Uses

What is metoprolol used for?

Metoprolol is commonly used for the following conditions.

  • To lower high blood pressure (hypertension) 
  • To prevent chest pain in people with heart disease
  • To lower the risk of heart attack in people who have recently had a heart attack
  • To lower the risk of hospitalization for heart failure and death in people with heart failure

Metoprolol may also be used for other conditions as determined by your healthcare provider.

How does metoprolol work (mechanism of action)?

Metoprolol blocks beta receptors in your heart. These receptors normally bind to hormones called catecholamines. When catecholamines bind to these receptors, it causes your heart to beat harder and faster. Blocking these receptors helps your heart beat more slowly. These effects can help your heart work better, lower blood pressure, and may reduce your risk for heart attack and stroke. 

How is metoprolol supplied (dosage forms)?

Metoprolol is available as Kapspargo Sprinkle, Lopressor, Toprol XR, and generic metoprolol in the following dosage forms that are taken by mouth.

  • 25 mg oral tablets
  • 37.5 mg oral tablets
  • 50 mg oral tablets
  • 75 mg oral tablets
  • 100 mg oral tablets
  • 25 mg oral extended-release capsules
  • 50 mg oral extended-release capsules
  • 100 mg oral extended-release capsules
  • 200 mg oral extended-release capsules
  • 25 mg oral extended-release tablets
  • 50 mg oral extended-release tablets
  • 100 mg oral extended-release tablets
  • 200 mg oral extended-release tablets

Metoprolol is also available in injectable forms.

How should I store metoprolol?

Extended-release tablets. Metoprolol extended-release tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Extended-release capsules. Metoprolol extended-release capsules should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Tablets. Metoprolol tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container. Protect from light and moisture.

Side Effects

What are the most common side effects of metoprolol?

The most common side effects of metoprolol are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Feeling unusually weak or tired 
  • Shortness of breath
  • Slow heartbeat
  • Low blood pressure
  • Diarrhea
  • Itching
  • Rash

There may be other side effects of metoprolol that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of metoprolol?

While less common, the most serious side effects of metoprolol are described below, along with what to do if they happen.

Heart Rate Changes. Metoprolol can make your heart beat slower than normal (bradycardia). Call your healthcare provider right away if you have any of the following symptoms of bradycardia. 

  • Feeling lightheaded, dizziness, or fainting
  • Confusion
  • Feeling weak or easily tired 
  • Chest pain
  • Shortness of breath

Decreased Blood Pressure (Hypotension). Metoprolol may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

New or Worsening Heart Failure. Metoprolol may worsen existing heart failure or cause fluid buildup in your body. For individuals with underlying heart disease or heart damage, metoprolol can potentially lead to heart failure over time. Tell your healthcare provider right away if you have any of the following symptoms.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Breathing Problems. Metoprolol may cause the muscles around the airways to tighten (bronchospasm) instead of relaxing, which can be serious. Stop using metoprolol and contact your healthcare provider right away if you have trouble breathing.

Peripheral Vascular Disease. Metoprolol can cause the heart to pump less blood to the rest of the body. This can make blood flow problems to the arms, legs and intestines worse. 

Severe Allergic Reactions. Metoprolol may cause allergic reactions, which can be serious. Stop using metoprolol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use metoprolol?

Allergies to Ingredients. People who are allergic to any of the following should not use metoprolol.

  • Lopressor
  • Toprol-XL
  • Kapspargo
  • Metoprolol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific metoprolol products they stock.

Bradycardia. Metoprolol should not be used if your heart is beating too slow (bradycardia).

Hypotension. Metoprolol should not be used if your blood pressure is too low (hypotension).

Heart Block. Metoprolol should not be used if the electrical signals in your heart move too slow (heart block).

Severe or Worsening Heart Failure. Metoprolol should not be used if your heart failure is severe or getting worse, causing you to feel very tired, have trouble breathing, or swelling in your legs. 

Cardiogenic Shock. Metoprolol should not be used if you have a life-threatening condition called cardiogenic shock where your heart cannot pump enough blood to the rest of your body.

What should I know about metoprolol before using it?

Do not take metoprolol unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

The tablets should be taken with food or right after food. The extended-release tablets and capsules can be taken with or without food. 

Do not share metoprolol with other people, even if they have the same condition as you. It may harm them.

Keep metoprolol out of the reach of children.

Metoprolol can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how metoprolol affects you.

Stopping metoprolol suddenly may lead to chest pain or heart attack in people with heart disease. Do not stop taking this medication without talking to your healthcare provider first. 

What should I tell my healthcare provider before using metoprolol?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if metoprolol is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart or circulation problems
  • Breathing problems
  • Liver problems
  • Pheochromocytoma
  • Thyroid problems

Diabetes. Metoprolol can decrease early signs of low blood sugar, such as fast heartbeat, and make it more likely for the low blood sugar to be serious, especially for people with diabetes.

Pregnancy. Available data does not show that metoprolol would negatively affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. Metoprolol passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

Interactions

Does metoprolol interact with foods or drinks?

There are no known interactions between metoprolol and foods or drinks.

It is unknown if drinking alcohol will affect metoprolol tablets. The risk of dizziness may be increased if you drink alcohol while taking metoprolol tablets.

Drinking alcohol while taking metoprolol extended-release capsules (Kapspargo) can cause a rapid release of the medicine. People should not drink alcohol while taking Kapspargo. 

Does metoprolol interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking metoprolol.

  • Diltiazem and verapamil, which are medicines used to treat chest pain and high blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Clonidine, which is a medicine used to treat high blood pressure and attention deficit hyperactivity disorder (ADHD)
  • Any medicine for irregular heart rate or rhythm
  • Any medicine for high blood pressure 
  • Any medicine for diabetes

Some other medicines may alter the blood levels of metoprolol. Tell your healthcare provider about all medicines that you take or have recently taken.

Does Metoprolol interact with other drugs you are taking?
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Overdose/Missed Dose

What should I do if I accidentally use too much metoprolol?

If you or someone else has used too much metoprolol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of metoprolol?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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