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because beta1 selectivity is not absolute use the lowest possible dose of metoprolol tartrate and consider administering metoprolol tartrate in smaller doses three times daily, instead of larger doses two times daily, to avoid the higher plasma levels associated with the longer dosing interval see dosage and administration .

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drugs that increase effects of antiadrenergic ophthalmic preparations 1 systemic antiadrenergics eg, propranolol, atenolol, when the client is receiving a topical beta blocker in ocular dis- metoprolol, nadolol, timolol orders, administration of systemic beta-blocking agents in cardio- vascular disorders may cause additive systemic toxicity.

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by blocking catecholamine-induced increases in heart rate, in velocity and extent of myocardial contraction, and in blood pressure, metoprolol reduces the oxygen requirements of the heart at any given level of effort, thus making it useful in the long-term management of angina pectoris.

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in patients without pre-excitation, intravenous metoprolol is recommended for the acute treatment in hemodynamically-stable patients and oral metoprolol is recommended for the ongoing management of symptomatic supraventricular tachycardias in patients who are not candidates for, or prefer not to undergo catheter ablation.

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