Metoprololdosage

Adult Hypertension: Usual initial dosage is 25 to 100 mg once daily. Titrate weekly (or longer) to optimal blood pressure.

Pediatric Hypertension 6 years of age and older: The recommended starting dose is 1 mg/kg, once daily and titrate to response. Do not exceed a maximum initial dose of 50 mg once daily.

Angina Pectoris: Usual initial dosage is 100 mg once daily. Titrate weekly based on clinical response.

Heart Failure: The recommended starting dose is 25 mg once daily doubled every two weeks to the highest dose tolerated or up to 200 mg.

2.1 Hypertension

Adults: The usual initial dosage is 25 mg to 100 mg once daily in a single dose. Adjust dosage at weekly (or longer) intervals until optimum blood pressure reduction is achieved. Dosages above 400 mg per day have not been studied. Pediatric Hypertensive Patients 6 Years of age or older: The recommended starting dose of KAPSPARGO Sprinkle is 1 mg/kg once daily, the maximum initial dose should not exceed 50 mg once daily. Adjust dosage according to blood pressure response. Doses above 2 mg/kg (or in excess of 200 mg) once daily have not been studied in pediatric patients. KAPSPARGO Sprinkle has not been studied in pediatric patients less than 6 years of age.

2.2 Angina Pectoris

Individualize the dosage of KAPSPARGO Sprinkle. The usual initial dosage is 100 mg once daily, given in a single dose. Gradually increase the dosage at weekly intervals until optimum clinical response has been obtained or there is a pronounced slowing of the heart rate. Dosages above 400 mg per day have not been studied. If treatment is to be discontinued, reduce the dosage gradually over a period of 1 to 2 weeks.

2.3 Heart Failure

Prior to initiation of KAPSPARGO Sprinkle, stabilize the dose of other heart failure drug therapy and ensure that the patient is not fluid overloaded. The recommended starting dose of KAPSPARGO Sprinkle is 25 mg once daily for two weeks. KAPSPARGO Sprinkle is not suitable for initial therapy in patients who are expected to require a starting dose less than 25 mg daily. Dosage must be individualized and closely monitored during up-titration. Double the dose every two weeks to the highest dosage level tolerated by the patient or up to 200 mg of KAPSPARGO Sprinkle. If a patient experiences symptomatic bradycardia, reduce the dose of KAPSPARGO Sprinkle. If transient worsening of heart failure occurs, consider treating with increased doses of diuretics, lowering the dose of KAPSPARGO Sprinkle or temporarily discontinuing it. The dose of KAPSPARGO Sprinkle should not be increased until symptoms of worsening heart failure have been stabilized. Initial difficulty with titration should not preclude later attempts to introduce KAPSPARGO Sprinkle. For patients who are taking metoprolol succinate extended-release tablets at a dose of 25 mg to 200 mg once daily, substitute KAPSPARGO Sprinkle for metoprolol succinate extended-release tablets, using the same total daily dose of metoprolol succinate.

2.4 Administration KAPSPARGO

Sprinkle should be swallowed whole. For patients unable to swallow an intact capsule, alternative administration options are available. Directions for use with soft food (applesauce, pudding, or yogurt) For patients with swallowing difficulty, KAPSPARGO Sprinkle can be opened and contents can be sprinkled over soft food. The contents of the capsules should be swallowed along with a small amount (teaspoonful) of soft food (such as applesauce, pudding, or yogurt). The drug/food mixture should be swallowed within 60 minutes and not stored for future use. Nasogastric tube administration Open and add contents of capsule to an all plastic oral tip syringe and add 15 mL of water. Gently shake the syringe for approximately 10 seconds. Promptly deliver through a 12 French or larger nasogastric tube. Ensure no pellets are left in the syringe. Rinse with additional water if needed.