Metoprolol

Metoprolol

Metoprolol is a prescription drug that comes in two different forms. This selective beta blocker can either be provided in extended-release or immediate release tablets, or capsules. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

Metoprolol is a form of beta blocker. This medication can help to lower blood pressure and reduce the heart rate in people who have heart conditions. Metoprolol is also effective at reducing the heart’s need for excessive oxygen.  

What is Metoprolol? 

Metoprolol is a prescription drug that comes in two different forms. This selective beta blocker can either be provided in extended-release or immediate release tablets, or capsules. There is also an injectable form of Metoprolol available that are used in hospital settings.  

Metoprolol tablets may be given in branded forms under the name Toprol XL, or Lopressor. This medication is also available in its generic form. Metoprolol and similar beta blockers work by treating high blood pressure. Blood pressure often raises when the blood vessels in your body tighten and constrict, placing an increased strain on your heart, and increasing the body’s demand for oxygen.  

When you take a beta blocker like Metoprolol, you prevent adrenaline (norepinephrine) from acting on the beta receptors in blood vessels and throughout the heart. This leads blood vessels in the heart to relax. When the blood vessels relax, beta blockers allow the heart rate to reduce, and decrease the demand for oxygen. This also reduces chest pain and blood pressure.  

When is Metoprolol used? 

Selective beta blocker medications like Metoprolol are used to treat heart failure, chest pain and angina, and high blood pressure. While high blood pressure doesn’t always cause symptoms by itself, it can lead to a higher risk of heart attacks, strokes, and kidney problems over time if it is left untreated. The Metoprolol drug works by blocking the action of certain chemicals in the body, like epinephrine, that affect the blood vessels and heart.  

Metoprolol lowers the heart rate, blood pressure, and the excess strain on your heart too when you’re experiencing cardiovascular issues. Metoprolol can be used as part of a combination therapy or treatment. This means that you would take Metoprolol alongside other approved medications for a condition like heart failure or high blood pressure.  

How do you use Metoprolol? 

Metoprolol is available in both extended-release and immediate-release forms. The kind of medication that you are prescribed will affect how you need to take it. It’s important to follow the instructions given by your doctor and read through the full patient leaflet provided to you with this medication.  

Metoprolol needs to be taken by mouth as directed by a doctor, and usually once per day. Some brands of this drug, including those containing metoprolol tartrate could be absorbed better after you have had a meal. Other brands, containing succinate can be taken without food or with food if you choose. It’s best to follow the instructions provided by your consultant in this regard.  

When you are taking Metoprolol extended release capsules, make sure that you do not chew them.  This could release too much of the drug at once; it is supposed to break down in your body over time. Releasing too much of the drug into your body at once will increase your risk of side effects. Make sure that you do not split the extended-release pills. Swallow your tablets whole whenever possible.  

It is best to avoid alcoholic beverages when taking Metoprolol as drinking alcohol can interfere with the release of this medication and increase your risk of side effects.  

What dosages are there? 

The dose you are given for Metoprolol will depend on a number of factors, including your response to previous treatments and your condition. To reduce your risk of suffering from more severe side effects it is likely that you will need to start this medication at a low dose. You can always gradually increase the dose over time. Follow the instructions provided to you carefully.  

The typical dose for Metoprolol is 50-200mg a day for high blood pressure, or between 100 and 200mg a day for angina. If you have a cardiac issue, then you may also be given 100 to 200mg of Metoprolol per day. To get the best benefit from this medication, you will need to use the drug regularly. It is best to take Metoprolol at the same time each day, and you can set an alarm to remind you. For the treatment of issues like high blood pressure it could take several weeks before you begin to notice the full benefit of this drug. Continue taking the medication for as long as you are advised to do so, even if your symptoms disappear.  

What are the side effects of Metoprolol? 

Aside from their intended effects, medications can also cause unintended side effects. Although you won’t necessarily experience side effects from taking Metoprolol, it is good to be aware of what the common side effects are in case you need to seek help. Keep in mind that many of the common side effects of Metoprolol are not overly dangerous and may only happen when you first begin using the tablets. The most common side effects of Metoprolol include: 

  • Drowsiness or dizziness – get up slowly when you are sitting or lying down to reduce your risk of lightheadedness when taking Metoprolol; 
  • Decreased sexual libido and ability; 
  • Diarrhea and sickness; 
  • Slow heartbeat. 

In some brands of this medication, you may notice an empty shell of a capsule in your stool – there is nothing to be alarmed of if this happens. This substance can reduce the blood flow to your feet and hands causing them to feel colder than usual. When you are taking Metoprolol you should dress warmly and avoid smoking. Tobacco use can worsen the effects of colder extremities.  

It is important to seek help from a doctor if you notice any side effects that seem to persist or worsen when you are taking Metoprolol. Even if you do not see the side effects listed here, you can talk to a pharmacist or consultant about your concerns.  

Seek emergency help immediately if you notice any very severe but rare side effects, such a severe dizziness or an extremely slow heartbeat. Other dangerous side effects might include: 

  • Fainting or dizziness; 
  • Blue toes or fingers; 
  • Problems with your breathing; 
  • Symptoms of heart failure, like shortness of breath, unusual tiredness, swelling in your feet or ankles; 
  • Mood or mental changes; 
  • Confusion or depression. 

A very serious reaction to this drug is not common. However, you should seek emergency attention if you notice any signs of an allergic reaction. Allergic reactions can present in the form of a rash, swelling around the throat and face, severe dizziness or trouble with your breathing.  

When shouldn't you use Metoprolol? 

Metoprolol may not be suitable for everyone with heart pain or high blood pressure. When you are having your consultation, you will be asked questions about your condition and medical history. It is important to answer any questions asked by your consultant truthfully to ensure that this medication is safe for you to use. Do not take this drug if you are allergic to Metoprolol or you have had any allergic reactions to beta blockers before like propranolol. If you have any other allergies, make sure that your consultant knows. Drugs can contain inactive ingredients that prompt allergic reactions. 

Before you begin using this medication, tell your consultant about your medical history, especially when it comes to certain type of heart issues. If you have a slow heartbeat or sick sinus syndrome then you should not take Metoprolol. Make sure your consultant is aware of any breathing issues you have had such as asthma, and if you have ever had any issues with liver disease or liver failure. Your consultant will need to be aware of any serious allergic reactions you may have had and blood circulation problems that could be affected when taking Metoprolol. 

You will need to take caution when using Metoprolol if you have any mood or mental disorders like depression, or certain muscular diseases like myasthenia gravis. If you have been diagnosed with diabetes, then this product can mask the fast heart rate that you would notice if you had a low blood sugar attack. You will need to keep track of your blood sugar very carefully when you are using Metoprolol. Your doctor might ask you to share regular information about your blood sugar readings with them to ensure you’re safe when taking this substance. 

If you have any symptoms of high blood sugar, such as increased urination or thirst, then your doctor might need to speak with you about adjusting your exercise program, medication or your diet. You will also need to tell your doctor or dentist that you are taking this medication before you get any treatments or procedures.  

Does Metoprolol interact with any other medications? 

Metoprolol can cause interactions with other drugs. It is important to tell your consultant about any other medications that you are using at the same time as Metoprolol, including herbal supplements, products that you purchased over the counter, and prescription drugs that were provided by a different person or the same consultant.  

There are many medications that can interact with metoprolol such as other blood pressure medication, mental health medication, antibiotics and others. Make sure that you speak to your doctor if you are taking antidepressants like fluoxetine or St John’s Wort.  

Some drugs and other substances can raise your heart rate and increase blood pressure. You will need to speak to your consultant about any products that you are using that might harm the efficacy of Metoprolol.  

Where can you buy Metoprolol? 

It is important to have your own doctor initiate Metoprolol, once you have taken it regularly and are established on a steady dose then it  is  available to purchase through corresponding pharmacies with Dokteronline.com. A consultant will discuss your condition with you and forward a prescription to a pharmacy near you. 

Can you get Metoprolol without a prescription?  

You will need a prescription to get Metoprolol. It is possible to have a prescription forwarded to your pharmacy and ready for you within 3 days.  

Sources  

Drugs.com, online, 2019, “Metoprolol” [Accessed 3rd of December 2019], Available on:: https://www.drugs.com/metoprolol.html  

Medicines.org, online, 2019, “Brand name: Naprosyn”, [Accessed 3rd of December 2019], Available on: https://www.medicines.org.uk/emc/product/5345/smpc 

Medline Plus, 2019,  “Metoprolol” [Accessed 3rd of December 2019], Available on: https://medlineplus.gov/druginfo/meds/a682864.html 

Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.