Metoprolol may be taken in combination with hydrochlorothiazide or chlorthalidone.
- 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.
- shortness of breath
- slower than normal heart rate (bradycardia)
- reduced interest in sex
- excessively low blood pressure
- poor circulation (cold or blue fingers or toes)
- very slow heart rate
- serious depression
- 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.
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)
These drugs include:
- amlodipine (Norvasc)
- diltiazem (Cardizem, Dilacor, Taztia, Tiazac)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- sertraline (Zoloft)
- bupropion (Wellbutrin, Zyban)
- clomipramine (Anafranil)
- desipramine (Norpramin)
- 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
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.
The 24-hour release product is often started at 25 mg taken once a day or more. It's also gradually increased if needed.
The 24-hour release product is often started at 100 mg taken once a day. It's gradually increased if needed.
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.
- 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
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.
- Lopressor: metoprolol tartrate tablets, USP. (2013, March). Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017963s068lbl.pdf
- Toprol XL- metoprolol succinate tablet, extended release. (2014, May). Retrieved from http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4a5762c6-d7a2-4e4c-10b7-8832b36fa5f4#williamsonbk1264646718476
- Toprol-XL (metoprolol succinate) tablet, extended-release for oral use. (n.d.). Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019962s044lbl.pdf