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Highlights for Metoprolol
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Metoprolol treats high blood pressure and chest pain. It can prevent heart attack or heart damage after a heart attack.
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Don't suddenly stop taking metoprolol. Stop gradually under a doctor's supervision.
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If you have asthma, diabetes, or poor circulation, tell your doctor before taking metoprolol.
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IMPORTANT INFORMATION
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FDA warning Details
Negative
May have negative effects for people with asthma, COPD, diabetes, and poor circulation
women
Women who are pregnant or breastfeeding should check with a doctor before taking Details
Drug Features
Metoprolol is a prescription drug. It is available in these forms: oral tablet, extended-release oral tablet, and intravenous (IV), which is only given by a healthcare provider.

Metoprolol may be taken in combination with hydrochlorothiazide or chlorthalidone.
Why It's Used
Metoprolol is used to:
  • lower high blood pressure
  • reduce chest pain
  • after a heart attack, the medication reduces the amount of work your heart muscle has to do to push blood through your body.
How It Works
Metoprolol belongs to a class of drugs called beta blockers. A class of drugs refers to medications that work similarly in your body. They have a similar chemical structure and are often used to treat similar conditions.
More details
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Metoprolol Side Effects
MOST COMMON SIDE EFFECTS
The most common side effects that occur with metoprolol include:
  • tiredness
  • dizziness
  • depression
  • diarrhea
  • shortness of breath
  • slower than normal heart rate (bradycardia)
  • reduced interest in sex
  • rash
SERIOUS SIDE EFFECTS
If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you're experiencing a medical emergency, call 9-1-1:
  • excessively low blood pressure
  • poor circulation (cold or blue fingers or toes)
  • very slow heart rate
  • fatigue
  • serious depression
Pharmacist's Advice
Alan Carter
Alan Carter – PharmD
Healthline Pharmacist
Editorial Team
Pharmacist's Advice
Know how to manage your side effects.
  • Avoid standing quickly or moving your head suddenly. Metoprolol causes your blood vessels to widen. This causes your blood flow to slow down and not flow to your brain as quickly as normal. When blood isn’t getting to your brain as quickly, these movements can make you dizzy.
  • Take your dose at the same time each day to keep the amount of metoprolol in your body the same each day. Taking it at different times each day changes the amount in your body from day to day. Fluctuations in the amount of drug in your body can change your blood pressure.
  • Avoid smoking or being around people who smoke. Smoke may make your lungs tighten, causing wheezing or shortness of breath.
Disclaimer: The side effects information provided may not include all possible side effects. Although our goal is to provide the most relevant and up-to-date information, we cannot guarantee full coverage. Always speak with your healthcare provider about possible side effects.
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Metoprolol Interactions
Metoprolol can interact with other medications, herbs, or vitamins you might be taking. That's why your doctor should manage all of your medications carefully. If you're curious about how this drug might interact with something else you're taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.
Medications That Might Interact with This Drug:

Mental Health Drugs

Reserpine and monamine oxidase (MAO) inhibitors may increase or add to the effects of metoprolol. They may also increase light-headedness or slow your heart rate more. MAO inhibitors can continue to interact with metoprolol for up to 14 days after taking them.

MAO inhibitors include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Emsam)
  • tranylcypromine (Parnate)

Heart Rhythm Drugs

These drugs can also interact with metoprolol. If you use digitalis (Lanoxin) with metoprolol, it could slow down your heart rate too much.

Calcium Channel Blockers

Like metoprolol, these drugs are used for hypertension and several other heart problems. Combined with metoprolol, calcium channel blockers may reduce the contraction of the heart and slow it down more. Doctors sometimes use this combination under close supervision.

These drugs include:
  • amlodipine (Norvasc)
  • diltiazem (Cardizem, Dilacor, Taztia, Tiazac)
  • felodipine
  • celvidipine
  • flunaraizine
  • isradipine
  • nicardipine
  • nifedipine
  • nimodipine
  • nisoldipine
  • verapamil

Drugs Processed in the Same Way as Metoprolol

Drugs used to treat depression and other mood disturbances are processed in the body by the same systems as metoprolol. So, combining them could also increase the levels of metoprolol in the body. These include:
  • fluoxetine (Prozac)
  • fluvoxamine (Luvox)
  • paroxetine (Paxil)
  • sertraline (Zoloft)
  • bupropion (Wellbutrin, Zyban)
  • clomipramine (Anafranil)
  • desipramine (Norpramin)
  • chlorpromazine
  • fluphenazine
  • haloperidol
  • thioridazine
Other drugs that are processed in the body the same way as metoprolol, include:
  • other heart rhythm drugs like quinidine and propafenone
  • the antiretroviral ritonavir (Norvir)
  • antihistamines, including diphenhydramine
  • antimalarials, such as hydroxychoroquine and quinidine
  • antifungals, such as terbinafine
  • the blood pressure drug hydralazine
These drugs can all increase the level of metoprolol in the body.

Alpha Blockers

Alpha blockers also lower blood pressure. They may decrease blood pressure too much when combined with metoprolol. Types include:
  • guanethidine
  • betanidine
  • reserpine
  • alpha-methyldopa
  • clonidine
  • prazosin
Clonidine must be carefully managed if it's combined with metoprolol. Stopping the drug suddenly while also taking metoprolol can cause a big jump in blood pressure.

Ergot Alkaloids

Ergot Alkaloids, like dihydroergotamine, interact with metoprolol. These drugs narrow blood vessels to treat headaches. If you take them at the same time as metoprolol, they may cause dangerous narrowing of blood vessels.

Dipyridamole

Dipyridamole, which is sometimes used in heart testing, can conflict with metoprolol.
Disclaimer: The drug interaction information provided may not include all possible interactions. Although our goal is to provide the most relevant and up-to-date information, we cannot guarantee full coverage. Always speak with your healthcare provider about possible interactions with any drugs, vitamins, herbs & supplements, and over-the-counter drugs you're taking.
Metoprolol may have negative effects in people with these medical conditions:
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How to Take Metoprolol (Dosage)

Metoprolol dosage depends on a person's body and specific condition. Based on a person's response to the drug, doctors usually adjust the dose gradually.

Having liver disease may affect your dose. Speak with your healthcare provider.

What Are You Taking This For?

High Blood Pressure

The fast release product is often started at 50 mg taken twice a day. It's gradually adjusted if needed.

The 24-hour release product is often started at 25 mg taken once a day or more. It's also gradually increased if needed.

Angina

The fast release product is often started at 50 mg taken twice a day. It's gradually increased as needed.

The 24-hour release product is often started at 100 mg taken once a day. It's gradually increased if needed.

Heart Failure or After a Heart Attack

After heart attack or for patients with heart failure, the dose is highly individual. The drug is often started in the hospital.

The fast release product is often dosed at 12.5 mg to 25 mg taken once a day to start. From there, the dose is slowly adjusted.
Disclaimer: The dosage information provided may not include all possible dosages. Although our goal is to provide the most relevant and up-to-date information, we cannot guarantee full coverage. This information is not a substitute for medical advice. If you take this drug, make sure to speak with your doctor or pharmacist to determine a dosage that's right for you.
Pharmacist's Advice
doc-img
Alan Carter – PharmD
Healthline Pharmacist
Editorial Team
Pharmacist's Advice
Metoprolol comes with serious risks if you don't take it as prescribed.
If You Don't Take It at All
If you have high blood pressure or chest pain and don't take your metoprolol, you risk:
  • increasing your blood pressure
  • damaging your blood vessels or main organs, such as your lungs, heart, or liver
  • increasing your risk of a heart attack
If You Stop Taking It Suddenly
If you suddenly stop taking metoprolol for high blood pressure, chest pain, or after a heart attack, you raise your risk of heart attack.
If You Miss a Dose
If you miss a dose, just take the next dose as planned. Don't double your dose.
If You Don't Take It on Schedule
Not taking metoprolol every day, skipping days, or taking doses at different times of day also come with risks. Your blood pressure might fluctuate too often. That might increase your risk for a heart attack.
Call your doctor if your blood pressure remains high or if you still have chest pain.
Important Considerations for Taking Metoprolol
Are There Any Alternatives?

There are alternatives to this drug that may be used to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Healthline has made every effort to make certain that all information presented is factually correct, comprehensive, and up-to-date. However, no guarantee is made to that effect, and you should always consult with you doctor or other healthcare professional before taking any medication. A missing warning or other label for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for a patient or specific use. The drug information contained herein may be time sensitive and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Please be mindful that our content is not a substitute for the knowledge and expertise of a licensed healthcare professional.

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FDA Warning

Metoprolol has a black box warning. This is the most serious warning from the U.S. Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous problems.

Warning: Don't stop taking metoprolol suddenly. If you do, you may experience worse chest pain, a jump in blood pressure, or even have a heart attack.

Stopping metoprolol is not recommended. If you need to stop taking the drug, first talk to your doctor. Your dose should be gradually decreased under a doctor's supervision.

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Details
Metoprolol is a category C pregnancy drug. That means two things:
  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven't been enough studies done in humans.
If you're pregnant and have high blood pressure, speak with your healthcare provider about your treatment options during pregnancy.
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How It Works

Metoprolol belongs to a class of drugs called beta blockers. A class of drugs refers to medications that work similarly in your body. They have a similar chemical structure and are often used to treat similar conditions.

Beta blockers prevent norepinephrine (adrenalin) from acting on beta receptors in blood vessels and in the heart. This causes blood vessels to relax. By relaxing the vessels, beta blockers help to lower blood pressure and reduce chest pain. Blood pressure is often raised because vessels are tightened. That puts a strain on the heart and increases the body's oxygen demand. Beta blockers help to lower the heart rate and the heart's demand for oxygen.

Beta blockers don't permanently change blood pressure and chest pain. Instead, they help to manage the symptoms.

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People with asthma or COPD

Generally, people with asthma or COPD shouldn't take metoprolol. A doctor may still prescribe it, but only in small doses with careful monitoring. At higher doses, metoprolol can block different receptors on the breathing passages. This narrows the passages, worsening asthma or COPD.

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People with diabetes

Metoprolol may eliminate tremors and increased heart rate, both of which are important signs of low blood sugar. Without these signals, it becomes more difficult to recognize low blood sugar levels.

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People with poor circulation

If you have poor circulation in your feet and hands, you may have worse symptoms when taking metoprolol. Because metoprolol reduces blood pressure, you might not get as much blood to your extremities.

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Pregnant women

Metoprolol is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven't been enough studies done in humans.

If you're pregnant and have high blood pressure, speak with your healthcare provider about your treatment options during pregnancy.

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Women who are nursing

Metoprolol enters the breast milk and could be passed to the infant. Talk to your healthcare provider before breastfeeding.

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Take it with food

Take metoprolol with food, either with a meal or right after. This drug may cause nausea. Taking it with food will allow your stomach to digest it better.

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Don't crush the pills

You shouldn't crush the 24-hour release tablet. However, you can cut the tablet along the score marks (the groove on the tablet) if your healthcare provider recommends a smaller dose.

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Store at room temperature

Storing metoprolol in the right conditions is important to its effectiveness.

Store metoprolol at room temperature: 68 – 77° F (20 – 25° C).

Protect it from light, heat, and moisture. You may also store the drug briefly at temperatures as low as 59° F and as high as 86° F.

Note: Be careful of moist environments, including bathrooms. To keep drugs away from moisture, store them somewhere other than your bathroom and any other damp location.

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Affects children differently

Kids ages 1 to 17 years old may be treated with the fast release form of the drug.

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Seniors

Seniors may need a smaller dose of metoprolol at first. The dose may then increase gradually.