Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or nurse.
• If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Betaloc IV is and what it is used for
2. What you need to know before you use Betaloc IV
3. How to use Betaloc IV
4. Possible side effects
5. How to store Betaloc IV
6. Contents of the pack and other information

Do not have Betaloc IV Injection

• If you are allergic to metoprolol tartrate or any of the other ingredients of this medicine (listed in section 6).
• If you are allergic to any other beta-blocker medicines (such as atenolol or propanolol).
• If you have ever had any of the following heart problems:
  • heart attack with shock
  • heart failure which is not under control (this usually makes you breathless and causes your ankles to swell)
  • second- or third-degree heart block (a condition which may be treated by a pacemaker)
  • very slow or very uneven heart beats (unless a permanent pacemaker is in place).
• If you have low blood pressure which may make you feel faint.
• If you have very poor circulation.
• If you have a tumour called phaeochromocytoma that is not being treated. This is usually near your kidney and can cause high blood pressure. If you are being treated for phaeochromocytoma your doctor will give you another medicine called an alpha-blocker, to take as well as your Betaloc IV Injection.
• If you have been told that you have higher than normal levels of acid in your blood (metabolic acidosis).

If any of the above apply to you, do not have Betaloc IV Injection. If you are not sure, talk to your doctor or nurse before having Betaloc IV Injection.

Warnings and precautions

Talk to your doctor or nurse before using Betaloc IV Injection

• If you have asthma, wheezing or any other similar breathing problems, or you get allergic reactions, for example to insect stings, foods or other substances. If you have ever had asthma or wheezing, do not have this medicine without first checking with your doctor.
• If you have a type of chest pain (angina) called Prinzmetal's angina.
• If you have poor blood circulation or controlled heart failure.
• If you have first-degree heart block.
• If you have problems with your liver.
• If you have diabetes. Your treatment for diabetes may need to be adjusted.
• If you have thyrotoxicosis (a condition caused by an overactive thyroid gland). Your medicine may hide the symptoms of thyrotoxicosis.
• If you have or have ever had psoriasis (a skin condition).

If you are not sure if any of the above apply to you, talk to your doctor before having Betaloc IV Injection.

Other medicines and Betaloc IV Injection

Tell your doctor or nurse if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because Betaloc IV Injection can affect the way some other medicines work and some medicines can have an effect on Betaloc IV Injection.

In particular, tell your doctor or nurse if you are taking any of the following medicines:

• Clonidine (for high blood pressure or migraine). If you are taking clonidine and Betaloc IV Injection together, do not stop taking clonidine unless your doctor tells you to do so. If you have to stop taking clonidine or Betaloc IV Injection, your doctor will give you careful instructions about how to do it.
• Medicines called Mono-Amine Oxidase Inhibitors (MAOIs).
• Verapamil, diltiazem or nifedipine (for high blood pressure or chest pain).
• Quinidine, amiodarone or digoxin (for heart problems).
• Hydralazine (for high blood pressure).
• Medicines for stomach ulcers (such as cimetidine).
• Medicines for infections caused by bacteria (such as rifampicin).
• Adrenaline, also known as epinephrine (a medicine that stimulates the heart).
• Medicines for pain, inflammation and arthritis (such as indometacin and celecoxib).
• Medicines for depression.
• Medicines for mental illness (such as phenothiazine).
• Barbiturates (a type of sedative).
• Anti-histamines (medicines for hay fever and allergies).
• Other beta-blocker medicines used as eye drops (such as timolol).
• Insulin or medicines that you take by mouth for diabetes. Your doctor may need to adjust your dose of these medicines.
• Lidocaine (a local anaesthetic).
• Ergotamine medicines (for migraines).

Operations

If you go into hospital or to the dentist to have an operation, tell the anaesthetist, medical staff or dentist that you are using Betaloc IV Injection. This is because you can get low blood pressure (hypotension) if you are given certain anaesthetics while you are taking Betaloc IV Injection.

Betaloc IV Injection with food, drink and alcohol

Before having Betaloc IV Injection, inform your doctor or nurse if you have recently had alcohol. This is because alcohol can affect how the medicine works.

Pregnancy, breast-feeding and fertility

• If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or nurse for advice before taking this medicine. Beta-blockers including Betaloc IV Injection may cause harm to the foetus and early labour.
• If you become pregnant while having Betaloc IV Injection, talk to your doctor as soon as possible.

Driving and using machines

If you feel dizzy or tired after using this medicine, do not drive or use any tools or machines.

Adults

Betaloc IV Injection will be given to you by a doctor or a nurse. It will be given to you as an injection into your vein. Your doctor will decide how much to give you. The amount depends on your illness.

Use in children

Your medicine must not be given to children.

If you use more Betaloc IV Injection than you should

If you think you have been given too much of this medicine, talk to your doctor or nurse straight away.

If you stop using Betaloc IV Injection

Your doctor or nurse will let you know when to stop having this medicine. You may need to stop having it gradually.

Conditions that may get worse

If you have any of the following conditions, they may get worse when you start to take your medicine:

• Being short of breath, feeling tired or having swollen ankles (if you have heart failure) may get worse for a while. This is uncommon affecting less than 1 in 100 people.
• Psoriasis (a skin condition) and poor circulation may get worse. This is very rare affecting less than 1 in 10,000 people.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme. Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

What Betaloc IV Injection contains

The active substance is metoprolol tartrate. Each 5 ml (millilitre) ampoule contains 5 mg (milligrams) of metoprolol tartrate (this is equal to 1 mg of metoprolol tartrate per ml).

The other ingredients are sodium chloride and water for injections.

What Betaloc IV Injection looks like and contents of the pack

Betaloc IV Injection comes in ampoules. Each ampoule contains 5 ml of a clear colourless liquid.

Marketing Authorisation Holder and Manufacturer

The Marketing Authorisation for Betaloc IV Injection is held by

Betaloc IV Injection is manufactured by

To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge:

0800 198 5000 (UK only)

Please be ready to give the following information:

Product name Betaloc IV Injection

Reference number 17901/0106

This is a service provided by the Royal National Institute of Blind People.