Dosage should be adjusted individually to avoid bradycardia. The tablets should be taken on an empty stomach. Concomitant intake of food increases the bioavailability of metoprolol with 40%. The following is valid as guidelines: Hypertension: 100-200 mg daily divided on one or two occasions. The tablets should be taken in the morning if once-daily dosage. In patients not responding to 200 mg, the dose could be combined with other antihypertensive agents, preferably diuretics and calcium antagonists of the dihydropyridine type, or increased.
Angina pectoris: 100-200 mg daily divided on two occasions. If needed, the dose can be combined with nitrates or increased.
Cardiac arrhythmias: 100-200 mg daily divided on two occasions. If needed, other antiarrhythmic agents may be added.
Prophylactic therapy after myocardial infarction: As maintenance dosage, 100 mg morning and evening.
Functional heart disorders with palpitations: 100 mg once daily, given as a single dose in the morning. If needed, the dose can be increased to 200 mg.
Migraine prophylaxis: 100-200 mg daily divided on two occasions.
Hyperthyroidism: The recommended dosage is 150-200 mg daily, divided in 3-4 doses. If needed, the dose can be increased.
Impaired renal function: The elimination rate is insignificantly affected by renal function, and dose adjustment is not needed in patients with impaired renal function.
Impaired hepatic function: Usually Betaloc is given in the same dose to patients suffering from liver cirrhosis as to patients with normal liver function. Only, when there are signs of serious impairment of liver function (e.g. shunt-operated patients) a dose reduction should be considered.
Elderly: Dose adjustment is not needed.
Children: There is limited experience with Betaloc treatment in children.