1 What is metoprolol?

Brand: Lopressor, Toprol XL

Generic: Metoprolol

Metoprolol is a prescription drug administered orally, that is presented as either sustained-release tablets or immediate-release tablets.

Metoprolol is available under the registered trade mark drugs as Lopressor or Toprol XL. It is also available as a non-branded drug, which is cheaper and is often not as effective as the brand-name version.

Metoprolol can be used alongside other drugs such as hydrochlorothiazide or chlorthalidone as part of a combination therapy.

Reasons for use

Metoprolol can be used to:

  • Decrease high blood pressure
  • Lower chest pain
  • Reduce the effort that heart muscles use to pump blood after surviving a heart attack.

 How metoprolol works

Metoprolol belongs to the class of beta blockers. A class of drugs have the same mode of action in the body, similar chemical composition and also cure conditions or treat symptoms that are alike.

2 What is metoprolol used for?

Metoprolol can be combined with some medicines to handle high blood pressure. Lowering high blood pressure prevents heart attacks, kidney complications and strokes. This medication can also be used to treat angina and improve your chances of surviving a heart attack.

Metoprolol is a beta blocker, hence it acts by inhibiting the action of certain body chemicals, especially those focused in blood vessels and heart muscles. This suppressive effect lowers blood pressure, the strain on the heart, and heart rate.

3 Metoprolol for anxiety

Sometimes your health practitioner may recommend a drug to treat some symptoms other than what it was originally meant for. This practice is called “off-label” use. For example, using metoprolol to treat anxiety is an off-label use.

This drug can help to relieve anxiety by limiting some receptors known as beta receptors. Such receptors are found in various areas including the heart and within blood vessels. Stress hormones (for example adrenaline) bind to these hormones, causing a number of responses such as increased heart rate and blood pressure. By jamming these receptors, metoprolol can inhibit the effect of stress hormones. It subsidizes the rate at which the heart beats, through both contraction and relaxing blood pressure, and reduces the effort of heart muscles when pumping blood.

4 Side effects of metoprolol

Side effects associated with taking metoprolol may not necessarily need medical attention, but it is wise to consult your doctor if they persist.

  • Fatigue and exhaustion: Metoprolol affects blood flow to the brain, by hindering the effect of adrenaline to the heart. This side effect usually vanishes after taking the drug occasionally since the body becomes adapted to its effects.
  • Slight dizziness: This drug is used to lower blood pressure and dizziness can occur especially if you engage in abrupt movements. Soon after, the body gets used to the dose and this side effect may not affect you. However, sometimes blood pressure may be made too low, or cause extremely rapid drop in blood pressure leading to severe drowsiness, which is hazardous. Such cases should be reported to the doctor as soon as they occur.
  • Loose bowels or constipation: Metoprolol can interfere with nerve signals from the brain to the bowels. This can hasten digestion causing diarrhea, or slow down digestion leading to constipation.
  • Difficulties in breathing: Shortly after taking the drug, muscles of the lung passage (bronchioles) contract causing symptoms such as shortness of breath, coughing and wheezing. This is as a result of metoprolol blocking signals from the brain to bronchioles allowing them to relax.
  • A slow heart beat (bradycardia): Metoprolol can restrict nervous impulses from the brain to the heart. This can cause your heart rate to subside below the normal.
  • Low libido: In men, metoprolol interferes with the part of the brain which signals an erection. It can also cause difficulty in reaching an orgasm and lowers the desire to have sex in both men and women.
  • Red, itchy and inflamed skin: There can be allergic responses to taking metoprolol, causing various types of skin rashes and hives. If you develop a rash, discontinue your medication and seek medical help.

Severe side effects

These require emergency medical attention as soon as they occur. Such serious side effects include:

  • Hypotension (low blood pressure): Metoprolol causes low blood pressure if the prescribed dose is too high, or your body receptors are extremely sensitive to it. Accompanying symptoms include drowsiness or fainting. If you experience any of these, seek medical attention as soon as possible.
  • Cold hands and feet: Metoprolol is a beta blocker. This class is inclined to lower the heart beats and the pressure of blood. If this gets to happen, less blood reaches your body parts, including your hands and feet, causing them to be cold. Sometimes this side effect gets to be very painful.
  • Severe bradycardia: Since beta blockers interfere with nerve impulses form the brain to the heart, they can slow down your heat beat to very low levels. They can even cause the heart to stop pumping blood.
  • Extreme fatigue: Metoprolol slows down your heart rate which consequently reduces blood flow to the brain, arms and legs. Due to this, some people will feel tired that worsens with each day. This can hinder them from accomplishing day to day chores.
  • Acute depression:Some people experience depression with extended use of metoprolol. It is unclear whether depression is caused by this drug since heart-disease patients exhibit higher levels of depression. In the last two decades, extensive research has been done, but still there are no conclusive results. Some show that taking metoprolol is directly associated with depression while some studies suggest that there is no direct link. If you have experienced depression before, this drug can worsen your state. Talk to your doctor if you experience depression while taking metoprolol, since it can become a fatal condition. 

5 Metoprolol dosage

All possible dosages are not covered here. However, the dose, form of medication and how frequently you take it relies on:

  • Your age
  • The ailment being treated
  • The severity of your condition
  • Underlying medical conditions
  • Your reaction to the initial dose

For high blood pressure

  • Adult dosage (18-64 years)
    • The immediate-release drug is often 50 mg taken twice a day. Modifications can be made when required to.
    • The extended-release drug is normally given at 25 mg once per day or sometimes more. Upon recommendation, it can be increased.
  • Child dosage (0-17 years)
    • A suitable dosage for people under the age of 18 has not been determined.
  • Senior dosage (65 years and older)
    • Since your body has a reduced capability to efficiently absorb this drug, the doctor will start you on a low dose so that your body does not absorb too much of it. High levels of this drug in the body can turn out to be toxic.
  • Special considerations
    • Consult your general practitioner if you suffer from liver disease so that a suitable dosage is formulated.

For angina (chest pain)

  • Adult dosage (18-64 years)
    • The dose for the immediate-release drug can be increased. The starting dose is normally 50 mg taken twice a day.
    • The extended release is started at 100 mg taken twice a day. The dose can be increased upon recommendation.
  • Child dosage (0-17 years)
    • For this age group, a suitable dose has not yet been arrived at or approved.
  • Senior dosage (65 years and older)
    • Since the body processes drugs much slower, the doctor will usually start at a low dose so that there isn’t a toxic build up in the body.
  • Special considerations
    • If you have a liver disease, speak with your health practitioner to come up with a suitable dose.

For heart failure or after a heart attack

  • Adult dosage (18-64 years)
    • For patients who survive a heart attack or have a heart failure, the dose will vary according to the person. The initial dose is normally given when still in hospital.
    • The immediate-release tablet is started at 12.5-25 mg taken once a day. Afterwards, the dose can be modified.
  • Child dosage (0-17 years)
    • Dosage for individuals under the age of 18 has not been established.
  • Senior dosage (65 years and older)
    • At this age, your body processes drugs much slower. To prevent flooding your body with this drug to poisonous levels, health practitioners are advised to start at a lower dose.
  • Special considerations
    • Liver disease greatly affects the dose. Speak with your general practitioner if you are affected by this condition.

6 Metoprolol extended-release

This medication can be used to relieve chest pain, heart failure, and high blood pressure since it is a beta blocker. Lowering blood pressure is a preventive measure against strokes, heart attacks and some kidney problems. The mode of action of this drug is suppressing the action of body chemicals, especially those acting on heart muscles and blood vessels. This will consequently lower blood pressure, the heart rate and strain on the heart.

In addition to that, this medication can also be used in treating irregular heartbeats, preventing migraine headaches, and to improve chances of surviving an acute heart attack.

This medicine is taken orally once in the morning, with or without food, as directed by the doctor. To get the best results, take this medicine at regular intervals. Aim to take it at the same time each morning, daily. Also, swallow this medicine without crushing or chewing the tablets. It is important to note that its effectiveness is limited when you use it when treating only chest pain or a headache caused by a migraine alone. Take this drug consistently as ordered by your GP to prevent some of the side effects. Dosage is usually given after considering your response to the drug and your medical state. The drug may take one to two weeks before its full effect is felt.

7 Metoprolol succinate

This is a beta blocker which is used to treat chest pain (angina), heart failure, and high blood pressure. The reason for lowering blood pressure is to minimize the instances of strokes, heart attacks, and kidney complications.

Metoprolol succinate works by inhibiting the action of some of the chemicals in the body, such as epinephrine, which majorly affects the heart muscles and blood vessels. This will reduce the heart rate, blood pressure and stress on the heart.

OTHER USES: Metoprolol succinate is sometimes used for purposes that are not listed in the permitted US expert cataloging for the medicine, but can be recommended by your health care giver. If your health care professional believes the medication can help you in other ways, he or she may prescribe it to you.  

Metoprolol succinate can also be used to relieve inconsistent heartbeats, for migraine headache prevention, and after a severe heart attack to improve survival.

How to use metoprolol succinate

The doctor will direct you on its use. Normally, you can take it with or after a meal once a day. The dose you will be prescribed is influenced by your health status and response to the drug.

Do not attempt to chew extended-release tablets, as this can cause them to flood your body, making you more vulnerable to develop side effects. Also, don’t split the tablets unless directed by your health practitioner or if the tablet has a score line and the doctor approves splitting it. Swallow metoprolol succinate tablets without chewing or crushing.

8 Metoprolol tartrate

Metoprolol tartrate has adrenaline qualities and is a beta-blocker. Its mechanism of action is reducing efforts the heart uses to pump blood and also subsidizing high blood pressure by regulating the volume of blood the heart pumps. It can also be used to steady heart beat rhythms when they are either too rapid or just irregular.

Metoprolol tartrate is not recommended when:

  • You develop allergies to ingredients used or beta blockers at large
  • You are taking mibefradil
  • You have a slow heart rate, irregular heartbeat, moderate to extreme heart failure, low systolic blood pressure, or other severe blood circulation problems

Tell the doctor if you struggle with any of the above.

There are some conditions which can interfere with the action of metoprolol tartrate. Tell your doctor if any of the following are applicable to you:

  • If you are with child or breastfeeding, or you are planning to become pregnant
  • If you take any medicine, prescribed or non-prescribed, or dietary supplements
  • If you have an allergy to certain foods, medicine or other substances
  • If you have a tumor of the adrenal glands, feverish thyroid or you are due for surgery
  • If you have blood circulation conditions, low pressure of blood and previous heart failure history, irregularities in the heartbeat and associated problems, chest pain caused by insufficient blood flow to the chest, or liver problems
  • If you suffer from chronic obstructive pulmonary disease, bronchitis, breathing complications, or diabetes mellitus or if you are asthmatic

Instructions of use

Check the package for additional instructions and also follow your medication routine as told by your doctor.

  • Metoprolol tartrate is typically dispensed as a shot by your GP. If you prefer to use it at your home, well-trained health practitioners will tutor you on how to dispense it. Be sure that you are knowledgeable on how to use metoprolol tartrate and follow your doctor’s instructions. Seek for any clarifications if you still have questions.
  • Never take metoprolol tartrate if it appears murky or tarnished, if it bears particles, or the ampoule has been altered or damaged.
  • Keep all equipment, including needles and syringes, and this product at a safe place inaccessible to children and pets. Do not reuse needles or syringes or any associated products. Dispose these materials hygienically and follow all local rules regarding their disposal.
  • If you had skipped a dose, take it as soon as possible. However, if it is closer to the next dose, leave out the missed dose and resume your normal dosage routine. Don’t use two doses at the same time.

If you still have unanswered queries, ask your health care provider when you get to meet for an appointment.

Essential precautionary information

  • Metoprolol tartrate will possibly instigate dizziness and drowsiness. This can be fatal if you use it with some other medicines or alcohol. Don’t attempt to drive or do chores which can turn out to be risky, until you are sure how you react to it.
  • Metoprolol tartrate may also cause dizziness, drowsiness and fainting. These can be worsened if you use alcohol, are in hot weather, exercising or have a fever. To prevent this, sit or stand slowly, especially during the morning hours. If you discern any of these secondary effects, sit or lie down for a while.
  • People who take drugs to suppress elevated pressure of blood feel worn out during the first weeks after onset of treatment. Nonetheless, continue your dose even if you don’t feel very well. Tell your doctor if symptoms worsen or if you develop new symptoms.
  • Do not discontinue using metoprolol tartrate abruptly. Instead, the doctor will devise a way in which you gradually decrease the dose, after finding that you need to discontinue its consumption.
  • Monitor your blood pressure and rate of heart beats regularly as instructed by the doctor.
  • Consult health experts before taking drugs used to alleviate colds and congestion.
  • Metoprolol tartrate can hide indications of depressed blood sugar in diabetes patients. Ensure you keep a keen eye on other signs such as restlessness, extreme sweating, and lightheadedness. It may even alter your vision, cause a headache, chills and tremors, or increase your hunger. Monitor blood sugar levels and consult with your doctor if you think you may need to change the dose.
  • If you are soon going for a surgery or dental care, inform the doctor.
  • If you ever had previous severe allergic reactions, inform your doctor. Some allergies are worsened by metoprolol tartrate and medicine used to treat them may not work as efficiently as expected.
  • Some lab tests, including kidney and liver performance, blood pressure and comprehensive blood cell counts can be done. These tests can be used to monitor your health and side effects. Ensure you attend all scheduled appointments with the doctor.
  • Metoprolol tartrate ought to be used with paramount care since it is unclear how effective or severe its use is towards children.
  • Expectant and breastfeeding women should inform the doctor of their state. Discuss in depth with your doctor to know all risks and advantages of using metoprolol while pregnant. If you are lactating, confer with your medic to know if this drug poses a risk to the child.

9 Metoprolol and hair loss

Hair loss was reported in less than 1% of people who use metoprolol. Some clinical investigations show that some of the side effects are temporary and can be reversed once the dose is completed.

If you notice hair loss while taking metoprolol, talk to your doctor. Depending on the hair loss, the dose can be altered or a substitute drug be recommended.

10 Metoprolol and alcohol

Avoid drinking alcohol while you are on metoprolol. Drinking alcohol while taking metoprolol can increase side effects including dizziness, drowsiness, fainting and abnormalities in the pulse rate. These side effects are usually only witnessed during the onset of metoprolol treatment, or after your dose is interrupted. Taking alcohol can induce side effects.

Do not attempt to operate any machinery as it can be very dangerous. Also, notify the doctor if symptoms persist or become irritating. It is important to tell the doctor any medication or supplements which you take, and don’t attempt to discontinue your medication without the doctor’s consent. If you drink alcohol while on metoprolol and notice abnormal or dangerous effects on your body, notify your doctor immediately. 

11 Does metoprolol cause erectile dysfunction?

It is normally believed that beta blockers can cause erectile dysfunction in men. However, it is also possible that some psychological factors, such as phobia of the disease, or side effects of medication, can trigger erectile dysfunction. Whether and how metoprolol plays a role in causing erectile dysfunction is unknown.

12 How long does it take metoprolol to work?

Effectiveness of this drug is impulsive and will diverge contingent on the blood volume and blood pressure. However, if blood pressure is low, use of the drug can be fatal since it also works by lowering blood pressure.

13 Related Clinical Trials