1.LOPRESSOR HISTORY
(How was Lopressor discovered?)

Lopressor is a product of Novartis pharmaceuticals.

Novartis Pharmaceuticals Corporation is the U.S. affiliate of Novartis, a world leader in healthcare.

Novartis has core businesses in pharmaceuticals, consumer health, generics, eye care, and animal health. In the U.S., Novartis has quickly achieved a reputation as an industry leader. 

Note: World-drugs.net sells generic version of Lopressor

2.LOPRESSOR FACTS

Lopressor is indicated for the treatment of hypertension. It may be used alone or in combination with other drugs.

Novartis has been ranked for the first time in the top 100 best global brands of 2005, entering at 43rd place. With a brand value of $7.746 billion, Novartis is the strongest pharmaceutical brand after Pfizer and ranks ahead of Johnson & Johnson. 

3.ABOUT LOPRESSOR MEDICATION

What is High Blood Pressure (Hypertension)?

High blood pressure, also known as hypertension, is a serious disease affecting your heart and blood vessels. It occurs when the blood exerts too much pressure against the walls of the blood vessels. In fact, that is what the term hypertension means: "too much" (hyper) "pressure" (tension). It affects upwards of 58 million people nationwide.

High blood pressure is serious because it places you at risk for certain life threatening and disabling conditions. If left untreated, High blood pressure could lead to heart attack, kidney disease, and/or stroke.

This happens because as your blood continuously exerts too much pressure against the walls of the blood vessels, it places extra stress on the heart and blood vessels.

Blood pressure is measured in two numbers, systolic (top or higher number) and diastolic (lower number). The higher number is the maximum pressure, which occurs when the heart beats (systole), and the lower number is the lowest pressure measured when the heart relaxes between beats (diastole), just before the next contraction. A systolic reading of 140 or greater and a diastolic reading of 90 or greater is considered high.

The normal blood pressure is less than 120/80. In fact, for every 20/10 increase in blood pressure, your risk of cardiovascular events, such as heart attack or stroke, is DOUBLED.

 

Symptoms of High Blood Pressure

High blood pressure is sometimes called the "silent killer" because the symptoms are rarely seen or felt. So, even though it might be upsetting to be told that you have High blood pressure, it's good that your doctor has discovered it. Treatment can help avoid the serious, long-term effects of High blood pressure.

What are antihypertensives?

Antihypertensives are medications used to treat High blood pressure (hypertension). Although some patients do not need to take medication to control their High blood pressure, anyone who is prescribed medication needs to take it exactly as prescribed to avoid the serious medical problems associated with the condition. People taking Antihypertensives are also encouraged to make healthy lifestyle changes, such as quitting smoking, losing weight and getting regular exercise. Furthermore, they are encouraged to speak with their physician before taking any prescription medications, such as narcotics, or over-the-counter medications, such as diet pills.

Finally, people with High blood pressure are urged to be patient as the type and level of their medication are adjusted for optimal results. This is especially important because the vast majority of patients have no symptoms, making hypertension the silent killer.

There are a wide variety of Antihypertensives and combinations of different medications that are available, and it may take some time before the ideal treatment has been found and finely tuned to the patients needs.

Antihypertensives include:

Diuretics ("water pills")
Diuretics are sometimes called "water pills" because they work in the kidney and flush excess water and sodium from the body.

Beta Blockers
Beta-blockers reduce nerve impulses to the heart and blood vessels. This makes the heart beat slower and with less force. Blood pressure drops and the heart works less hard.

Alpha Blockers
Alpha-blockers reduce nerve impulses to blood vessels, which allows blood to pass more easily, causing the blood pressure to go down.

Alpha-Beta Blockers
Alpha-beta-blockers work the same way as alpha-blockers but also slow the heartbeat, as beta-blockers do. As a result, less blood is pumped through the vessels and the blood pressure goes down.

Nervous System Inhibitors
Nervous system inhibitors relax blood vessels by controlling nerve impulses. This causes the blood vessels to become wider and the blood pressure to go down.

Angiotensin Converting Enzyme (ACE) Inhibitors
Angiotensin converting enzyme (ACE) inhibitors prevent the formation of a hormone called angiotensin II, which normally causes blood vessels to narrow. The ACE inhibitors cause the vessels to relax and blood pressure goes down.

Calcium Channel Blockers
CCBs keep calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax and pressure goes down.

Angiotensin Receptor Blockers (formal medical name angiotensin-2-receptor antagonists, known as "sartans" for short). These agents are sometimes prescribed together, for instance an ACE inhibitor along with a calcium channel blocker.

Angiotensin antagonists shield blood vessels from angiotensin II. As a result, the vessels become wider and blood pressure goes down.

Some common beta-blockers include:

• Acebutolol
• Atenolol
• Betaxolol
• Bisoprolol
• Carteolol
• Metoprolol
• Nadolol
• Penbutolol
• Pindolol
• Propranolol
• Timolol

Lopressor
Lopressor is a beta-adrenergic blocking agent.

Lopressor blocks the action of the sympathetic nervous system, a portion of the involuntary nervous system. The sympathetic nervous system stimulates the pace of the heartbeat. By blocking the action of these nerves, Lopressor reduces the heart rate and is useful in treating abnormally rapid heart rhythms.

4.LOPRESSOR EFFECTIVENESS
(When is Lopressor best taken?)

In man, absorption of Lopressor is rapid and complete. Plasma levels following oral administration of Lopressor tablets, however, approximate 50% of levels following intravenous administration, indicating about 50% first-pass metabolism. Lopressor crosses the blood- brain barrier and has been reported in the CSF in a concentration 78% of the simultaneous plasma concentration.

Plasma levels achieved are highly variable after oral administration. Only a small fraction of the drug (about 12%) is bound to human serum albumin. Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. Less than 5% of an oral dose of Lopressor is recovered unchanged in the urine; the rest is excreted by the kidneys as metabolites that appear to have no clinical significance. 

5.LOPRESSOR EFFECTS ON SPECIAL POPULATION
(How do different people react to Lopressor?)

Lopressor has been shown to increase post-implantation loss and decrease neonatal survival in rats at dose of Lopressor up to 55.5 times the maximum daily human dose of Lopressor 450 mg. Distribution studies in mice confirm exposure of the fetus when Lopressor is administered to the pregnant animal. These studies have revealed no evidence of impaired fertility or teratogenicity. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. 

Nursing Mothers
Lopressor is excreted in breast milk in very small quantities. An infant consuming 1 liter of breast milk daily would receive a Lopressor dose of less than 1 mg of the drug. Caution should be exercised when Lopressor is administered to a nursing woman.

Pediatric Use
Safety and effectiveness in children have not been established.

6.LOPRESSOR EFFECTS ON MEDICAL CONDITIONS
(How does Lopressor affect your existing condition/ailment?)

Cardiac Failure:
Sympathetic stimulation is a vital component supporting circulatory function in congestive heart failure, and beta-blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure. In hypertensive and angina patients who have congestive heart failure controlled by digitalis and diuretics, Lopressor should be administered cautiously. Both digitalis and Lopressor slow AV conduction.

In Patients Without a History of Cardiac Failure:
Continued depression of the myocardium with beta-blocking agents over a period of time can, in some cases, lead to cardiac failure. At the first sign or symptom of impending cardiac failure, patients should be fully digitalized and/or given a diuretic. The response should be observed closely. If cardiac failure continues, despite adequate digitalization and diuretic therapy Lopressor should be withdrawn.

Ischemic Heart Disease:
Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred. When discontinuing chronically administered Lopressor, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1-2 weeks and the patient should be carefully monitored. If angina markedly worsens or acute coronary insufficiency develops, Lopressor administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician's advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue Lopressor therapy abruptly even in patients treated only for hypertension. 

Bronchospastic Diseases:
PATIENTS WITH BRONCHOSPASTIC DISEASES SHOULD, IN GENERAL, NOT RECEIVE BETA-BLOCKERS. Because of its relative beta1-selectivity, however, Lopressor may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. Since beta1- selectivity is not absolute, a beta2-stimulating agent should be administered concomitantly, and the lowest possible dose of Lopressor should be used.

Major Surgery:
The necessity or desirability of withdrawing beta-blocking therapy prior to major surgery is controversial; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures. 

Lopressor like other beta-blockers, is a competitive inhibitor of beta-receptor agonists, and its effects can be reversed by administration of such agents, e.g., dobutamine or isoproterenol. However, such patients may be subject to protracted severe hypotension. Difficulty in restarting and maintaining the heart beat has also been reported with beta- blockers.

Diabetes and Hypoglycemia:
Lopressor should be used with caution in diabetic patients if a beta-blocking agent is required. Beta- blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected.

Thyrotoxicosis:

Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of beta-blockade, which might precipitate a thyroid storm.

7.OTHER/ALTERNATE USES OF LOPRESSOR
(What else does Lopressor treat?)

Lopressor also reduces the force of heart muscle contraction and lowers blood pressure. By reducing the heart rate and the force of muscle contraction, Lopressor reduces heart muscle oxygen demand. Since angina occurs when oxygen demand of the heart exceeds supply,

Lopressor is helpful in treating angina.

8.ADVERSE/SIDE EFFECTS of LOPRESSOR
(What are the side effects of Lopressor?)

Hypertension and Angina
Most adverse effects have been mild and transient. The following adverse reactions have been reported for Lopressor.

Central Nervous System:
Tiredness and dizziness have occurred in about 10 of 100 patients. Depression has been reported in about 5 of 100 patients. Mental confusion and short-term memory loss have been reported. Headache, somnolence, nightmares, and insomnia have also been reported.

Cardiovascular:
Shortness of breath and bradycardia have occurred in approximately 3 of 100 patients. Cold extremities; arterial insufficiency, usually of the Raynaud type; palpitations; congestive heart failure; peripheral edema; syncope; chest pain; and hypotension have been reported in about 1 of 100 patients.

Respiratory:
Wheezing (bronchospasm) and dyspnea have been reported in about 1 of 100 patients.

Gastrointestinal:
Diarrhea has occurred in about 5 of 100 patients. Nausea, dry mouth, gastric pain, constipation, flatulence, digestive tract disorders and heartburn have been reported in about 1 of 100 patients.

Hypersensitive Reactions:
Pruritus or rash have occurred in about 5 of 100 patients. Worsening or psoriasis has also been reported.

Miscellaneous:
Peyronie's disease has been reported in fewer than 1 of 100,000 patients. Musculoskeletal pain, blurred vision, decreased libido and tinnitus have also been reported.

There have been rare reports of reversible alopecia, agranulocytosis, and dry eyes. Discontinuation of the drug should be considered if any such reaction is not otherwise explicable. The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with Lopressor.

Potential Adverse reactions
A variety of adverse reactions not listed above have been reported with other beta-adrenergic blocking agents and should be considered potential adverse reactions to extended release metoprolol succinate.

Central Nervous System:

Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics.

Cardiovascular:

Intensification of AV block.

Hematologic:

Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura.

Hypersensitive Reactions:

Fever combined with aching and sore throat, laryngospasm, and respiratory distress.