Metoprolol

DRUG INFORMATION

  ADULT
    - (2) Hypertension: Starting dose is 25 to 100 mg.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'dosage and
      administration', retrieved 2026-08-29
    - (2.1) Angina Pectoris: Starting dose is 100 mg.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'dosage and
      administration', retrieved 2026-08-29
    - (2.2) Heart Failure: Starting dose is 12.5 or 25 mg.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'dosage and
      administration', retrieved 2026-08-29

  CHILD
    - One hundred forty-four hypertensive pediatric patients aged 6 to 16 years were
      randomized to placebo or to one of three dose levels of metoprolol succinate (0.2,
      1 or 2 mg/kg once daily) and followed for 4 weeks. The study did not meet its
      primary endpoint (dose response for reduction in SBP). Some pre-specified
      secondary endpoints demonstrated effectiveness including: Dose-response for
      reduction in DBP, 1 mg/kg vs.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'pediatric
      use', retrieved 2026-08-29
    - Administer once daily. Titrate at weekly or longer intervals as needed and
      tolerated. (2) Hypertension: Starting dose is 25 to 100 mg. (2.1) Angina Pectoris:
      Starting dose is 100 mg. (2.2) Heart Failure: Starting dose is 12.5 or 25 mg.
      (2.3) Switching from immediate-release metoprolol to metoprolol succinate
      extended-release tablets: use the same total daily dose of metoprolol succinate
      extended-release tablets.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'dosage and
      administration', retrieved 2026-08-29
    - One hundred forty-four hypertensive pediatric patients aged 6 to 16 years were
      randomized to placebo or to one of three dose levels of metoprolol succinate (0.2,
      1 or 2 mg/kg once daily) and followed for 4 weeks.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'pediatric
      use', retrieved 2026-08-29

  RENAL IMPAIRMENT
    - Therefore, initiate therapy at doses lower than those recommended for a given
      indication; and increase doses gradually in patients with impaired hepatic
      function. 8.7 Renal Impairment The systemic availability and half-life of
      metoprolol in patients with renal failure do not differ to a clinically
      significant degree from those in normal subjects.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'use in
      specific populations', retrieved 2026-08-29

  HEPATIC IMPAIRMENT
    - Hepatic Impairment: Consider initiating metoprolol succinate therapy at low doses
      and gradually increase dosage to optimize therapy, while monitoring closely for
      adverse events.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'use in
      specific populations', retrieved 2026-08-29
    - In general, use a low initial starting dose in elderly patients given their
      greater frequency of decreased hepatic, renal, or cardiac function, and of
      concomitant disease or other drug therapy. 8.6 Hepatic Impairment No studies have
      been performed with metoprolol succinate extended-release tablets in patients with
      hepatic impairment.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'use in
      specific populations', retrieved 2026-08-29

  PREGNANCY
    - Risk Summary Untreated hypertension and heart failure during pregnancy can lead to
      adverse outcomes for the mother and the fetus (see Clinical Considerations).
      Source: US FDA label for metoprolol (metoprolol succinate), section 'pregnancy',
      retrieved 2026-08-29
    - Available data from published observational studies have not demonstrated a drug-
      associated risk of major birth defects, miscarriage, or adverse maternal or fetal
      outcomes with metoprolol use during pregnancy.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'pregnancy',
      retrieved 2026-08-29
    - However, there are inconsistent reports of intrauterine growth restriction,
      preterm birth, and perinatal mortality with maternal use of beta-blockers,
      including metoprolol, during pregnancy ( see Data ).
      Source: US FDA label for metoprolol (metoprolol succinate), section 'pregnancy',
      retrieved 2026-08-29

  BREASTFEEDING
    - Risk Summary Based on the published literature, beta-blockers (including
      metoprolol) may cause erectile dysfunction and inhibit sperm motility.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'nursing
      mothers', retrieved 2026-08-29
    - No evidence of impaired fertility due to metoprolol was observed in rats [see
      Nonclinical Toxicology (13.1) ].
      Source: US FDA label for metoprolol (metoprolol succinate), section 'nursing
      mothers', retrieved 2026-08-29
    - No fetal abnormalities were observed when pregnant rats received metoprolol orally
      up to a dose of 200 mg/kg/day, i.e., 10 times, the daily dose of 200 mg in a 60-kg
      patient. 8.2 Lactation Risk Summary Limited available data from published
      literature report that metoprolol is present in human milk.
      Source: US FDA label for metoprolol (metoprolol succinate), section 'use in
      specific populations', retrieved 2026-08-29