Metoprolol is a prescription medication used to treat high blood pressure, angina (chest pain), congestive heart failure, and to improve survival after a heart attack. Metoprolol belongs to a group of drugs called beta blockers which work by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
This medication comes in tablet form (metoprolol tartrate) and as an extended-release tablet (metoprolol succinate). The regular tablet is taken once or twice daily. The extended-release form is taken once a day.
Common side effects of metoprolol include dizziness, tiredness, and nausea.
Metoprolol is a prescription medication used alone or in combination with other medications for the following conditions:
- to control high blood pressure
- angina (chest pain)
- in the treatment of congestive heart failure
- to improve survival after a heart attack
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Metoprolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
dizziness or lightheadedness
gas or bloating
rash or itching
cold hands and feet
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
shortness of breath
swelling of the hands, feet, ankles, or lower legs
unusual weight gain
rapid, pounding, or irregular heartbeat
Metoprolol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
Be sure to mention any of the following:
- bupropion (Wellbutrin), cimetidine (Tagamet), clonidine (Catapres), diphenhydramine (Benadryl), fluoxetine (Prozac, Sarafem), hydroxychloroquine, paroxetine (Paxil), propafenone (Rythmol), quinidine (Quinaglute, Quinidex), ranitidine (Zantac), reserpine (Serpalan, Serpasil, Serpatab), ritonavir (Norvir), terbinafine (Lamisil), and thioridazine (Mellaril).
- Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
Before taking metoprolol,
- tell your doctor and pharmacist if you are allergic to metoprolol, acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), betaxolol (Kerlone), bisoprolol (Zebeta, in Ziac), carvedilol (Coreg), esmolol (Brevibloc), labetalol (Trandate), nadolol (Corgard, in Corzide), pindolol, propranolol (Inderal, Inderal LA, Innopran XL, in Inderide), sotalol (Betapace, Betapace AF, Sorine), timolol (Blocadren, in Timolide), any other medications, or any of the ingredients in metoprolol tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: bupropion (Wellbutrin), cimetidine (Tagamet), clonidine (Catapres), diphenhydramine (Benadryl), fluoxetine (Prozac, Sarafem), hydroxychloroquine, paroxetine (Paxil), propafenone (Rythmol), quinidine (Quinaglute, Quinidex), ranitidine (Zantac), reserpine (Serpalan, Serpasil, Serpatab), ritonavir (Norvir), terbinafine (Lamisil), and thioridazine (Mellaril). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have a slow heart rate, heart failure, problems with blood circulation, or pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heartbeat). Your doctor may tell you not to take metoprolol.
- tell your doctor if you have or have ever had asthma or other lung disease; heart or liver disease; diabetes; severe allergies; or an overactive thyroid gland (hyperthyroidism).
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking metoprolol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoprolol.
- you should know that metoprolol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- remember that alcohol can add to the drowsiness caused by this medication.
- you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using metoprolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of metoprolol there are no specific foods that you must exclude from your diet when receiving metoprolol.
Do not stop taking metoprolol without talking to your doctor. Suddenly stopping metoprolol may cause chest pain or heart attack. Your doctor will probably decrease your dose gradually.
Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, or herbal supplements.
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if metoprolol will harm your unborn baby.
Tell your doctor if you are breastfeeding or plan to breastfeed. Metoprolol is excreted in human breast milk in small quantities.
Your blood pressure should be checked regularly to determine your response to metoprolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Metoprolol succinate extended-release tablets are intended for once daily administration. Metoprolol tartrate immediate-release tablets are intended for twice daily dosage. Take metoprolol exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you. The dosage of atenolol must be individualized.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
difficulty breathing or swallowing
swelling of the hands, feet, ankles, or lower legs
Metoprolol tartrate (immediate-release) tablets are available as 25 mg, 50 mg and 100 mg strengths.
Metoprolol succinate (extended-release) tablets are available as 25 mg, 50 mg, 100 mg and 200 mg strengths.
Keep this and all medications out of the reach of children.
Store metoprolol at room temperature away from light and moisture. Keep it in the original container.
Ischemic Heart Disease: Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred. When discontinuing chronically administered metoprolol, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored. If angina markedly worsens or acute coronary insufficiency develops, metoprolol administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician’s advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue metoprolol therapy abruptly even in patients treated only for hypertension.