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Atrioventricular block of second or third degree; patients with unstable decompensated cardiac failure (pulmonary oedema, hypoperfusion or hypotension), and patients with continuous or intermittent inotropic therapy acting through β-receptor agonism; clinically relevant sinus bradycardia, sick-sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock; severe peripheral arterial circulatory disorder.
Metoprolol should not be given to patients with suspected acute myocardial infarction as long as the heart rate is <45 beats/min, the P-Q interval is >0.24 sec or the systolic blood pressure is <100 mmHg.
Metoprolol CR is contra-indicated in patients who have shown hypersensitivity to any component of the product or to other β-blockers.
