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It is the prototype of cardio selective (ß1) blockers. Its potency to block cardiac stimulation is similar to propranolol & is less likely to worsen asthma, but not entirely safe. It may also be preferred to propranolol in diabetics receiving insulin or oral hypoglycaemics.

INDICATIONS: Hypertension, angina pectoris, acute myocardial infarction.

DOSAGE: Adult: 100-200 mg in two divided doses.

Children: 1-5 mg/kg/day in two divided doses.

CONTRA-INDICATIONS: Bradycardia, cardiogenic shock, 2nd or 3rd degree A.V. block, cardiac failure. Verapamil therapy. Br. Astham/COPD.

SPECIAL PRECAUTIONS: General anaesthesia, pregnancy, reduced cardiac reserve, C.C.F.

Paediatrics: reduced dose necessary.

Pregnancy: may pass in breast milk. Hence use only if clearly indicated.

Elderly: reduce the dose if necessary.

SIDE-EFFECTS: Headache, nightmares, hypotension, eye and skin reactions, bradycardia.

DRUG INTERACITONS: Cimetidine potentiates metoprolol, negative ionotropic effect with general anaesthetics. Bioavailability increased by food Enhancement of antihypertensive effect with diuretics and vasodialators, useful combination with digitalis.