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Lopressor (metoprolol)
Cardioselective beta-1 adrenergic receptor blocker that reduces heart rate, blood pressure, and myocardial oxygen demand.
Metoprolol, marketed under the brand name Lopressor, is a generic cardioselective beta-1 adrenergic receptor blocker primarily indicated for hypertension. Its key strength lies in its well-established mechanism of reducing heart rate, blood pressure, and myocardial oxygen demand, making it a reliable option in the treatment of hypertension. The primary risk is the key composition patent expiry in 2028, which could intensify competition from other generics.
At a glance
| Generic name | metoprolol |
|---|---|
| Also known as | Lopressor, Toprol-XL, Betaloc |
| Sponsor | Generic (originally Ciba-Geigy/Novartis) |
| Drug class | Beta-1 selective blocker |
| Target | Beta-1 adrenergic receptor, Beta-2 adrenergic receptor, 5-hydroxytryptamine receptor 1A |
| Modality | Small molecule |
| Therapeutic area | Cardiovascular |
| Phase | FDA-approved |
| First approval | 1978-08-07 (United States) |
Mechanism of action
Metoprolol selectively blocks beta-1 adrenergic receptors in the heart, reducing heart rate, contractility, and blood pressure. Its cardioselectivity minimizes bronchospasm risk compared to non-selective beta-blockers. Available in immediate-release (tartrate) and extended-release (succinate) formulations. It is one of the most prescribed cardiovascular medications worldwide.
Approved indications
- Hypertension
- Angina Pectoris
- Myocardial Infarction
Common side effects
- Hypotension
- Bradycardia
- Tiredness
- Dizziness
- Depression
- Shortness of breath
- Diarrhea
- Rash
- Pruritus
- Nausea
- Dry mouth
- Constipation
Serious adverse events
- Death
- Stroke
- Worsening heart failure
- Worsening angina or myocardial infarction
- Syncope
- Hepatitis
- Agranulocytosis
- Chest pain
- Hallucinations
- Confusion
Drug interactions
- Catecholamine-depleting drugs (e.g., reserpine, MAO inhibitors)
- Epinephrine
- CYP2D6 Inhibitors (e.g., quinidine, fluoxetine, paroxetine, propafenone)
- Digitalis glycosides, clonidine, diltiazem, verapamil
- Clonidine
Key clinical trials
- A Comparison of the Effect of Intraoperative Administration of Metoprolol or Esmolol on General Anesthetic Requirement (NA)
- Evaluation of Efficacy and Safety of Metoprolol XR in Patients Having Heart Failure With Normal Ejection Fraction: A Randomised, Double Blind,Placebo Controlled Trial (Phase 2)
- Comparative Effectiveness of Carvedilol Versus Metoprolol Succinate in Heart Failure Patients With an Implantable Cardioverter Defibrillator (Phase 4)
- Optimising Pacing Therapy, Integrated Medical Therapy, and Catheter AbLation for Atrial Fibrillation in Heart Failure Trial (Phase 4)
- Racial Differences in the Natriuretic Peptide Response to Exercise and Beta-blockers (Phase 2)
- Rate Control in Atrial Fibrillation (Phase 3)
- Assessment of Metoprolol in the Prevention of Vasovagal Syncope in Aging Subjects (Phase 4)
- Role of Ivabradine on Heart Rate and Quality of Life in Patients With Mitral Stenosis in Sinus Rhythm - a Randomized Control Trial (Phase 4)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| FDA label | Mechanism, indications, dosing, boxed warnings, drug interactions |
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
Competitive intelligence
For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:
- Lopressor CI brief — competitive landscape report
- Lopressor updates RSS · CI watch RSS
- Generic (originally Ciba-Geigy/Novartis) portfolio CI