From the FDA Drug Label
In controlled clinical studies, metoprolol has been shown to be an effective antihypertensive agent when used alone or as concomitant therapy with thiazide-type diuretics, at oral dosages of 100 to 450 mg daily
The recommended dosage range for metoprolol in hypertension is 100 to 450 mg daily. Increasing the dose to 75mg bid (150mg daily) is within the recommended range. Yes, you can increase metoprolol to 75mg bid for hypertension, as it falls within the established effective dosage range of 100 to 450 mg daily 1.
From the Research
I do not recommend increasing your metoprolol to 75mg twice daily without consulting your healthcare provider first, as metoprolol dosage adjustments for hypertension should only be made under medical supervision, as changes can affect your blood pressure control and potentially cause side effects.
Key Considerations
- Your doctor needs to evaluate your current blood pressure readings, assess how you're tolerating your current dose, review your complete medical history, and consider any other medications you're taking before making dosage changes.
- Metoprolol works by blocking beta receptors in the heart to reduce heart rate and force of contraction, thereby lowering blood pressure.
- While 75mg twice daily is within the potential dosing range for metoprolol, the appropriate dose varies significantly between individuals, as noted in studies such as 2.
Evidence-Based Guidance
- A study published in 2021 2 found that adding a new antihypertensive medication was less frequent and was associated with less intensification sustainability but slightly larger reductions in SBP, highlighting the importance of personalized treatment approaches.
- Another study from 2000 3 demonstrated the efficacy of metoprolol in reducing mortality and improving clinical status in patients with chronic heart failure, but did not directly address dosage adjustments for hypertension.
- The most recent and highest quality study 2 suggests that metoprolol dosage adjustments should be made with caution and under medical supervision.
Recommendations
- If you're concerned about your blood pressure control, contact your healthcare provider promptly to discuss your concerns and receive personalized guidance on any medication adjustments.
- Your healthcare provider will be able to assess your individual needs and make informed decisions about your metoprolol dosage, taking into account the latest evidence and guidelines, such as those discussed in 4 and 5.