propranolol, block beta 1 and beta 2-adrenoceptors equally.Ĭardioselective beta-blockers, e.g. carvedilol, also bind to alpha-adrenoceptors and prevent contraction of vascular smooth muscle. Beta 3-adrenoceptors are located on adipocytes and are thought to be involved with fatty acid metabolism.Beta 2-adrenoceptors are located in vascular and bronchial smooth muscle.Beta 1-adrenoceptors (75%) are located in the heart.There are three main sub-types of beta-adrenoceptors: 3 Non-selective, cardioselective and vasodilating beta-blockersīeta-blockers are classified according to their adrenoceptor binding affinities ( Table 1), the degree In different cardiovascular conditions and co-morbidities is therefore timely. A review of the different properties of beta-blockers, their role Highlights the risk of depending on one beta-blocker. The recent disruption of the supply of metoprolol succinate where dispensing was limited to fortnightly or monthly amounts Reliance on one medicine may cause problems The innovator brand (Betaloc) was also heavily marketed in New angina, arrhythmia, heart failure, hypertension and post-myocardial infarction, it isĭosed once-daily and it is cardioselective (see below). It is likely that metoprolol succinate is the beta-blocker of choice among New Zealand prescribers because it has a 2 Why is metoprolol succinate prescribed so widely? This pattern of prescribing is different to other countries, such as Australia where less than 5% of patients are 4% were prescribed carvedilol or propranolol.72% were prescribed metoprolol succinate the seventh most prescribed medicine in New Zealand.In 2016, 325 000 people received a beta-blocker from a community pharmacy in New Zealand: 1 Metoprolol succinate is the most frequently prescribed beta-blocker in New Zealand Preferred for patients with co-existing chronic obstructive pulmonary disorder (COPD) because they cause less bronchoconstriction That are less likely to cause fatigue and cold extremities than non-specific beta-blockers and are often

Bisoprolol is an alternative to metoprolol succinate in many cases both are once-daily cardioselective beta-blockers.From 6-12 months onwards post-myocardial infarction, consider withdrawing beta-blockers for patients without heartįailure or arrhythmias, if re-vascularisation has occurred.Should also be withdrawn slowly, ideally over several months, to prevent rebound symptoms such as resting When a beta-blocker is initiated, a slow upwards titration of dose is recommended to minimise adverse effects.With the presence of co-morbidities, to individualise care for patients with cardiovascular conditions Beta-blockers are a diverse group of medicines and prescribers should consider their different properties, along.

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