Metoprolol Interactions, Uses, and Side Effects – What You Need to Know

Written by Phil Rossi, Melissa Bostock PharmD

NowRx Pharmacy

metoprolol written prescription

With over 74 million prescriptions written each year, Metoprolol is one of the most popular medications in America. Commonly sold under the brand names Toprol XL (metoprolol succinate) and Lopressor (metoprolol tartrate) it is used to treat high blood pressure as well as several other heart-related conditions. Although metoprolol is usually taken as a tablet, it may be administered to some patients through an IV.

Let’s take a look at what you need to know about this popular prescription medication.

What Is Metoprolol

Metoprolol is a prescription medication that belongs to a class of drugs called beta blockers. These medications are commonly prescribed to treat hypertension, otherwise known as high blood pressure. However, metoprolol has also been FDA approved to treat a range of heart conditions including chest pain, irregular heartbeat, and secondary prevention.

While metoprolol is the generic name of the medication, the most common brand name drugs are Toprol XL (metoprolol succinate) and Lopressor (metoprolol tartrate). In total, metoprolol is used by over 15 million patients across the US.

What is metoprolol used for?

Metoprolol is mainly used to treat high blood pressure when other medications haven’t worked. However, it has been FDA approved for a range of heart conditions. These include angina (chest pain), heart failure, myocardial infarction (heart attack), and atrial fibrillation/flutter. In some cases, metoprolol may also be used to prevent migraine headaches and treat movement disorders caused by medications for mental illness.

If you have questions about metoprolol or its use, talk to your doctor or pharmacist.

Is metoprolol a beta blocker or ace inhibitor?

Metoprolol is a beta blocker, also called a beta-adrenergic blocking agent. These medications are commonly used to reduce blood pressure when other medications haven’t worked. In addition, research shows that beta blockers are effective in long-term secondary prevention after a heart attack.

Beta-blockers work by blocking receptor sites for epinephrine (adrenaline). These receptors are found throughout the body on cells of the heart muscle, lungs, arteries, kidneys, and other sympathetic nervous system tissue. By blocking these receptors, beta-blockers cause the heart to beat more slowly and with less force which helps to lower blood pressure.

What is the difference between metoprolol succinate and metoprolol tartrate?

Simply put, the difference between metoprolol succinate and metoprolol tartrate is the timing of their release. Metoprolol succinate is an extended release that can be taken once a day. Conversely, metoprolol tartrate is only available as an immediate release.

These characteristics affect the dosage of each as well as what they are typically used for. For example, metoprolol tartrate can be used to reduce the risk of a heart attack or a secondary attack immediately following an MI. However, both have many similar uses as each contains the same active ingredient metoprolol.

Should I Take Metoprolol In The Morning Or At Night

Deciding to take metoprolol in the morning or night depends on the specific medication you are taking. For example, metoprolol tartrate is typically taken more than once a day and should be taken in the morning and night. However, if you are taking metoprolol succinate, you can take it in the morning or at night.

Your doctor may advise you to take your first dose before bedtime since it could make you dizzy. Remember to always take exactly as directed and do not stop taking metoprolol without first talking with your doctor.

How long does it take metoprolol to work?

How long it takes metoprolol to work depends on how the medication is taken. When the drug is injected intravenously, the effect on the heart can be seen within 20 minutes. By contrast, tablets will begin to take effect within one hour.

Both metoprolol tartrate and succinate follow similar timelines. However, metoprolol tartrate will usually need to be taken twice per day while metoprolol succinate will only need to be taken once.

How long does metoprolol stay in your system?

Metoprolol stays in your system for about 20 hours depending on the type of metoprolol and how the medication is taken. This is based on a 3-4 hour half-life – the time it takes the drug to reduce to half its original amount in your blood. After about 5 half-lives a drug is completely eliminated from the body. However, several medical conditions, foods, supplements, and medications will impact how long this medication stays in your body.

Talk with your doctor or pharmacist if you have questions about your specific condition and medication or dosage.

Metoprolol Side Effects

Despite its widespread use, metoprolol has a number of side effects. These include common and relatively benign side effects and some rare and serious side effects. Although not everybody will experience side effects, it is important to understand what to expect and when to seek medical attention.

Let’s take a look at some of the different metoprolol side effects that may occur.

*Please note that this is not a comprehensive list of side effects. Talk with your doctor or pharmacist if you have questions regarding your medication. Do not stop or change any medication regimen without first speaking with a qualified health professional.

Common Side Effects

There are a number of common side effects that you may experience when starting or taking metoprolol. While some of these may go away as you adjust to the medication, others could be serious and require medical attention.

Talk with your doctor immediately if you experience any of the following side effects:

  • Dizziness
  • Fatigue or unexplained weakness
  • Confusion
  • Depression
  • Mild Itching or rash
  • Gas/bloating
  • Diarrhea
  • Trouble Sleeping

Get immediate medical attention if you experience any of the following side effects:

  • Blurred vision
  • Chest pain/discomfort
  • Lightheadedness
  • Shortness of breath
  • Slow or irregular heartbeat
  • Sweating
  • Sudden unexplained weight gain

Less Common and Rare Side Effects

Rare side effects may occur in some patients. Should any of the following side effects occur, you should tell your doctor immediately.

  • Bloating or swelling of extremities
  • Cough
  • Change in urine or urination frequency
  • Problems with vision
  • Trouble speaking
  • Dilated neck veins
  • Extreme fatigue
  • Fast, pounding, or racing heartbeat or pulse
  • Unusual bleeding or bruising
  • Muscle pain or tension
  • Unexplained headaches
  • Short-term memory loss
  • Hallucination
  • Yellow eyes or skin

This is not a comprehensive list of side effects. If you have questions about any side effects you should contact your doctor or pharmacist.

Signs of an Overdose

If you or a loved one are experiencing any of the following symptoms, you should seek immediate emergency medical attention. Symptoms of an overdose may include:

  • Blue or bluish fingernails, lips, skin, palms, or nails
  • Change in consciousness
  • Loss of consciousness
  • No blood pressure or pulse
  • Very drowsy or sleepy

Can metoprolol cause weight gain?

Yes, research shows that metoprolol can cause weight gain. Typically, beta-blockers are associated with weight gain in the first few months of treatment followed by a plateau. However, this weight gain is generally moderate and clinically insignificant. Of the commonly prescribed beta-blockers, metoprolol is associated with the greatest amount of weight gain.

Do not stop or change your medication regimen without talking with a qualified healthcare professional as it may result in serious health consequences or even death.

Does metoprolol cause hair loss?

Yes, metoprolol may cause hair loss in some cases although it is rare. Generally, this will depend on the dosage as well as individual predisposition to hair loss. In addition, hair loss is generally reversible when discontinuing treatment.

However, you should not stop or change your medication regimen under any circumstances without first talking with a qualified healthcare professional as this can result in serious health consequences or even death.

Metoprolol Interactions

Metoprolol has a number of interactions with both over-the-counter medications and prescription medications. Some of the most significant metoprolol interactions include:

  • atazanavir
  • aminophylline
  • ceritinib
  • clonidine
  • diltiazem
  • disopyramide
  • dolasetron
  • dyphylline
  • fexinidazole
  • fingolimod
  • mavacamten
  • methacholine
  • oxtriphylline
  • ponesimod
  • ritodrine
  • saquinavir
  • siponimod
  • theophylline
  • tizanidine
  • verapamil

This is not a complete list of metoprolol interactions. Talk to your doctor or pharmacist if you have questions about whether a medication you are taking will interact with metoprolol.

Can I take ibuprofen with metoprolol?

You should not take ibuprofen and metoprolol without first talking with your doctor. This is because non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may reduce the effectiveness of metoprolol in lowering your blood pressure. Avoid using these medications together especially if you are using NSAIDs frequently like to treat inflammation or chronic pain from rheumatoid arthritis.

Remember, talk with your doctor if you have questions, and do not stop taking any prescribed medication unless directed.

Can I take Tylenol with metoprolol?

There are no known interactions between metoprolol and Tylenol (acetaminophen). In other words, it is safe to take Tylenol with metoprolol.

Remember, it is important to tell your doctor and pharmacist about all medications, supplements, vitamins, and herbs you are taking. This is especially true when you start a new medication.

Never start, stop, or change any medication regimen without first speaking with a qualified healthcare professional.

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