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

What is metoprolol?

Metoprolol is a selective beta-blocker available on prescription in two different forms, either extended-release or immediate- release tablets or capsules. There is also an injectable form of metoprolol available used in hospital settings. Metoprolol tablets can be found in branded forms under the name Toprol XL and Lopressor, and also in their generic form.

Metoprolol and similar beta-blockers work by treating high blood pressure, often due to the blood vessels in the body tightening and constricting, placing an increased strain on the heart and increasing the body’s demand for oxygen. Taking a beta-blocker like metoprolol prevents adrenaline (norepinephrine) from acting on the beta receptors in blood vessels and throughout the heart, leading the blood vessels in the heart to relax. The beta-blockers then allow the heart rate to reduce, and decrease the demand for oxygen, easing chest pain and blood pressure.

When is metoprolol used?

Selective beta-blocker medications such as metoprolol are used to treat heart failure, chest pain and angina, and high blood pressure. While high blood pressure does not always cause symptoms by itself, it can lead to a higher risk of heart attacks, strokes and kidney problems over time if left untreated. Metoprolol 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 excess strain on the heart too when you are experiencing cardiovascular issues. Metoprolol can be used as part of a combination therapy or treatment, i.e. you take it alongside other approved medications for a condition such as heart failure or high blood pressure.

How do you use metoprolol?

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

Metoprolol beta-blockers need to be taken by mouth as directed by a doctor, usually once a day. Some brands of this drug, including those containing metoprolol tartrate, are absorbed better after a meal. Other brands containing succinate can be taken with or without food. It is best to follow the instructions provided by your consultant in this regard.

When taking metoprolol extended-release capsules, make sure that you do not chew them as this might release too much of the drug at once. They are intended to break down in the body over time, and releasing too much of the drug at once will increase the risk of side effects. Make sure that you do not split the extended-release pills: swallow the tablets whole whenever possible.

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

What dosages are there?

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

The typical dose for metoprolol is 50 mg – 200 mg a day for high blood pressure, and between 100 mg and 200 mg a day for angina. If you have a cardiac issue, then you may also be given 100 mg to 200 mg of metoprolol per day. To get the most benefit from this medication, you will need to use it regularly. It is best to take metoprolol beta-blockers at the same time each day, and you can set an alarm to remind you. For the treatment of issues such as 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 will not necessarily experience side effects from taking metoprolol, it is good to be aware of what the common ones 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.

These 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;
  • Diarrhoea 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 about. 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 beta-blockers. 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 of the rare very severe side effects, such as severe dizziness or an extremely slow heartbeat. Other dangerous side effects can include:

  • Fainting or dizziness;
  • Blue toes or fingers;
  • Breathing problems;
  • Symptoms of heart failure such as shortness of breath, unusual tiredness, swelling in the 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. These can present in the form of a rash, swelling around the throat and face, severe dizziness or trouble breathing.

When should not you use metoprolol?

Metoprolol beta-blockers 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 them all 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 such as propranolol before. If you have any other allergies, make sure that your consultant knows. Drugs can contain inactive ingredients that prompt allergic reactions.

Before you begin taking this medication, tell your consultant about your medical history, especially certain types of heart issues. If you have a slow heartbeat or sick sinus syndrome, you should not take metoprolol beta-blockers. Make sure your consultant is aware of any breathing issues you have had such as asthma, and if you have ever had any problems 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 beta-blockers.

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

If you have any symptoms of high blood sugar, such as increased urination or thirst, your doctor may need to speak with you about adjusting your exercise program, medication or 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 beta-blockers can interact with other drugs. It is important to tell your consultant about any other medications that you are using at the same time as metoprolol beta-blockers, 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 and antibiotics. Make sure that you also speak to your doctor if you are taking antidepressants such as 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 prescribe metoprolol beta-blockers. Once you have taken them regularly and are established on a steady dose, they will be available to purchase through corresponding pharmacies with 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 beta-blockers. It is possible to have a prescription forwarded to your pharmacy and ready for you within three days.

Sources:, online, 2019, “Metoprolol” [accessed 3 December 2019], Available on::, online, 2019, “Brand name: Naprosyn”, [accessed 3 December 2019], Available on:

Medline Plus, 2019, “Metoprolol” [accessed 3 December 2019], Available on:

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