Lopressor injection
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# Black Box Warning
FDA Package Insert for Lopressor injection contains no information regarding Black Box Warning.

# Overview
Lopressor injection is a anti-anginal, antiarrhythmic, beta-adrenergic blocker drug that is FDA approved for the treatment of acute myocardial infarction (AMI). Common adverse reactions include bradyarrhythmia, constipation, depression, diarrhea, dizziness, dyspnea, fatigue, headache, heart block, heart failure, hypotension, indigestion, nausea, pruritus, rash, and wheezing.

# Adult Indications and Dosage

## FDA-Labeled Indications and Dosage (Adult)
- Dosing Information
- Upon patient presentation: Lopressor injection 5 mg IV x 3 boluses at 2-min intervals
- 15 minutes after the full IV dose: Lopressor tablet 50 mg PO q6h for 2 days followed by Lopressor tablet 100 mg PO q12h (or Lopressor tablet 2550 mg PO q6h for 2 days if intolerable to the full IV dose; discontinue Lopressor in patients with severe intolerance.)
Lopressor injection is indicated in the treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality when used in conjunction with oral Lopressor maintenance therapy. Treatment with Lopressor injection can be initiated as soon as the patients clinical condition allows.
Early Treatment: During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor injection as soon as possible after the patients arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patients hemodynamic condition has stabilized. Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor injection each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor blood pressure, heart rate, and electrocardiogram.
In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see Warnings).

## Off-Label Use and Dosage (Adult)

### Guideline-Supported Use
- Developed by: American College of Cardiology (ACC) and American Heart Association (AHA)
- Class of Recommendation: Class I
- Level of Evidence: Level B
- Dosing Information
In the absence of preexcitation, intravenous administration of beta blockers (esmolol, metoprolol, or propranolol) or nondihydropyridine calcium channel antagonists (verapamil, diltiazem) is recommended to slow the ventricular response to atrial fibrillation in the acute setting, exercising caution in patients with hypotension or heart failure.

### NonGuideline-Supported Use
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# Pediatric Indications and Dosage

## FDA-Labeled Indications and Dosage (Pediatric)
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## Off-Label Use and Dosage (Pediatric)

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# Contraindications
- Ventricular fibrillation
- Hypersensitivity to digoxin

# Warnings
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# Adverse Reactions

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# Administration and Monitoring

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# IV Compatibility

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# Overdosage

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# Precautions with Alcohol
Alcohol-Lopressor injection interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

# Look-Alike Drug Names
- (Paired Confused Name 1a)  (Paired Confused Name 1b)
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