Treatment with Metoprolol, also known as Selo-Zok

The preparation

Metoprolol was developed to treat heart and circulatory conditions, but it can also be effective for migraines. When you are prescribed this medication, it is not to lower your blood pressure, but to treat your migraines.

Effect

Metoprolol may help prevent migraines by stabilizing blood vessels, though the exact mechanism of action is not fully understood.

The effect of metoprolol usually begins after 1-3 weeks. On average, metoprolol halves the number of migraine attacks. However, the effectiveness of the medication varies significantly from person to person.

Side effects

The most common side effects are fatigue, dizziness, a drop in blood pressure when changing positions, nausea, abdominal pain, diarrhea, constipation, cold hands and feet, slow pulse, heart palpitations, and breathing difficulties.

Precautions

Metoprolol should not be used for certain types of heart conditions, such as conduction disorders, and should be used with caution or not at all if you suffer from diabetes, asthma, or certain heart conditions. It should also be used with caution if you are taking other medications, especially other heart medications.

Before starting treatment

Before starting treatment, an electrocardiogram (ECG) must be performed, and your pulse and blood pressure must be measured.

What is the dosage?

Typically, you start by taking 50 mg once a day for one week. After that, the dose is increased to 100 mg daily. If the effect is insufficient and there are no bothersome side effects after one month, increase to 150 mg once daily for a week, and then further to 200 mg once daily (the dose can be split into 100 mg twice daily). Stay at the dose where you experience the best balance between effect and side effects (usually between 100-200 mg daily). If there is no effect after one month at 200 mg per day, it can be concluded that the medication is not working. You should then taper off by 50 mg per week until you have stopped taking the medication completely.

Once the correct final dose is found, it should be taken daily for 6-12 months, after which the dose can often be tapered off slowly in consultation with your doctor. However, some patients need to use metoprolol for several years.