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Metoprolol Warnings and Precautions

Specific Metoprolol Precautions and Warnings

Some warnings and precautions to be aware of prior to taking metoprolol include the following:
  • Metoprolol can interact with certain medications (see Drug Interactions With Metoprolol).
  • This medication may hide certain signs of hyperthyroidism. Do not stop metoprolol abruptly, as this can cause serious symptoms. Make sure to talk with your healthcare provider before stopping treatment so that it can be done so in a safe manner.
  • Metoprolol may cause extreme low blood pressure and/or a slow heart rate in some people. Symptoms can include dizziness, lightheadedness, and fainting. If you develop any of these symptoms, contact your healthcare provider. Extreme low blood pressure is more likely to occur in people who are taking a diuretic, who are on dialysis, or who have diarrhea or vomiting.
Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how metoprolol affects you.
  • Using beta blockers such as metoprolol for a long time can, in some cases, lead to heart failure. If you notice any of the following symptoms, contact your healthcare provider:
  • People with severe congestive heart failure taking metoprolol are at increased risk for the condition becoming worse. This occurs more often when the dose is increased. Therefore, if your healthcare provider prescribes metoprolol because he or she believes that the benefits outweigh the potential risks, he or she may choose to monitor your situation more closely, especially during dosage changes. Contact your healthcare provider if you notice any congestive heart failure symptoms.
  • People taking metoprolol should not stop it abruptly. In clinical studies, this has been shown to increase a person's chances for developing angina (chest pain), heart attack, or serious irregular heart rhythms (arrhythmias). This risk is even greater in people with existing heart disease.
  • Beta blockers, including metoprolol, are used with caution (if at all) in people with certain lung diseases, such as asthma, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease (COPD). This is because beta blockers affect the lungs and can cause a narrowing of the airways. This risk is increased in people with certain lung diseases. If you develop problems breathing or experience wheezing, call your healthcare provider.


  • People with a type of tumor known as pheochromocytoma should not take metoprolol unless they have been treated first with an alpha blocker medication, since using metoprolol without an alpha blocker may actually cause a dangerous increase in blood pressure in such situations. Previously, it was recommended that people with a pheochromocytoma not take metoprolol at all, but this recommendation has been updated.


  • For people with allergies, metoprolol may increase the reaction to the specific allergens, and your body may not respond to the usual doses of epinephrine.
  • If you are going to have surgery, let your healthcare provider or dentist know that you are taking metoprolol.
  • Metoprolol is a pregnancy Category C medicine, which means there may be an increased risk to the fetus. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking the drug, contact your healthcare provider (see Metoprolol and Pregnancy for more information).
  • If you are breastfeeding, keep in mind that metoprolol passes through breast milk. Therefore, if you are breastfeeding, be sure to talk to your healthcare provider about your particular situation (see Metoprolol and Breastfeeding).
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