing heart rate and respiratory function in asthma patients, but their respiratory response cannot be predicted.

RCT

1986·

29citations

·Pearce Wilcox et al.

Osmotic release oral drug delivery system of metoprolol in hypertensive asthmatic patients. Pharmacodynamic effects on beta 2-adrenergic receptors.

The osmotic release oral metoprolol system does not significantly affect the effects of inhaled salbutamol on bronchomotor tone, skeletal muscle, and the circulatory system in hypertensive asthmatic patients.

RCT

1994·

16citations

·K. Bauer et al.

Comparison of effects of metoprolol and propranolol on asthmatic airway obstruction.

Metoprolol shows a better effect on asthmatic airway obstruction than propranolol, with less risk of bronchoconstriction.

1976·

65citations

·C. Skinner et al.

The effects of dilevalol, metoprolol, and placebo on ventilatory function in asthmatics.

Metoprolol significantly decreases forced expiratory volume in 1 second (FEV1) in asthmatics, while dilevalol and metoprolol both inhibit the isoproterenol response in FEV1 compared to placebo.

RCT

1988·

20citations

·S. Chodosh et al.

Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol.

Labetalol may be a safer antihypertensive than metoprolol for patients with concomitant bronchial asthma, as it increases FEV1 and has an antagonistic interaction with isoproterenol.

RCT

1986·

7citations

·C. Falliers et al.

Interaction of orally administered metoprolol, practolol and propranolol with isoprenaline in asthmatics

Propranolol effectively blocks the effects of isoprenaline on heart rate, FEV1, and tremor, while selective beta1-blocking agents do not inhibit the effect of isoprenaline on FEV1.

RCT

1976·

35citations

·G. Thiringer et al.

The effect of the cardioselective beta blocker celiprolol on pulmonary function in asthmatic patients.

Celiprolol appears to be a safe drug for treating asthmatic patients, with no significant change in airway resistance, FEV1, and MEF 50.

RCT

1986·

19citations

·R. Schindl et al.

Controlled-release metoprolol compared with atenolol in asthmatic patients: Interaction with terbutaline

The new controlled-release metoprolol formulation caused fewer adverse effects on 2-adrenoceptor mediated bronchodilatation than a clinically equivalent dose of atenolol in asthmatic patients.

RCT

2004·

15citations

·C. Löfdahl et al.

Asthma and beta-blockers

Atenolol is the preferred beta-blocker for asthma patients, as it causes less bronchospasm and has a similar blood pressure reduction as metoprolol, but with less impact on asthma symptoms.

RCT

2004·

16citations

·D. S. Lawrence et al.

Try another search

machine learning types

universe end

ghg greenhouse

climatic zones

anti drinking pill

the human genome