EXP: 1
DAY (RT).
The dilutions listed are conservative guidelines
that can be used in non-acute conditions. The
infusion times were formulated to mimic the onset
of an oral formulation. (@ onset-oral= 45-60min).
Oral to IV conversion (2.5 to 1) : eg 50mg
oral=20mg IV (equivalent beta-blockade).
Lopressor may be given by IV bolus (HR, BP, and
EKG should be carefully monitored). IV therapy
permits rapid control of HR and contractility.
Post MI (early tx): 5 mg IV bolus x 3 doses q2
minutes. In patients who tolerate full 15 mg dose,
oral lopressor 50mg po q6h should be started 15
min after last IV dose x 48 hours.
Unstable angina: 5 mg IV bolus x3 q2min f/b 2 to 5
mg hourly titrated to min HR of 55 to 60 BPM or
min systolic BP of 80 . May switch to oral dosing
(50 to 100mg po q6h) after IV bolus therapy.
Supraventricular tachycardias(PAT, A-fib/flutter):
5 to 15 mg (usually 5 mg) over 2.5 min at 7.5min
intervals-usually a high response rate.
DOSAGE
AND ADMINISTRATION
Myocardial Infarction
Early Treatment: During the early phase of
definite or suspected acute myocardial infarction,
treatment with metoprolol tartrate can be
initiated as soon as possible after the
patient’s arrival in the hospital. Such
treatment should be initiated in a coronary care
or similar unit immediately after the patient’s
hemodynamic condition has stabilized.
Treatment in this early phase should begin with
the intravenous administration of three bolus
injections of 5 mg of metoprolol tartrate each;
the injections should be given at approximately
2-minute intervals. During the intravenous
administration of metoprolol tartrate, blood
pressure, heart rate, and electrocardiogram should
be carefully monitored.
In patients who tolerate the full intravenous dose
(15 mg), metoprolol tartrate tablets, 50 mg every
6 hours, should be initiated 15 minutes after the
last intravenous dose and continued for 48 hours.
Thereafter, patients should receive a maintenance
dosage of 100 mg twice daily (see Late Treatment
below).
Patients who appear not to tolerate the full
intravenous dose should be started on metoprolol
tartrate tablets either 25 mg or 50 mg every 6
hours (depending on the degree of intolerance) 15
minutes after the last intravenous dose or as soon
as their clinical condition allows. In patients
with severe intolerance, treatment with metoprolol
should be discontinued.
Late Treatment: Patients with
contraindications to treatment during the early
phase of suspected or definite myocardial
infarction, patients who appear not to tolerate
the full early treatment, and patients in whom the
physician wishes to delay therapy for any other
reason should be started on metoprolol tartrate
tablets, 100 mg twice daily, as soon as their
clinical condition allows. Therapy should be
continued for at least 3 months. Although the
efficacy of metoprolol beyond 3 months has not
been conclusively established, data from studies
with other beta blockers suggest that treatment
should be continued for 1 to 3 years.
Note: Parenteral drug products should be inspected
visually for particulate matter and discoloration
prior to administration, whenever solution and
container permit.
HOW SUPPLIED
Metoprolol Tartrate Injection, USP is available
as:
| NDC |
Container |
Concentration |
Fill |
Quantity |
| 0409–1778–35 |
CARPUJECT
with Luer Lock |
1
mg/mL |
5
mL |
3
cartridges per carton |
| 0409–2285–05 |
Ampul |
1
mg/mL |
5
mL |
3
ampuls per carton |
Store at 20 to 25°C
(68 to 77°F). [See USP Controlled Room
Temperature.] Do not freeze.
PROTECT FROM LIGHT. Retain in carton until time of
use.
Discard unused portion.
Revised: February, 2008
EN-1722
Hospira, Inc., Lake Forest, IL 60045 USA
|
