From the Guidelines
The highest dose of Lopressor (metoprolol tartrate) that can be administered is 200 mg daily, as tolerated, according to the most recent guidelines. This dose is recommended for patients with ST-elevation myocardial infarction, without contraindications, as stated in the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction 1. The dosing should be individualized, starting with 25 to 50 mg every 6 to 12 hours orally, and then transitioning to twice-daily dosing of metoprolol tartrate or to daily metoprolol succinate, titrating to a daily dose of 200 mg as tolerated.
Key considerations for dosing Lopressor include:
- Starting with lower doses and gradually increasing as needed and tolerated
- Monitoring for signs of heart failure, low output state, increased risk of cardiogenic shock, prolonged first-degree or high-grade AV block, and reactive airways disease
- Avoiding use in patients with certain contraindications, such as signs of heart failure, low output state, or reactive airways disease
- Titration of the dose should be based on heart rate and blood pressure response.
It's essential to note that the dosing of Lopressor should be tailored to each patient's response and tolerance, with careful monitoring for potential side effects, such as bradycardia, hypotension, and heart failure exacerbation, as recommended by the guideline 1.
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 oral dosage used in these studies ranged from 100 to 400 mg daily
The highest dose of Lopressor (metoprolol) is 450 mg daily 2.
From the Research
Highest Dose of Lopressor
- The highest dose of Lopressor, also known as metoprolol, is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, the studies discuss the efficacy and safety of metoprolol in various cardiovascular conditions, including hypertension, heart failure, and atrial fibrillation.
- According to the studies, metoprolol is generally well-tolerated and effective in reducing blood pressure and improving outcomes in patients with cardiovascular diseases 3, 5, 7.
- The optimal dose of metoprolol may vary depending on the specific condition being treated and the individual patient's response to the medication 3, 5.
- Some studies suggest that metoprolol succinate, a controlled-release formulation of metoprolol, may be associated with significant mortality and morbidity benefits in the treatment of heart failure 5.
- However, the choice of beta-blocker and the optimal dose may depend on various factors, including the patient's medical history, comorbidities, and concomitant medications 6, 7.