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Possible substitutes for atenolol could be metoprolol tartrate, metoprolol succinate, and bisoprolol.

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Consider treating the patient with intensive carePatients with myocardial infarction or heart failure may be prone to significant hemodynamic instabilitySeek consultation with a regional poison control center and a medical toxicologist as neededBeta-blocker overdose may result in significant resistance to resuscitation with adrenergic agentsincluding beta-agonistsOn the basis of the pharmacologic actions of metoprololemploy the following measures.

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Get emergency medical help if you have any of these signs of an allergic reactionhivesdifficulty breathingswelling of your facelipstongueor throat.

Plasma levels achieved are highly variable after oral administrationOnly a small fraction of the drugabout 12is bound to human serum albuminMetoprolol is a racemic mixture of Rand Senantiomersand is primarily metabolized by CYP2D6When administered orallyit exhibits stereoselective metabolism that is dependent on oxidation phenotypeElimination is mainly by biotransformation in the liverand the plasma half-life ranges from approximately 3 to 7 hoursLess than 5of an oral dose of metoprolol is recovered unchanged in the urinethe rest is excreted by the kidneys as metabolites that appear to have no beta-blocking activity.

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