Metoprolol

Metoprolol is licensed for the treatment of high blood pressure, angina symptoms, and congestive heart failure. The medicine, which is a type of beta blocker, is available in two different forms: immediate-release and extended-release. Administering the immediate-release version of metoprolol following a heart attack can also help improve survival. Potential side effects of the drug include slow heart rate, dizziness, and tiredness.

 

What Is Metoprolol?

Metoprolol is a prescription medicine that has been licensed to treat several conditions related to the heart and blood vessels. It is part of a class of drugs called beta blockers. Metoprolol is sold under the brand names Lopressor® and Toprol-XL®. It is also available in generic form. Lopressor and generic Metoprolol Tartrate are the immediate-release forms of the drug, while Toprol-XL and generic Metoprolol Succinate are the extended-release forms.
 

Who Makes It?

Metoprolol is manufactured by a number of different companies, depending on whether it is the brand-name or generic version. Lopressor is manufactured by Novartis Pharmaceuticals, AstraZeneca makes Toprol-XL, and a number of companies make the generic version of metoprolol, including:
 
  • Mylan Laboratories
  • Sandoz
  • Teva Pharmaceuticals
  • Watson Pharmaceuticals.
     

Metoprolol Uses

This medication has been licensed to treat a number of conditions.
 The uses for the immediate-release form include:
 
Uses for the extended-release form include treatment for:
 
Metoprolol does not cure high blood pressure, angina, or congestive heart failure.
 
The medication may also be recommended for other reasons, such as treatment for migraines or anxiety. Metoprolol has not been licensed for use in children, although it is often used to treat specific conditions in children.
 
(Click What Is Metoprolol Used For? for more information, including possible off-label uses.)
 

How Does It Work?

Metoprolol is part of a class of drugs called beta-adrenergic blocking agents, or beta blockers for short. As the name implies, beta blockers block beta receptors, which are located in a number of places within the body, including the heart and blood vessels. These receptors are what stress hormones (such as adrenaline) attach to, causing certain reactions in the body. These reactions can include increases in:
 
  • Heart rate
  • The force with which the heart pumps blood
  • Blood pressure (both systolic and diastolic).
     
Metoprolol helps to block a specific type of beta receptor called beta-1 receptors. By blocking them, the medication causes the reverse effect of these stress hormones. It decreases heart rate and both systolic and diastolic blood pressure, as well as the workload of the heart. This means that the heart requires less blood and oxygen to work properly.
 

Effects of Metoprolol

By lowering blood pressure, metoprolol can decrease the risks that accompany long-term high blood pressure (see Effects of High Blood Pressure). By decreasing the workload of the heart, the drug can also decrease the number of angina attacks and increase exercise tolerance. Finally, although the exact mechanism is not known, metoprolol can increase the chances of survival in people who have just had a heart attack.
 
For people with congestive heart failure, the effects of this drug on the heart and blood vessels have been shown to result in a decrease in hospitalizations and loss of life from congestive heart failure.
 

When and How Do I Take It?

Some general considerations for when and how to take metoprolol include the following:
 
  • The medication comes in tablet form and, depending on the form and your healthcare provider's recommendation, is taken either once or several times a day.
     
  • Metoprolol should be taken with or immediately after a meal.
     
  • Do not break, chew, or crush the tablets.
     
  • Metoprolol should be taken at the same time each day to maintain an even level in your blood.
     
  • For the medication to work properly, you have to take it as prescribed. Metoprolol will not work if you stop taking it.
     
  • You should not stop taking the drug without first discussing it with your healthcare provider. Stopping it abruptly increases the risk for serious side effects (see Metoprolol Warnings and Precautions).
     

Dosing Information

The dose of metoprolol your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • Your age
  • The form (immediate-release or extended-release)
  • The medical condition you are being treated for
  • Other medical conditions you may have
  • Other medications you may be taking
  • How you respond to the medication.
     
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Metoprolol Dosing for more information.)
 

Are There Any Side Effects?

As with any medicine, side effects are possible with metoprolol. However, not everyone who takes it will experience problems. Most people have no problems with the drug. If side effects do occur, they are often minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
The most common side effects include:
 
(Click Metoprolol Side Effects to learn more, including potentially serious side effects you should report to your healthcare provider.)
 
You can read about specific side effects by clicking the following eMedTV links:
 

Drug Interactions

Metoprolol can potentially interact with several different medications (see Drug Interactions With Metoprolol for more information).
 

What Should I Tell My Healthcare Provider Before Taking Metoprolol?

Prior to taking this medication, you should tell your healthcare provider if you have:
 
Also, let your healthcare provider know if you:
 
  • Are pregnant or trying to become pregnant (see Metoprolol and Pregnancy)
  • Are breastfeeding
  • Will be undergoing surgery or anesthesia.
     
Tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, antacids, vitamins, and herbal supplements.
 
(Click Metoprolol Warnings and Precautions for more information on this topic, including information on who should not take the drug.)
 

What If I Take an Overdose?

People who take too much metoprolol may have overdose symptoms that could include but are not limited to:
 
  • Extremely low blood pressure (hypotension)
  • Severe decrease in heart rate (bradycardia)
  • Low blood sugar (hypoglycemia)
  • Congestive heart failure.
     
If you happen to take too much, seek immediate medical attention.
 
(Click Metoprolol Overdose for more information.)
 

How Should Metoprolol Be Stored?

Metoprolol should be stored at room temperature in a dry place. The tablets should be kept in an airtight, light-resistant container.
 
Keep this and all medications out of the reach of children.
 

What Should I Do If I Miss a Dose?

If you do not take your metoprolol as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed one and continue with your regular schedule. Never take a double dose.
 

Strengths of Metoprolol

Immediate-release metoprolol tablets come in a number of strengths, including:
 
The extended-release tablets also come in several strengths, including:
 
(Click Generic Metoprolol for more information.)
 
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;