Cardiology · β₁-selective adrenergic blocker (extended release)
Metoprolol succinate (XL)
Dose
HF: 12.5–25 mg OD, double q2 weeks to 200 mg OD. Post-MI: 25–200 mg OD.
Mechanism
Selective β₁ blockade with sustained 24-h profile.
Indications
- • HFrEF
- • Post-MI secondary prevention
- • Angina
- • Rate control AF
Contraindications
- • Severe bradycardia
- • High-grade AV block
- • Acute decompensated HF
- • Cardiogenic shock
Use
Guideline β-blocker for HFrEF and post-MI.
Monitoring
HR, BP, symptoms, K+ if combined with MRA.
Side effects
- • Bradycardia
- • Hypotension
- • Fatigue
- • Depression
- • Nightmares
Pregnancy safety
Category C — labetalol preferred.
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
