Metoprolol is the most commonly prescribed beta-blocker in the U.S. Here’s what you need to know about Metoprolol’s effects on dentistry before your next patient comes in:
Generic Name: Metoprolol
Brand Name(s): Lopressor, Toprol, Toprol XL
Pronunciation: meh TOE pro lol
About this drug:
Metoprolol is a selective beta1-adrenergic receptor blocker used to treat high blood pressure. This may reduce the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
Metoprolol is also used for the long-term treatment of angina.
Metoprolol can also be used off-label for prevention/prophylaxis of migraine headache.
Dentistry-related tidbits:
Exercise caution when administering local anesthesia to a patient taking Metoprolol. Common local anesthetics (e.g. Articaine, Bupivacaine, Lidocaine, Mepivacaine, and Ropivacaine) can cause hypotension and bradycardia when combined with Metoprolol.
Also, ensure that the patient’s hypertension is controlled before giving Epinephrine.
Metoprolol may cause severe lightheadedness, tiredness, dizziness, hypotension, and syncope, especially in elderly patients.
Remind diabetic patients to check blood sugar levels regularly. Metoprolol may mask the signs and symptoms of hypoglycemia.
The combination of Carbamazepine and Metoprolol can cause PR interval prolongation, AV block, and bradycardia.
Metoprolol has numerous drug interactions with meds commonly prescribed by dentists (e.g. NSAIDs, steroids, narcotics, and more). Make sure to check for potential interactions before prescribing using a tool like Rx Check.
Fun facts:
According to ClinCalc, Metoprolol was the 6th most common medication in the U.S. in 2020, ranking at 66.4M prescriptions for 15M patients.
Metoprolol is a “selective” beta-blocker, meaning it’s less likely to affect breathing and insulin response than other nonselective beta-blockers.
There is an FDA Warning that abruptly stopping Metoprolol can cause chest pain or heart attack.
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