Metoprolol

Written by Rachel Nall | Published on November 11, 2013
Medically Reviewed by George Krucik, MD, MBA on November 11, 2013

What Is Metoprolol?

Brand Name: Lopressor, Toprol, Toprol XL; combination medications include Dutoprol, Lopressor, Lopressidone
Generic Name: metoprolol

Physicians prescribe metoprolol to lower high blood pressure and/or treat the symptoms of chest pain following a heart attack. Metoprolol belongs to a class of medications known as beta blockers. It used either alone or with other medications to reduce blood pressure.

Read the FDA description of metoprolol succinate.

Read the FDA description of metoprolol tartrate.

What Does Metoprolol Do?

Metoprolol is a beta-adrenergic blocking agent. This means it keeps the hormone epinephrine or adrenaline from acting on receptors in the body. Adrenaline can affect a number of body functions, including heart rate and blood vessel size. Metoprolol relaxes the blood vessels, which in turn reduces heart rate and blood pressure. While metoprolol is used to reduce high blood pressure and chest pain symptoms, it does not cure these symptoms; it only controls them.

Metoprolol is available in a number of preparations, including tablets, extended-release tablets, and injection.

While metoprolol’s uses are chiefly heart disease related, a physician may prescribe it to prevent migraine headaches, regulate an irregular heartbeat, or reduce movement side effects from taking medications for mental illness.

This information is a summary. Before starting this medication, discuss questions with your healthcare provider and make sure you understand dosage instructions.

What Should I Tell My Doctor Before Starting Metoprolol?

Tell your doctor if you:
  • have a heart block that is greater than first degree
  • are breastfeeding
  • are pregnant or could possibly be pregnant: metoprolol can cross the placental barrier and cause fetal injury, including the birth of infants that are small for gestational age
  • have asthma
  • have cardiogenic shock
  • have diabetes
  • have heart disease
  • have a history of allergic reaction to metoprolol or other beta blockers (medications ending in -olol), such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), and propranolol (Inderal)
  • have hyperthyroidism
  • have liver disease
  • have lung disease
  • have overt (symptomatic) cardiac failure: beta blockers like metoprolol can depress the cardiac muscle’s ability to contract, which can lead to worsening heart failure
  • have renal conditions or impairment
  • have severe peripheral arterial circulatory disorder
  • have sinus bradycardia, a heart rhythm of less than 60 beats per minute that originates in the heart’s sinus node
  • have untreated pheochromocytoma

Drinking alcohol while taking metoprolol can increase fatigue. You should also tell your physician you are taking metoprolol before undergoing any type of surgery, including dental surgery.

What Medications May Interact with Metoprolol?

Always tell your physician about any prescription medications or herbal remedies you are taking.

Medications that can adversely interact with metoprolol include:

  • bupropion (Wellbutrin)
  • cimetidine (Tagamet)
  • clonidine  (Catapres)
  • diphenhydramine (Benadryl)
  • fluoxetine (Prozac, Sarafem)
  • hydroxychloroquine (Plaquenil)
  • paroxetine (Paxil)
  • propafenone (Rythmol)
  • quinidine (Quinaglute, Quinidex)
  • ranitidine (Zantac)
  • reserpine (Serpalan, Serpasil, Serpatab)
  • ritonavir (Norvir)
  • terbinafine (Lamisil)
  • thioridazine (Mellaril)

Possible Side Effects of Metoprolol

The following are severe and emergent side effects of these medications. Contact your medical provider immediately if you experience the following:

  • change in color of the fingertips, lips, skin, palms, or nail beds to blue
  • depression
  • loss of consciousness
  • wheezing (bronchospasm) or shortness of breath
  • worsening heart condition symptoms, such as low blood pressure and/or slow heart rate

The following side effects may occur, but do not usually represent an emergency. Discuss with your doctor or healthcare professional if they continue or are bothersome.

  • bloating
  • constipation
  • diarrhea
  • difficulty concentrating
  • difficulty sleeping
  • dizziness
  • dry mouth
  • fatigue
  • flatulence/gas
  • irritability
  • loss of sexual interest or performance
  • mental confusion
  • nausea
  • runny nose

This list may not describe all possible side effects. Call your doctor or healthcare provider for advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Where Should I Keep Metoprolol?

Metoprolol tablets and injection vials should be stored at room temperature—somewhere around 77 degrees Fahrenheit or 25 degrees Celsius. Keep the medication tightly closed in a light-resistant container.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

FDA WARNING: Metoprolol carries a black box warning (meaning the medication has potentially lethal side effects) for its potential to cause chest pain exacerbation in patients when the medication is suddenly discontinued. Do not stop taking your medication unless your doctor instructs you to do so.

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Article Sources:

●      Dutoprol. (2011, November). U.S. Food and Drug Administration. Retrieved October 27, 2013, from http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021956s003lbl.pdf
●      Lopressor (metoprolol tartrate). (2008, February). U.S. Food and Drug Administration. Retrieved October 27, 2013, from http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/017963s062,018704s021lbl.pdf
●      Metoprolol. (2012, August 1). Mayo Clinic. Retrieved from October 27, 2013, from http://www.mayoclinic.com/health/drug-information/DR602483/METHOD=print&DSECTION=all
●      Metoprolol. (2010, July 1). MedlinePlus. Retrieved October 27, 2013, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682864.html

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