Disease relevance of metoprolol

• BACKGROUND: The African American Study of Kidney Disease and Hypertension was a multicenter trial of African Americans with hypertensive kidney disease randomized to an angiotensin-converting enzyme inhibitor (ramipril), a beta-blocker (metoprolol succinate), or a calcium channel blocker (amlodipine besylate) [1].
• A factorial study of combination hypertension treatment with metoprolol succinate extended release and felodipine extended release results of the Metoprolol Succinate-Felodipine Antihypertension Combination Trial (M-FACT) [2].
• Examination of serial Holter electrocardiographic recordings indicate that metoprolol succinate therapy was associated with a significant (P <.05) decrease in total ventricular ectopy at 8 weeks of therapy and a decrease in ventricular couplets and nonsustained ventricular tachycardia at 8 through 26 weeks of therapy [3].
• CONCLUSIONS: This study indicates that treatment with metoprolol succinate for a 6-month period is safe and well tolerated and is associated with an increase in left ventricular ejection fraction and a decrease in ventricular ectopic beats [3].
• METHODS: Thirty-three conscious, chronically instrumented dogs with pacing-induced (240 min(-1) for 4 weeks) dilated cardiomyopathy (DCM) were randomized to carvedilol (25 mg twice daily, Coreg, Glaxo Smith Kline, Research Triangle, North Carolina) or metoprolol succinate (100 mg qd, Toprol XL, Astra Zeneca, Wilmington, Delaware) [4].

High impact information on metoprolol

• OBJECTIVE: To examine the effects of the beta1-blocker controlled-release/extended-release metoprolol succinate (metoprolol CR/XL) on mortality, hospitalization, symptoms, and quality of life in patients with heart failure [5].
• Monotherapy with ER metoprolol succinate induced dose-related reductions in sitting systolic/diastolic BP (DBP) (mean 8.1/7.7 to 9.7/11.1 mm Hg) as did ER felodipine (mean 7.7/7.7 to 14.0/11.8) and the combinations reflected additive effects (mean 13.8/11.0 to 19.8/15.2) [2].
• A prototype formulation of metoprolol succinate using this technology was developed and the drug release from the formulation was adjusted to have a release profile which would match the circadian rhythm i.e. a higher amount of drug would be available after an initial lower release (accelerated type of release) [6].
• Carvedilol and extended-release metoprolol succinate are 2 beta-blockers currently approved in the United States for the treatment of patients with heart failure [7].
• The increase in left ventricular ejection fraction measure at baseline and 6 months measured by radioisotopic ventriculography was greater in the metoprolol succinate group (27. 5% to 36.3%) than in the placebo group (26% to 27.9%) (P <.015) [3].

Chemical compound and disease context of metoprolol

• OBJECTIVE: To evaluate the efficacy, tolerability, and blood pressure (BP) lowering effect of extended release metoprolol succinate (ER metoprolol) in children 6 to 16 years of age with established hypertension [8].

Biological context of metoprolol

• BACKGROUND: This study was designed to investigate the tolerability, safety, and effect on left ventricular function of a new long-acting preparation of metoprolol, metoprolol succinate (CR/XL) [3].
• Metoprolol succinate was used for blood pressure control, and there were no cardiovascular side effects and no significant increase in blood pressure detected [9].
• Each microcapsule acts as a diffusion cell and is designed to deliver metoprolol succinate at a near constant rate for about 20 hours independently of food intake, pH and other physiological variations [10].
• OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and tolerability of extended-release (ER) metoprolol succinate and its role in the management of chronic heart failure [11].
• When b-blocker therapy is considered, metoprolol succinate can be used to treat hypertension without adverse metabolic effects [12].

Associations of metoprolol with other chemical compounds

• CONCLUSIONS: ER metoprolol succinate therapy provides substantial mortality and morbidity benefits in patients with New York Heart Association class II and III heart failure who are stabilized on angiotensin-converting enzyme inhibitors and diuretics [11].
• Based on published clinical trial results, bisoprolol, carvedilol, and sustained-release metoprolol succinate are recommended for systolic HF [13].
• Drugs administered to maintain blood pressure and heart rate within acceptable levels included phenylephrine (3-4 mug kg(-1)), ephedrine (0.1-0.2 mg kg(-1)), nitroglycerine (50-150 mug kg(-1) h(-1)) and metoprolol succinate (30-80 mug kg(-1)) [14].

Gene context of metoprolol

• The objective of this study was to determine whether 3 months of treatment with extended-release metoprolol succinate would reduce C-reactive protein (CRP) levels [15].

Analytical, diagnostic and therapeutic context of metoprolol

• Of the 287 patients included, 143 received metoprolol succinate 100 mg/day, and 144 received no BB and served as the control group [16].
• We measured the effects of chronic beta-receptor blockade (beta-RB) on ISF NE and EP release using in vivo microdialysis in open-chest anesthetized dogs after 4 wk of MR with or without extended release of metoprolol succinate (100 mg/day) as well as in control dogs [17].
• Treatment was initiated with a very low dose with careful titration to a maximum target dose of 200 mg metoprolol succinate controlled release/extended release (CR/XL), or highest tolerated dose [18].
• In vivo studies were performed in 9 individuals receiving metoprolol succinate (190 mg/d) or carvedilol (50 mg/d) for 11 days in a randomized crossover design [19].
• Only three beta-blockers, carvedilol, bisoprolol and metoprolol succinate, have had favorable effects on prognosis in controlled clinical trials in the patients with chronic heart failure [20].

References