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Overview: Metoprolol is a beta blocker. It is is used to treat high blood pressure, chest pain, heart failure, and lower the risk of a repeat heart attack. Common side effects include tiredness, weakness, shortness of breath, diarrhea, or itchiness. Contact your health care provider or seek care right away if you have fainting, confusion, rapid weight gain or swelling, or trouble breathing. This medicine is available in several forms including injectable forms, oral tablets, oral sprinkle capsules, and oral liquid.

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 health care 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)?

Brands and other names

  • Kapspargo Sprinkle
  • Lopressor
  • Toprol XL

Dosage forms and strengths

  • 12.5 mg, 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg oral tablets
  • 25 mg, 50 mg, 100 mg, 200 mg oral extended-release capsules
  • 25 mg, 50 mg, 100 mg, 200 mg oral extended-release tablets
  • 10 mg/mL oral solution

Metoprolol is also available in injectable forms.

How should I store metoprolol?

Extended-Release Capsules and Tablets. Metoprolol extended-release capsules and tablets should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 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 and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 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.

Oral Solution. Store metoprolol oral solution at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C), for shorter periods of time, such as when transporting it. Store in a tightly closed container and protect from heat and light. After opening the bottle, the medicine should be used within 30 days or thrown away. 

Side Effects

What are the most common side effects of metoprolol?

The most common side effects of metoprolol are listed below. Tell your health care 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 health care 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 (800-332-1088). 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 health care 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 health care 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 people with underlying heart disease or heart damage, metoprolol can potentially lead to heart failure over time. Tell your health care 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), which can be serious. Stop using metoprolol and contact your health care 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 or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • 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 health care provider. Take it as prescribed.

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

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 health care provider first. 

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.

When using metoprolol oral solution, use the oral syringe that comes with the medicine to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Sit in an upright position when taking the oral solution.

What should I tell my health care provider before using metoprolol?

Tell your health care 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 know if metoprolol is right for you.

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

Current and Past Health Conditions. Tell your health care 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. It is not known if or how metoprolol could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take metoprolol while you are pregnant or trying to get pregnant.

Breastfeeding. Metoprolol passes into breast milk. Tell your health care 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.

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.

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

Does metoprolol interact with other medicines (drug interactions)?

Always tell your health care 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 health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with metoprolol. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

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.