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Of the 849 subjects randomized to treatment with both metoprolol succinate extended release and hydrochlorothiazide in a factorial clinical study, 129 15 were 65 and over, while 16 2 were 75 and over.
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Although beta-adrenergic receptor blockade is useful in the treatment of anginahypertensionand heart failure there are situations in which sympathetic stimulation is vitalIn patients with severely damaged heartsadequate ventricular function may depend on sympathetic driveIn the presence of AV blockbeta-blockade may prevent the necessary facilitating effect of sympathetic activity on conductionBeta 2adrenergic blockade results in passive bronchial constriction by interfering with endogenous adrenergic bronchodilator activity in patients subject buypropranolol. to bronchospasm and may also interfere with exogenous bronchodilators in such patients.
If clonidine and a beta blockersuch as metoprolol are coadministeredwithdraw the beta-blocker several days before the gradual withdrawal of clonidine because beta-blockers may exacerbate the rebound hypertension that can follow the withdrawal of clonidineIf replacing clonidine by betablocker therapydelay the introduction of beta-blockers for several days after clonidine administration has stoppedsee WARNINGS AND PRECAUTIONS
Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgeryhoweverthe impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.
This drug passes into breast milkDiscuss the risks and benefits with your doctor before breast-feeding.
If you have a severe allergic reaction to foodsmedicines or insect stingstell your doctor immediately.
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