Metolar (metoprolol) is a beta-blocker used to manage hypertension, angina, rapid or irregular heartbeat, and similar conditions to prevent complications and maintain a high quality of life. It works by dilating blood vessels and slowing heart rate, which reduces the heart's workload while lowering blood pressure.

Metolar tablets are regular, fast-acting tablets. For some conditions, such as heart failure, long-acting versions of the medication are preferred, which can be found under the name Toprol XL.

What to Expect from Treatment

Metolar is a relatively slow-acting medication; it takes about a week from the start of treatment for maximum benefit to be acheived. Likewise modifications to dosage will not be fully realized for about a week. This is a maintenance medication, not a "rescue" treatment.

Treatment is typically long term, even for the remainder of life, unless the underlying cause of the condition is successfully resolved.

Metolar is usually started at low doses, gradually increased if lower doses fail to produce the desired results. In most cases treatment is similar to:

• Treatment starts with 100 mg per day for at least one week.
• Dosage may be increased weekly if the previous dose was not sufficient, up to 450 mg per day.
• The total dose is usually split into two doses taken twice per day, especially at higher doses.
• Doses should be taken with or immediately following a meal.
• Tablets may be split if they have a score line, but should not be crushed, chewed, or dissolved.
• Treatment may continue for as long as it provides benefit.
• If treatment ceases it should be done so gradually, reducing the daily dosage slowly over several weeks.

Treatment will likely need to be modified to some extent if other medications that influence blood pressure or heart rate are being taken along with Metolar.

Many patients may experience mild side effects in the first few weeks of treatment with Metolar; patients may feel tired, lightheaded, and generally feel run-down. These effects should fade away as the body adjusts to the medication and its new, lower blood pressure. Note that many symptoms of low blood pressure can occur even if blood pressure is still in normal ranges. If the above side effects become severe or persist past the first few weeks of treatment a doctor should be consulted.

Serious side effects like fainting, difficulty breathing, vision changes, and rapid or pounding heartbeat are not normal and warrant medical attention.

Off-Label Uses

Though not officially approved uses by regulatory agencies in most parts of the world, Metolar is sometimes used to manage a variety of other conditions, such as:

• Reducing the frequency, severity and duration of migraine headaches
• Minimizing mental and physical effects of anxiety
• Alleviating side effects of other medications

There are no widely-accepted dosage and administration guidelines for off-label uses. Patients are advised to find a doctor or organization familiar with using Metolar to treat a given condition prior to starting treatment.

Precautions

Metolar, like all beta-blockers, has properties than put certain individuals at greater risk of experiencing adverse reactions or complications, most notably:

• Beta-blockers may mask symptoms of hypoglycemia and hyperthyroidism.
• Beta-blockers are not recommended in patients with chronic breathing ailments, such as asthma or COPD.
• Beta-blockers inhibit the body's response to epinephrine. This can cause issues in those dependent on epinephrine to manage other conditions, as well as reduce effectiveness in emergency use of epi-pens, such as for anaphylactic shock or severe asthma attacks.
• Patients who have poor circulation are at greater risk of experiencing circulation complications.

Patients to whom the above conditions apply should discuss the risks of Metolar use carefully with a doctor before initiating treatment; there are many alternative options available which may prove less risky.