What is metoprolol?


Generic Name: Metoprolol Brand Name(s): Generics only. No brands available.

Know the basics

What is metoprolol used for?

Metoprolol is a beta-blocker used to treat chest pain (angina), heart failure, and high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This lowers heart rate,blood pressure, and strain on the heart.

This section contains uses of this drug that are not listed in the approved US professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Metoprolol may also be used for irregular heartbeats, migraine headache prevention, and after an acute heart attack to improve survival.

How should I take metoprolol?

Take metoprolol by mouth, with or right after a meal, as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.

Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

To reduce your risk of side effects, your doctor may direct you to start metoprolol at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Use metoprolol regularly to get the most benefit from it. To help you remember, take it at the same time each day. Do not suddenly stop taking metoprolol without consulting your doctor. Your condition may become worse when the drug is suddenly stopped.

For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. It is important to continue taking metoprolol even if you feel well. Most people with high blood pressure do not feel sick.

To prevent chest pain, a second heart attack, or migraine headaches, it is very important to take metoprolol regularly as prescribed. This drug should not be used to treat chest pain or migraines when they occur. Use other medication to relieve sudden attacks as directed by your doctor (for example, nitroglycerin tablets placed under the tongue for chest pain, “triptan” drugs such as sumatriptan formigraines). Consult your doctor or pharmacist for details.

Tell your doctor if your condition does not improve or if it worsens (for example, if your routine blood pressure readings remain high or increase, if your chest pain or migraines occur more often).

How do I store metoprolol?

Metoprolol is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store metoprolol in the bathroom or the freezer. There may be different brands of metoprolol that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush metoprolol down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using metoprolol?

Before taking metoprolol,

  • Tell your doctor and pharmacist if you are allergic to metoprolol, acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), betaxolol (Kerlone), bisoprolol (Zebeta, in Ziac), carvedilol (Coreg), esmolol (Brevibloc), labetalol (Trandate), nadolol (Corgard, in Corzide), pindolol, propranolol (Inderal, Inderal LA, Innopran XL, in Inderide), sotalol (Betapace, Betapace AF, Sorine), timolol (Blocadren, in Timolide), any other medication, or any of the ingredients in metoprolol tablets. Ask your pharmacist for a list of the ingredients.
  • Tell your doctor and pharmacist what prescription and nonprescription medication, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: bupropion (Wellbutrin), cimetidine (Tagamet), clonidine (Catapres), diphenhydramine (Benadryl), fluoxetine (Prozac, Sarafem), hydroxychloroquine, paroxetine (Paxil), propafenone (Rythmol), quinidine (Quinaglute, Quinidex), ranitidine (Zantac), reserpine (Serpalan, Serpasil, Serpatab), ritonavir (Norvir), terbinafine (Lamisil), and thioridazine (Mellaril). Your doctor may need to change the doses of your medication or monitor you carefully for side effects.
  • Tell your doctor if you have a slow heart rate, heart failure, problems with blood circulation, or pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heartbeat). Your doctor may tell you not to take metoprolol.
  • Tell your doctor if you have or have ever had asthma or other lung disease; heart or liver disease; diabetes; severe allergies; or an overactive thyroid gland (hyperthyroidism).
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking metoprolol, call your doctor.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoprolol.
  • You should know that metoprolol may make you drowsy. Do not drive a car or operate machinery until you know how metoprolol affects you.
  • Remember that alcohol can add to the drowsiness caused by metoprolol.
  • You should know that if you have allergic reactions to different substances, your reactions may be worse while you are using metoprolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

Is it safe to take metoprolol during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using metoprolol during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking metoprolol. Metoprolol is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Know the side effects

What are the side effects of metoprolol?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • Chest pain, pounding heartbeats or fluttering in your chest;
  • Feeling light-headed, fainting;
  • Feeling short of breath, even with mild exertion;
  • Swelling of your hands or feet;
  • Nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • Wheezing, trouble breathing;
  • Depression, confusion, memory problems, hallucinations; or
  • Cold feeling in your hands and feet.

Less serious side effects may include:

  • Dry mouth, constipation, heartburn, vomiting, diarrhea;
  • Decreased sex drive, impotence, or difficulty having an orgasm;
  • Headache, drowsiness, tired feeling;
  • Sleep problems (insomnia);
  • Anxiety, nervousness.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with metoprolol?

Metoprolol may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

  • Prazosin;
  • Terbinafine;
  • An antidepressant – bupropion, clomipramine, desipramine, duloxetine, fluoxetine, fluvoxamine, paroxetine, sertraline;
  • An ergot medicine – dihydroergotamine, ergonovine, ergotamine, methylergonovine;
  • Heart or blood pressure medication – amlodipine, clonidine, digoxin, diltiazem, dipyridamole, hydralazine, methyldopa, nifedipine, quinidine, reserpine, verapamil, and others;
  • A mao inhibitor – isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine; or
  • Medicine to treat mental illness – chlorpromazine, fluphenazine haloperidol, thioridazine.

Does food or alcohol interact with metoprolol?

Metoprolol may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with metoprolol?

Metoprolol may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Angina (chest pain);
  • Hypotension (low blood pressure);
  • Ischemic heart disease;
  • Lung disease (eg, asthma, bronchitis, emphysema);
  • Pheochromocytoma (adrenal gland tumor)—Use with caution. May make these conditions worse.
  • Blood circulation problems, severe;
  • Bradycardia (slow heartbeat);
  • Cardiogenic shock (shock caused by heart attack);
  • Heart block;
  • Heart failure, severe;
  • Peripheral vascular disorders (clogged blood vessels);
  • Sick-sinus syndrome (heart rhythm problem)—Should not be used in patients with these conditions.
  • Diabetes ;
  • Hyperthyroidism (overactive thyroid);
  • Hypoglycemia (low blood sugar)—May cover up some of the symptoms of these diseases, such as a fast heartbeat.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using metoprolol.

What is the dose of metoprolol for an adult?

Usual Adult Dose for Angina Pectoris Prophylaxis

  • Initial dose: 100 mg orally in 1 or 2 divided doses.
  • Maintenance dose: 100 to 450 mg/day.
  • Extended release may be used at the same total daily dose given once a day.

Usual Adult Dose for Hypertension

  • Initial dose: 100 mg orally in 1 or 2 divided doses.
  • Maintenance dose: 100 to 450 mg/day.
  • Extended release may be used at the same total daily dose given once a day.

Usual Adult Dose for Supraventricular Tachycardia

  • Initial dose: 100 mg orally in 1 or 2 divided doses.
  • Maintenance dose: 100 to 450 mg/day.
  • Extended release may be used at the same total daily dose given once a day.

Usual Adult Dose for Angina Pectoris

  • Initial dose: 100 mg orally in 1 or 2 divided doses.
  • Maintenance dose: 100 to 400 mg/day.
  • Extended release may be used at the same total daily dose given once a day.

Usual Adult Dose for Myocardial Infarction

  • Early treatment:
  • Intravenous injection: 3 bolus injections of 5 mg of metoprolol given at 2 minute intervals.
  • Oral: In patients who tolerate the full Intravenous injection dose (15 mg), metoprolol tablets, 50 mg every 6 hours, should be initiated 15 minutes after the last Intravenous injection dose and continued for 48 hours. Maintenance dose: 100 mg orally twice a day.
  • Patients who appear not to tolerate the full Intravenous injection dose should be started on metoprolol tablets at 25 mg or 50 mg every 6 hours 15 minutes after the last intravenous dose or as soon as their clinical condition allows.
  • Late treatment:
  • Oral: 100 mg orally twice a day.
  • Patients with contraindications to treatment during the early phase of suspected or definite myocardial infarction, patients who appear not to tolerate the full early treatment, and patients in whom the physician wishes to delay therapy for any other reason should be started on metoprolol tablets as soon as their clinical condition allows.

Usual Adult Dose for Congestive Heart Failure

  • Initial dose: 25 mg once daily (of the XL formulation) for two weeks in patients with NYHA class II heart failure and 12.5 mg once daily (of the XL formulation) in patients with more severe heart failure.
  • Maintenance dose: This dosage should then be doubled every two weeks to the highest dosage level tolerated or up to 200 mg.

What is the dose of metoprolol for a child?

Usual Pediatric Dose for Hypertension

  • Immediate release: 1 to 17 years
  • Initial dose: 1 to 2 mg/kg/day, administered in 2 divided doses. Dosage should be adjusted based on patient response.
  • Maximum dose: 6 mg/kg/day (less than or equal to 200 mg/day)
  • Extended release: 6 to 16 years:
  • Initial dose: 1 mg/kg orally once daily (not to exceed 50 mg once daily). The minimum available dose is one half of the 25 mg tablet.
  • Maintenance dose: Dosage should be adjusted according to blood pressure response. Doses above 2 mg/kg (or in excess of 200 mg) once daily have not been studied.

How is metoprolol available?

Metoprolol is available in the following dosage forms and strengths:

Tablet, Oral: 25 mg, 50 mg, 100 mg.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of metoprolol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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