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metoprolol and acetylsalicylic acid

C07FX03

Forms & Strengths

Fixed-dose combination products containing metoprolol tartrate/succinate and acetylsalicylic acid (aspirin)
Common strengths vary by region (e.g., metoprolol succinate 50mg / aspirin 75mg or 100mg)

Adult Dosing

Hypertension or post-myocardial infarction: individualized based on component drugs, typically 1 tablet daily (e.g., metoprolol 50-100 mg + aspirin 75-100 mg once daily)

Pediatric Dosing

Safety and efficacy not established in pediatric patients; use not recommended

Indications

Secondary prevention of myocardial infarction and ischemic stroke in patients with hypertension and/or stable angina requiring concurrent beta-blocker and antiplatelet therapy
Management of chronic stable angina and hypertension

Mechanism of Action

Metoprolol: Selective beta-1 adrenergic receptor blocker, decreasing heart rate, cardiac output, and blood pressure
Acetylsalicylic acid (Aspirin): Irreversible inhibition of platelet cyclooxygenase-1 (COX-1), preventing the synthesis of thromboxane A2 and inhibiting platelet aggregation

Contraindications

Hypersensitivity to metoprolol, other beta-blockers, acetylsalicylic acid, or other NSAIDs
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
Sinus bradycardia, cardiogenic shock, overt cardiac failure, second- or third-degree AV block, sick sinus syndrome
Active pathological bleeding such as peptic ulcer or intracranial hemorrhage

Adverse Reactions

Metoprolol components: Bradycardia, hypotension, fatigue, dizziness, cold extremities, depression, bronchospasm
Aspirin components: Dyspepsia, gastrointestinal ulceration/bleeding, increased bleeding time, nausea, abdominal pain
Hypersensitivity reactions including rash and anaphylaxis

Drug Interactions

CYP2D6 inhibitors (e.g., bupropion, fluoxetine) may increase metoprolol plasma concentrations
Coadministration with other antiplatelets, anticoagulants, or NSAIDs increases the risk of severe bleeding
Concomitant use with calcium channel blockers (e.g., verapamil, diltiazem) may lead to excessive AV conduction slowing or bradycardia
Aspirin may diminish the natriuretic effect of loop diuretics and increase toxicity of methotrexate or valproic acid

Curated Content: Needs Vetting Before Put to Clinical Use