Metoprolol succinate er 50 mg side effects
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Side Effects of Metoprolol Succinate ER 50 mg
Common Side Effects of Metoprolol Succinate ER
Metoprolol succinate ER, a beta-adrenergic blocker, is commonly prescribed for conditions such as hypertension and heart failure. However, like all medications, it comes with potential side effects. Common side effects include fatigue, dizziness, and gastrointestinal issues such as nausea and diarrhea1 2. These side effects are generally mild and often diminish as the body adjusts to the medication.
Hemodynamic Effects
Metoprolol succinate ER can have significant hemodynamic effects, particularly in patients with heart failure. Studies have shown that long-term use can lead to a decrease in cardiac index and stroke volume index, as well as an increase in systemic vascular resistance2. These changes can manifest as symptoms such as fatigue and shortness of breath, especially during the initial stages of treatment.
Impact on Plasma Concentrations and Drug Interactions
The pharmacokinetics of metoprolol succinate ER can be influenced by other medications. For instance, coadministration with the CYP2D6 inhibitor paroxetine significantly increases the plasma concentration of metoprolol, which could enhance its beta-blocking effects and potentially lead to more pronounced side effects such as bradycardia and hypotension5. This interaction underscores the importance of monitoring patients for adverse effects when metoprolol is taken alongside other medications.
Tolerability and Safety
In clinical trials, metoprolol succinate ER has been shown to be generally well-tolerated. A study involving heart failure patients indicated that the drug was associated with an increase in left ventricular ejection fraction and a decrease in ventricular ectopic beats, suggesting a favorable safety profile4. However, it is crucial to monitor for any adverse effects, particularly during the initial stages of therapy.
Bioequivalence and Adverse Events
Research comparing different formulations of metoprolol succinate ER has demonstrated bioequivalence, meaning that different brands of the medication are expected to have the same therapeutic effect and safety profile6. Adverse events reported in these studies were consistent with those observed in other clinical trials, with no significant differences between formulations.
Conclusion
Metoprolol succinate ER 50 mg is an effective medication for managing conditions like hypertension and heart failure, but it is not without its side effects. Common issues include fatigue, dizziness, and gastrointestinal disturbances. More serious hemodynamic changes can occur, particularly in heart failure patients, and drug interactions can significantly alter its pharmacokinetics. Despite these potential issues, the medication is generally well-tolerated and effective, making it a valuable option in cardiovascular therapy. Regular monitoring and patient education are essential to manage and mitigate these side effects effectively.
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Most relevant research papers on this topic
Metoprolol vs carvedilol in heart failure
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Rigorous JournalHemodynamic comparison of twice daily metoprolol tartrate with once daily metoprolol succinate in congestive heart failure.
Metoprolol tartrate and metoprolol succinate both produce similar hemodynamic and clinical effects in congestive heart failure patients, with once daily metoprolol succinate offering a faster initiation and potentially better treatment outcomes.
RCTThe effect of nebivolol versus metoprolol succinate extended release on asymmetric dimethylarginine in hypertension.
Metoprolol succinate extended release increases plasma asymmetric dimethylarginine and augmentation index in hypertensive patients, while nebivolol does not, suggesting different effects on these markers.
RCTMetoprolol CR/XL in patients with heart failure: A pilot study examining the tolerability, safety, and effect on left ventricular ejection fraction.
Metoprolol succinate (CR/XL) is a safe and well-tolerated treatment for heart failure, increasing left ventricular ejection fraction and decreasing ventricular ectopic beats.
RCTInfluence of Metoprolol Dosage Release Formulation on the Pharmacokinetic Drug Interaction With Paroxetine
Paroxetine interacts with both immediate-release and extended-release metoprolol formulations, resulting in greater beta-blockade and lost cardioselectivity, with the interaction being greater with extended-release metoprolol.
RCTRigorous JournalPharmacokinetics and bioequivalence of two metoprolol succinate extended release tablets in healthy Chinese subjects under fasting and fed conditions.
The test metoprolol ER tablet was bioequivalent to the reference metoprolol ER tablet (Betaloc ZOK) in healthy Chinese subjects under both fasting and fed conditions, with both formulations being well-tolerated by study participants.
RCTEfficacy and safety of extended release metoprolol succinate in hypertensive children 6 to 16 years of age: a clinical trial experience.
Extended release metoprolol succinate is an effective and well-tolerated treatment for hypertension in children aged 6-16 years.
RCT
Highly CitedEffects of metoprolol succinate extended release vs. amlodipine besylate on the blood pressure, heart rate, and the rate-pressure product in patients with hypertension.
Metoprolol succinate extended release effectively reduces early morning blood pressure, heart rate, and rate-pressure product compared to amlodipine in middle-aged patients with Stages 1 and 2 hypertension.
RCTA factorial study of combination hypertension treatment with metoprolol succinate extended release and felodipine extended release results of the Metoprolol Succinate-Felodipine Antihypertension Combination Trial (M-FACT).
Combining low-dose metoprolol succinate 25/felodipine 2.5 is as effective as high-dose monotherapy for lowering blood pressure, with better tolerability.
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Large Human TrialPharmacokinetic and pharmacodynamic properties of a new controlled-release formulation of metoprolol: A comparison with conventional tablets
The new controlled-release metoprolol formulation maintains a constant degree of 1-selective blockade without plasma peaks and troughs, offering potential benefits over conventional tablets.
Non-RCTHighly Cited