Metoprolol tartrate side effects
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Common Side Effects of Metoprolol Tartrate
Metoprolol tartrate, a beta-blocker used for heart conditions and high blood pressure, can cause several side effects. The most frequently reported side effects include bradycardia (slow heart rate) and hypotension (low blood pressure), especially after the first dose or in patients with certain genetic backgrounds that affect drug metabolism 14. Some patients may also experience subjective symptoms such as burning, itching, and tearing when the drug is used as an eye drop for glaucoma or ocular hypertension .
Cardiovascular Side Effects: Bradycardia and Hypotension
Bradycardia and hypotension are among the most significant side effects of metoprolol tartrate. These effects can be more pronounced in individuals who are poor metabolizers of the CYP2D6 enzyme, leading to higher drug levels in the body and stronger side effects 14. In some cases, these symptoms can persist even after stopping the medication . Both oral and intravenous forms of metoprolol can cause these cardiovascular effects, although in some studies, no clinically relevant changes in heart rhythm or blood pressure were observed at certain doses .
Genetic Factors and Side Effect Risk
The risk and severity of side effects from metoprolol tartrate can be influenced by genetic differences, particularly in the CYP2D6 enzyme. Poor and intermediate metabolizers may experience a greater reduction in heart rate, but overall rates of adverse effects do not differ significantly between genetic groups 14. Genetic testing may be considered for patients who experience strong side effects or are on multiple medications .
Other Systemic and Local Side Effects
When used as an eye drop, metoprolol tartrate can cause local side effects such as burning, itching, and tearing, but no significant systemic side effects were observed in the studied patients . In animal studies, sweating was noted as a side effect, but no major cardiovascular changes were seen at the tested doses .
Rare and Serious Side Effects: Liver Injury
There have been reports of liver injury associated with metoprolol tartrate, possibly due to the formation of reactive metabolites during drug metabolism. These metabolites can cause cytotoxicity in liver cells, and the risk may be reduced by inhibiting certain liver enzymes .
Hemodynamic Effects in Heart Failure
In patients with congestive heart failure, metoprolol tartrate can cause decreases in cardiac index and stroke volume, and increases in vascular resistance, similar to other forms of metoprolol. These effects are seen both acutely and with chronic use .
Conclusion
Metoprolol tartrate is generally well tolerated, but common side effects include bradycardia, hypotension, and local irritation when used as eye drops. Genetic factors can influence the risk of side effects, particularly in heart rate reduction. Rarely, liver injury may occur due to reactive metabolites. Monitoring and dose adjustments may be necessary for patients at higher risk of adverse effects.
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