Summary
The purpose of the first part of this study was to determine the dose of metoprolol which produced an equal degree of β1-blockade over 24 hours (assessed by suppression of exercise heart rate) to atenolol 100mg daily in normal volunteers. Both drugs had been given for 5 days. The equivalent dose was 300mg once daily or 100mg twice daily.
The second part set out initially to investigate the effects on respiratory function in 14 asthmatic hypertensive patients of single doses of propranolol 40mg, atenolol 100mg and metoprolol 100mg. Propranolol had a greater deleterious effect and blocked the effects of salbutamol significantly more than either atenolol or metoprolol, which were very similar. Atenolol 100mg daily, metoprolol 100mg twice daily and placebo were then given for 3 weeks each under blind, randomised, crossover conditions and the effects assessed by diary card and peak flow rate. Atenolol caused significantly less aggravation of asthma than metoprolol. However, no β-blocker is completely safe to give to asthmatics and they should be avoided if possible. If a β-blocker must be given to an asthmatic, atenolol given with a β2-stimulant bronchodilator appears to be the drug of choice.
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Lawrence, D.S., Sahay, J.N., Chatterjee, S.S. et al. β-Blockers in Asthma. Drugs 25 (Suppl 2), 232–236 (1983). https://doi.org/10.2165/00003495-198300252-00067
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DOI: https://doi.org/10.2165/00003495-198300252-00067