Comparative Pharmacology
Head-to-head clinical analysis: BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER versus METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER versus METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE.
BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER vs METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective beta-1 adrenergic receptor antagonist; reduces heart rate, myocardial contractility, and blood pressure by blocking catecholamine effects at beta-1 receptors.
Metoprolol is a cardioselective beta-1 adrenergic receptor antagonist that reduces heart rate, myocardial contractility, and blood pressure. Hydrochlorothiazide is a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, increasing excretion of sodium and water, thereby reducing plasma volume and blood pressure.
Intravenous: For stable patients, an initial loading dose of 500 mcg/kg/min over 1 minute followed by a maintenance infusion of 50 mcg/kg/min for 4 minutes; if response is inadequate, increase maintenance infusion to 100 mcg/kg/min and repeat loading dose after 10 minutes. Titrate in 50 mcg/kg/min increments up to 200 mcg/kg/min. For intraoperative and postoperative use, see full prescribing information.
Oral: 50-100 mg metoprolol tartrate/12.5-25 mg hydrochlorothiazide once or twice daily; maximum 200 mg metoprolol/50 mg hydrochlorothiazide per day.
None Documented
None Documented
Terminal elimination half-life is approximately 9 minutes (range 8–10 minutes). Clinically, the half-life is consistent with rapid offset of effect upon discontinuation; steady state is achieved within 30 minutes of continuous infusion.
Metoprolol: 3–7 h (terminal), clinical context: may require twice-daily dosing; prolonged in hepatic impairment. Hydrochlorothiazide: 6–15 h (terminal), clinical context: supports once-daily dosing; prolonged in renal impairment.
Primarily metabolized by red blood cell esterases; <1% excreted unchanged in urine. Elimination is not dependent on renal or hepatic function.
Metoprolol: <5% renal (unchanged), >95% hepatic metabolism, metabolites excreted renally. Hydrochlorothiazide: >95% renal (unchanged).
Category C
Category C
Beta-Blocker
Beta-Blocker