LOPRESSOR HCT Dosage & Rx Info | Uses, Side Effects

Lopressor Hct Generic Name & Formulations

Legal Class

General Description

Metoprolol tartrate, hydrochlorothiazide 50mg/25mg; scored tabs.

Pharmacological Class

Cardioselective beta-blocker + diuretic.

How Supplied

Tabs—100

Manufacturer

Validus Pharmaceuticals

Generic Availability

YES

Mechanism of Action

The mechanism of the antihypertensive effects of beta-blocking agents has not been elucidated. However, several possible mechanisms have been proposed: (1) competitive antagonism of catecholamines at peripheral (especially cardiac) adrenergic neuron sites, leading to decreased cardiac output; (2) a central effect leading to reduced sympathetic outflow to the periphery; and (3) suppression of renin activity. The mechanism of antihypertensive effect of thiazide diuretics is unknown.

Lopressor Hct Indications

Indications

Hypertension.

Lopressor Hct Dosage and Administration

Adult

Titrate individual components. Give in 1–2 divided doses. Max 50mg/day HCTZ.

Children

Not established.

Lopressor Hct Contraindications

Contraindications

Cardiogenic shock. Decompensated heart failure. Sinus bradycardia. Sick-sinus syndrome. Greater than 1^st-degree block, unless paced. Anuria. Sulfonamide allergy.

Lopressor Hct Boxed Warnings

Not Applicable

Lopressor Hct Warnings/Precautions

Warnings/Precautions

Ischemic heart disease. Worsening cardiac failure (reduce or interrupt dose if necessary). Bronchospastic disease. Conduction disorders (including Wolff-Parkinson-White). Monitor HR; reduce dose or discontinue if severe bradycardia occurs. Major surgery. Renal or hepatic impairment. Volume depletion. Diabetes. May mask signs and increase risk for hypoglycemia. Monitor serum electrolytes periodically. Peripheral vascular disease. Pheochromocytoma. Thyrotoxicosis (hyperthyroidism). History of severe anaphylactic reactions. Acute myopia. Secondary angle-closure glaucoma. SLE. Gout. Avoid abrupt cessation (gradually reduce dose over 1–2 weeks and monitor). Elderly. Pregnancy. Nursing mothers: monitor infants.

Lopressor Hct Pharmacokinetics

Distribution

HCTZ: Volume of distribution: 3.6–7.8 L/kg. Plasma protein bound: 67.9%.

Metabolism

Hepatic.

Elimination

Renal. Half-life: 10–17 hours (HCTZ); ~7.5 hours (metoprolol poor metabolizer); ~2.8 hours (metoprolol extensive metabolizers).

Lopressor Hct Interactions

Interactions

Additive effects with catecholamine-depleting drugs (eg, reserpine, monoamine oxidase). Potentiated by strong CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone); monitor closely if concomitant use is unavoidable. Risk of bradycardia with digitalis, clonidine, diltiazem, verapamil. Potentiated by alcohol, CNS depressants, other antihypertensives. Adjust antidiabetic medication. Decreased absorption with cholestyramine and colestipol resins. May increase lithium toxicity. Antagonized by NSAIDs. May antagonize epinephrine.

Lopressor Hct Adverse Reactions

Adverse Reactions

Fatigue, bronchospasm, dizziness, drowsiness, headache, fluid or electrolyte imbalance, bradycardia, depression, dyspnea, GI upset, blurred vision, tinnitus, earache, impotence, myalgia, cold extremities, CHF, heart block.

Lopressor Hct Clinical Trials

See Literature

Lopressor Hct Note