What is metoprolol?

Metoprolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to treat or prevent heart attack.

Metoprolol may also be used for other purposes not listed in this medication guide.

Precautions

You should not use this medication if you are allergic to metoprolol, or if you have a serious heart problem such as heart block, sick sinus syndrome, or slow heart rate.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

  • pheochromocytoma;
  • problems with circulation (such as Raynaud's syndrome);
  • congestive heart failure;
  • asthma, bronchitis, emphysema;
  • diabetes;
  • low blood pressure;
  • depression;
  • liver or kidney disease;
  • a thyroid disorder; or
  • myasthenia gravis.

FDA pregnancy category C. It is not known whether metoprolol is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

Metoprolol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Metoprolol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking metoprolol.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include slow or uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, or fainting.

Take the missed dose as soon as you remember. If your next dose is less than 4 hours away, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side Effects

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:

  • slow or uneven heartbeats;
  • feeling light-headed, fainting;
  • feeling short of breath, even with mild exertion;
  • swelling of your ankles or feet;
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • depression; or
  • cold feeling in your hands and feet.

Less serious side effects may include:

  • vomiting;
  • decreased sex drive, impotence, or difficulty having an orgasm;
  • sleep problems (insomnia);
  • tired feeling; or
  • anxiety, nervousness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before taking metoprolol, tell your doctor if you are using:

  • digoxin (digitalis, Lanoxin);
  • clonidine (Catapres);
  • ritonavir (Norvir);
  • terbinafine (Lamisil);
  • anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox);
  • medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others;
  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
  • a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);
  • a heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);
  • medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair);
  • a diuretic (water pill) such as amiloride (Midamor, Moduretic), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others; or
  • cold medicines, stimulant medicines, or diet pills.

This list is not complete and there may be other drugs that can interact with metoprolol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

Lopressor, Toprol-XL, metoprolol, and Metoprolol Succinate ER

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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