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Metoprolol (Cardiosel): Indications And Considerations

Metoprolol (Cardiosel): Indications And Considerations

Did your doctor recently prescribe Cardiosel? If so, you may find this guide helpful. How does this medication work, and what precautions should you keep in mind? Find out here. 

What Is Cardiosel?

If your doctor prescribed this medication for you, chances are, you set an appointment for high blood pressure or chest pain. Or perhaps, the doctor noticed your rising blood pressure during a routine exam. 

After all, Cardiosel, with the generic name, metoprolol tartrate, is a common medicine for such complaints. Let’s learn more about its indications. 

Indications

In many cases, doctors give metoprolol tartrate to hypertensive patients. Metoprolol is a cardioselective beta blocker, which means they act more on the heart muscle and cells.  It is effective in slowing heart rate, decreasing cardiac contractility, increasing cardiac relaxation and decreased conduction time. Here’s a breakdown of its indications:

Hypertension

Cardiosel can help lower a person’s blood pressure by slowing the heartbeat and relaxing the blood vessels. Initially, the doctor may only give 50 to 100mg of this medicine, but they can increase it weekly (or longer) until the optimal blood pressure is reached (maximum dose is 450 mg daily). Note may not take effect until after a week of treatment. 

Angina Pectoris

Angina pectoris is the medical term for chest pain due to coronary heart disease. Cardiosel eases chest discomfort because the heart beats more slowly and relaxed blood vessels allow the heart to have more oxygen. The initial dose is 100 mg daily, but it can increase to 400 mg. 

Arrhythmias

Besides hypertension and chest pain, Cardiosel can also improve irregular heartbeats or arrhythmias. The initial dose may be up to 150 mg divided into up to 3 doses daily, but it can go as high as 300 mg. 

Myocardial Infarction

Cardiosel may also be given as an early treatment for myocardial infarction or heart attack to reduce the risk of death and the size of the affected area. It may also be given to patients who are recovering from heart attack. 

Note:

Besides these, the doctor may also prescribe Cardiosel to prevent migraine and as a treatment for thyrotoxicosis where there is increased thyroid hormone in the body.  However, these are non-FDA approved, off label indications.

Side Effects

As with any medicine, side effects may occur. These include drowsiness, dizziness, slow heartbeat, tiredness, and diarrhea.

Other common side effects are heart failure, bradycardia or heart block, cold extremities, bronchospasm, decreased libido, tinnitus, decreased exercise tolerance, and glucose intolerance. Furthermore, the drug may also mask hypoglycemia. 

If you notice or feel these symptoms, please consult your doctor immediately. Getting medical help is also necessary if you have symptoms of serious allergic reactions, such as trouble breathing, severe dizziness, rash, swelling of the face, mouth, and throat, as well as itching.

Considerations

On top of its indications, here are some of the most important things to know about Cardiosel:

1. It is not suitable for hypertensive and angina patients with certain conditions

Even if you have angina or hypertension, if your doctor determines you have at least one of these conditions, they will not recommend metoprolol tartrate:

  • Sinus bradycardia
  • Overt or decompensated cardiac failure
  • Severe peripheral arterial circulatory disorder
  • Pheochromocytoma, a usually benign tumor in the adrenal gland
  • Sick sinus syndrome
  • Heart block greater than the first degree

2. It’s not suitable for myocardial infarction patients who…

Cardiosel is also contraindicated in patients who had a heart attack and have:

  • Significant first degree, 2nd and 3rd degree heart block
  • Heart rate of less than 45 beats per minute
  • Systolic blood pressure (upper number) of less than 100 mmhg
  • Decompensated heart failure
  • Hypersensitivity to the drug and its components

3. Doctors are cautious in prescribing metoprolol to patients with history of noncompliance 

This medicine can cause withdrawal symptoms, such as angina and heart attack, and even hypertension and fast heart rates if stopped abruptly. Hence, NEVER stop taking Cardiosel without your doctor’s advice. If your doctor decides this medicine is no longer for you, they will most likely reduce the dose gradually. 

4. Additional precautions apply

Experts say there are precautions on those taking illicit drugs such as cocaine or methamphetamine and pregnant patients. Metoprolol is under Pregnancy Category C, which means while there are no human studies yet, animal studies indicated that the medicine increased post-implantation loss and decreased neonatal survival. 

5. Monitoring is necessary

Patients taking Cardiosel need to monitor their blood pressure and heart rate. 

Also, it’s crucial to note that while the medicine is excreted in the urine, it is metabolized by the liver. Hence, if the patient has history of liver problem, the doctor must know so doses can be adjusted accordingly.

Learn more about Heart Health here. 

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Disclaimer

Hello Health Group does not provide medical advice, diagnosis or treatment.

Cardiosel®, https://www.unilab.com.ph/products/cardiosel, Accessed July 20, 2022

Metoprolol, https://www.ncbi.nlm.nih.gov/books/NBK532923/, Accessed July 20, 2022

Metoprolol Tartrate 50 mg tablets, https://www.medicines.org.uk/emc/product/5345/smpc#gref, Accessed July 20, 2022

metoprolol tartrate 25 mg tablet, https://healthy.kaiserpermanente.org/health-wellness/drug-encyclopedia/drug.metoprolol-tartrate-25-mg-tablet.453953, Accessed July 20, 2022

Metoprolol Tartrate, https://www.sciencedirect.com/topics/medicine-and-dentistry/metoprolol-tartrate, Accessed July 21, 2022

 

Current Version

09/01/2022

Written by Lorraine Bunag, R.N.

Medically reviewed by Lauren Labrador, MD, FPCP, DPCC

Updated by: Lorraine Bunag, R.N.


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Written by Lorraine Bunag, R.N. · Updated Sep 01, 2022

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