Home Drug Guide Metipranolol Hydrochloride

Drug Guide

Generic Name

Metipranolol Hydrochloride

Brand Names Optipranolol

Classification

Therapeutic: Antihypertensive, Anti-anginal

Pharmacological: Beta-adrenergic blocker (beta-blocker)

FDA Approved Indications

Chronic stable angina pectoris
Hypertension (off-label or under additional approval)

Mechanism of Action

Metipranolol is a non-selective beta-adrenergic blocker that reduces myocardial oxygen demand by decreasing heart rate, myocardial contractility, and cardiac output, resulting in its anti-anginal and antihypertensive effects.

Dosage and Administration

Adult: Typically, 20 mg twice daily, titrated up to 40 mg twice daily as needed. Doses should be individualized based on patient response.

Pediatric: Not generally recommended for pediatric patients due to lack of sufficient data.

Geriatric: Start at lower doses due to increased sensitivity and potential comorbidities; monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; no specific dosage adjustments established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Extensively metabolized in the liver.

Excretion: Primarily excreted in the urine.

Half Life: Approximately 6-10 hours.

Contraindications

Severe bradycardia
Heart block greater than first degree (without pacemaker)
Cardiogenic shock
Uncompensated heart failure

Precautions

Use with caution in patients with asthma or other obstructive airway diseases, diabetes mellitus, and peripheral vascular disease.

Adverse Reactions - Common

Fatigue (Common)
Dizziness (Common)
Bradycardia (Less common)

Adverse Reactions - Serious

Severe hypotension (Rare)
Bronchospasm (in asthmatics) (Rare)
Heart block (Rare)

Drug-Drug Interactions

Other antihypertensives, calcium channel blockers, antiarrhythmics, cocaine, and clonidine — may enhance hypotensive effects.
May increase serum levels of concomitant drugs metabolized by hepatic enzymes.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and respiratory status regularly. Assess for signs of worsening heart failure and bronchospasm.

Diagnoses:

Risk for falls due to hypotension or dizziness.
Ineffective tissue perfusion related to bradycardia or hypotension.

Implementation: Administer with food if GI upset occurs, monitor for adverse effects, and educate patient about signs of hypotension and bradycardia.

Evaluation: Assess effectiveness by reduction in anginal attacks and blood pressure control.

Patient/Family Teaching

Take medication exactly as prescribed.
Do not suddenly stop medication to avoid rebound hypertension or angina.
Notify provider if symptoms worsen or if experiencing side effects like dizziness or slow heart rate.
Caution in activities requiring alertness until response to medication is known.

Special Considerations

Black Box Warnings:

None currently.

Genetic Factors: None established.

Lab Test Interference: May alter glucose and triglyceride levels.

Overdose Management

Signs/Symptoms: Severe bradycardia, hypotension, bronchospasm, loss of consciousness.

Treatment: Supportive measures including atropine for bradycardia, vasopressors for hypotension, and advanced cardiac life support as needed.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended storage conditions.