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Cardiogenic shock.
Sick-sinus syndrome (provided there is no permanent pacemaker).
AV-block of second and third degree.
Patients with unstable, not compensated heart failure (pulmonary oedema, hypoperfusion or hypotension), and patients with continuous or intermittent inotropic therapy acting through beta-receptor agonism.
Symptomatic bradycardia or hypotension. Metoprolol should not be given to patients with suspected acute myocardial infarction as long as the heart rate is < 45 beats/min, the P-Q interval is > 0.24 sec or the systolic blood pressure is < 100 mm Hg.
In the indication heart failure, patients with repeated supine blood pressure below 100 mmHg should be re-evaluated before treatment is initiated.
Serious peripheral vascular disease with gangrene threat.
Hypersensitivity to the active substance, to other beta-blockers or to any of the excipients specified in Description.
