GENERIC NAME: Metoprolol

COMMON BRANDS: Lopressor, Toprol XL

Metoprolol is an oral prescription drug that belongs to a class of drugs called cardioselective beta-blockers. A class of drugs is often used to treat similar conditions.

Beta-blockers work by preventing adrenaline (norepinephrine)  from acting on beta receptors that are present in blood vessels and the heart. This causes the relaxation of blood vessels. Beta-blockers lowers the heart rate and reduces the demand of oxygen by heart by relaxing the blood vessels. This, in turn, helps to decrease blood pressure and reduce chest pain.

What is Metoprolol uses for?

Metoprolol is prescribed as such or in combination with other medications for the treatment of hypertension (high blood pressure). Lowering high blood pressure prevents the risk of strokes, heart attacks, and kidney problems. This drug is also used for the treatment of angina (chest pain) and increases the chances of survival in case of a sudden heart attack.

How to use Metoprolol?

Metoprolol is taken orally, with meals or after meals, as directed by the doctor, usually 1-3 times in a day. The dosage of this drug depends on your medical condition and response to the treatment.

Your doctor may recommend you to start this drug at a lower dose and gradually increase the dose to reduce your risk of side effects. Follow the instructions of your doctor carefully.

Use this medication regularly without missing the dose to benefit the most from it. To help you remember, take this drug at the same time each day. Do not stop this drug suddenly. Your condition may worsen when this drug is suddenly discontinued.

It may take weeks to get the full benefit of this drug in the treatment of high blood pressure. Do not stop taking this drug even if you feel better. Most people suffering from hypertension do not feel sick.

It is vital to take this medication regularly as prescribed to prevent chest pain, a second heart attack, or migraine headaches. This drug is not recommended for the treatment of chest pain or migraines. Use other medications (for example, “nitroglycerin” tablets placed under the tongue for chest pain, “triptan” drugs such as sumatriptan for migraines) to relieve sudden attacks as directed by your doctor. Ask your doctor/pharmacist for further information.

Discuss with your doctor if your medical condition does not get better or if it worsens (such as, if your blood pressure remains high or increase when your chest pain or migraines occur more often).

What are the side effects of Metoprolol?

Some of the significant side effects include dizziness, drowsiness, tiredness, diarrhea and low heart rate. The decreased sexual ability is reported rarely. If any of the above results persist or worsen, inform your doctor/pharmacist immediately.

Get up slowly from a sitting or lying position, and this may help to reduce the risk of dizziness and lightheadedness.

You may experience coldness in your hands and feet as this drug may decrease the blood flow to these parts of the body. Avoid smoking or chewing of tobacco as this may worsen this effect.

Remember that your doctor/physician has prescribed this medication because he or she has found that the benefits to you are more than the side effects. Most of the people using this medication do not have severe side effects.

Notify your doctor on time if any of these serious side effects occur: very slow heartbeat, severe dizziness, fainting, blue fingers/toes, new or worsening symptoms of heart failure (such as shallow breath, swelling of ankles/feet, unusual tiredness, unusual/sudden weight gain), trouble in breathing, mental/mood changes (such as confusion, depression, mood swings).

A severe allergic reaction to this drug is not typical. However, a severe allergic reaction that includes rashes, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing may occur. Get medical assistance immediately if you notice any of the above side effects.

This is not a complete list of all possible side effects. Inform your doctor at the earliest, if you notice any of the side effects that are not mentioned.

What are the precautions while using Metoprolol?

Inform your doctor/pharmacist before taking metoprolol, if you are allergic to it; or to any other beta-blockers (for example atenolol, propranolol, acebutolol, bisoprolol, nebivolol); or if you have other allergies. Drug formulations (products containing metoprolol) may also contain some ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for further information.

Inform your doctor/pharmacist before using metoprolol about your medical history, especially if you have any heart problems (such as a slow heartbeat, second- or third-degree atrioventricular block, sick sinus syndrome), blood circulatory problems (such as Raynaud’s disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), liver disease, heart failure, a certain muscle disease (myasthenia gravis), serious allergic reactions, including those needing treatment with epinephrine, mental/mood disorders (such as depression).

This drug may cause you dizzy. Alcohol or marijuana can make you dizzier. Avoid driving, use of machinery or doing anything that needs sharpness until you can do it safely. Limit alcoholic beverages. Speak to your doctor/physician if you are using marijuana.

If you have diabetes, this drug may mask the symptoms of hypoglycemia (sudden fall in blood sugar level) such as fast/pounding heartbeat you would usually feel when you are hypoglycemic. Other symptoms of hypoglycemia such as sweating and dizziness, does not change by this drug. This drug can also make it difficult to control your blood sugar level. Monitor your blood sugar levels regularly share the results with the doctor. Inform your doctor immediately if you have any symptoms of hyperglycemia (high blood sugar level) such as an increase in thirst or urination. Your doctor may recommend you exercises, diet or may adjust your diabetes medication.

Before having any surgery, notify your doctor or dentist about all the products you use (such as prescription drugs, nonprescription drugs, and herbal product).

You may sometimes experience dizziness or drowsiness.

This medication should be used only when needed during pregnancy. It may be harmful to the fetus. This drug can also cross into breast milk. For further information about the risks and benefits discuss with your doctor.

What are the drug interactions of Metoprolol?

Drug interactions may alter drug’s action or increase your chance for severe side effects. This section does not contain the full list of all possible drug interactions. Have a list of all the products you use (for example prescription/nonprescription drugs and herbal products) and inform it to your doctor/pharmacist. Do not start, stop, or adjust the dosage of any medicines without your doctor’s advice.

Some drugs can influence the excretion of metoprolol from your body, which may alter how metoprolol works such as lumefantrine, quinidine, propafenone, SSRI antidepressants (such as fluoxetine, paroxetine), St. John’s wort, among others. A product that may interact with metoprolol is fingolimod.

Some products may contain ingredients that could raise your blood pressure, heart rate, or increase the risk of heart failure. Tell your doctor/pharmacist about products you are using, and ask how to use them safely (particularly cough-and-cold products, NSAIDs such as ibuprofen/naproxen, diet aids).

WARNINGS:

Do not suddenly stop this medication without informing your doctor. Some conditions may become dangerous when you suddenly discontinue this drug. Some people who have abruptly discontinued taking similar drugs have had chest pain, heart attack, and even irregular heartbeat. If your doctor recommends you to stop this drug, your doctor may ask you to reduce your dose gradually.

When you are gradually reducing the dose of this drug to discontinue this medication slowly, your doctor may recommend you to limit physical activity to reduce strain on your heart. Get medical assistance immediately if you notice symptoms like chest pain/tightness/pressure, unusual sweating, trouble breathing, chest pain spreading to the jaw/neck/arm, or fast/irregular heartbeat.

What are the forms and strengths of Metoprolol?

Generic: Metoprolol

Form: Immediate-release oral tablet
Strength: 25mg, 37.5mg, 50mg, 75mg, and 100mg

Form: Extended-release oral tablet
Strength: 25mg, 50mg, 100mg, and 200mg

Brand: Lopressor

Form: Immediate-release oral tablet
Strength: 50 mg and 100 mg

Brand: Toprol XL

Form: Extended-release oral tablet
Strength: 25mg, 50mg, 100mg, and 200mg

What is the dosage of Metoprolol?

For High Blood Pressure:

Adult dosage (18–64 years):

Immediate-release tablets:

Typical starting dosage: 100mg daily in a single or divided dose. This dose can be gradually increased if required.
Typical maintenance dosage: 100–450mg per day.
Maximum dosage: 450mg per day.

Extended-release tablets:

Typical starting dosage: 25–100mg daily in a single dose. This dose can be gradually increased if needed.
Maximum dosage: 400mg per day.

Children (6–17 years):

Extended-release tablets:

Typical starting dosage: 1mg/kg once daily (maximum initial dose should not exceed 50mg once a daily). This dosage can be gradually increased if needed.
Maximum dosage: 2mg/kg once a day.

Immediate-release tablets:

These tablets are not approved for the treatment in this age group.

Children (0–5 years):

Dosage for children younger than 6 years is not established.

Senior dosage (65 years and older):

If you are an older person, your body may process this drug slowly. Your doctor may start the treatment at a lower dosage to prevent drug build up the body. Accumulation of the drug in your body can be deadly.

For Angina (chest pain):

Adult dosage (18–64 years):

Immediate-release tablets:

Typical starting dosage: 50mg, taken twice a day. This dose can be gradually increased as needed.
Typical maintenance dosage: 100–400mg per day.
Maximum dosage: 400mg per day.

Extended-release tablets:

Typical starting dosage: 100mg taken once a day. This dose can be gradually increased if needed.
Maximum dosage: 400mg per day.

Children (0–17 years):

For people younger than 18 years, the dosage hasn’t established.

Senior dosage (65 years and older):

If you are an older person, your body may process this drug slowly. Your doctor may start the treatment at a lower dosage to prevent drug build up the body. Accumulation of the drug in your body can be deadly.

Following A Heart attack:

Adult dosage (18–64 years):

Immediate-release tablets:

Treatment with this drug hospital is often started with intravenous formulation immediately after a heart attack. Treatment with the oral medication as mentioned below can be given if your body tolerates the intravenous dose.

Typical starting dosage: 50mg every 6 hours starting 15 minutes after the last intravenous dose and continuing for 48 hours.
Typical maintenance dosage: 100 mg twice daily.

Children (0–17 years):

For people younger than 18 years, the dosage hasn’t established.

Senior dosage (65 years and older):

If you are an older person, your body may process this drug slowly. Your doctor may start the treatment at a lower dosage to prevent drug build up the body. Accumulation of the drug in your body can be deadly.

For Heart Failure:

Adult dosage (18–64 years):

Extended-release tablets:

Typical starting dosage: For patients with NYHA Class II cardiac failure, it’s 25mg once a day for 2 weeks. For people with more severe cardiac failure, it’s 12.5mg once a day.
Typical maintenance dosage: Your doctor may double the dosage every 2 weeks to the maximum dosage level your body can tolerate, or up to 200mg per day.

Children (0–17 years):

For people younger than 18 years, the dosage hasn’t established.

Senior dosage (65 years and older):

If you are an older person, your body may process this drug slowly. Your doctor may start the treatment at a lower dosage to prevent drug build up in the body. Accumulation of the drug in your body can be deadly.

Special dosage considerations:

For liver disease: Liver disease may affect your dosage. Discuss with your doctor for more details.

Most common questions asked about Metoprolol / Q&A’s:

Does Metoprolol contain Valsartan?

No, Metoprolol and Valsartan are both different drugs. Metoprolol is a drug that belongs to a class known as beta-blockers and Valsartan is a drug that belongs to a class known as angiotensin-converting enzyme inhibitors (ACE inhibitors). However, both the drugs are used for the treatment of hypertension (blood pressure) depending on the medical diagnosis.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.