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because toprol-xl is metabolized by the liver, metoprolol blood levels are likely to increase substantially with poor hepatic function.

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reserpine and monamine oxidase mao inhibitors may increase or add to the effects of metoprolol.

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metoprolol moderate because the pharmacologic effects of metoprolol include depression of av nodal conduction and myocardial function, additive effects are possible when used in combination with cardiac glycosides, especially in patients with pre-existing left ventricular dysfunction.

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i have never given a 10mg dose of metoprolol iv all at once, due to the hypotension that it could potentially cause, and wonder if that is why it was dosed as it was, as a single dose.

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