Metoprolol - a beta-blocker

About metoprolol

What is metoprolol used for?

Metoprolol is a type of beta-blocker that is used to treat several heart-related conditions including high blood pressure, angina (chest pain) and irregular heartbeats (arrhythmias).

It is also used to ease some of the symptoms of an overactive thyroid gland and to help prevent migraines. It can be helpful for people who find other treatments for migraine unsuitable.

How does metoprolol work?

Metoprolol slows down the activity of your heart by stopping messages sent by some nerves to your heart. It does this by blocking tiny areas (called beta-adrenergic receptors) where the messages are received by your heart.

As a result, your heart beats more slowly and with less force. This allows the pressure of blood within your blood vessels to be reduced if you have high blood pressure (hypertension), and helps to prevent abnormally fast heart rhythms (arrhythmias).

Because your heart is using less energy, this helps to reduce chest pain if you have angina. Metoprolol can also help to protect the heart following a heart attack.

Side effects of metoprolol

The most common side effects of metoprolol are:

• Feeling dizzy or lightheaded - especially when getting up from a sitting or lying down position.

• Feeling tired.

• Feeling sick (nausea).

• Being sick (vomiting).

• Stomach pain or upset.

• Headache.

• Slow heartbeat.

• Cold hands or feet.

You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

How to manage metoprolol side effects

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

Who should not take metoprolol?

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking metoprolol it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breastfeeding.

• If you have asthma or any other breathing disorder.

• If you have any problems with the way your liver works.

• If you have low blood pressure or poor circulation.

• If you have high blood sugar levels (diabetes mellitus).

• If you have a skin problem called psoriasis.

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you have been told you have a slow heartbeat or heart block (a slow and irregular heartbeat).

• If you have been told you have chest pain called Prinzmetal's angina (caused by spasms of your heart's blood vessels).

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine, or if you have ever had any other serious allergic reaction.

How to take metoprolol

• Read the manufacturer's printed information leaflet from inside the pack. It will give you more information about metoprolol and will provide you with a full list of the side effects which you may experience from taking it.

• Your doctor will tell you what dose is right for you, and this information will be printed on the label of the pack of tablets to remind you.

• Take metoprolol exactly as your doctor tells you to. You may be prescribed one, two, three or four doses to take each day, depending upon your medical condition.

  • Try to take your doses at the same times of day each day, as this will help you to remember to take the tablets regularly. It is recommended that you take your doses before meals.

• If you forget to take a dose, take it as soon as you remember unless your next dose is due. If your next dose is due then take the tablet which is due but leave out the forgotten one. Do not take two doses together to make up for missing one.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• Treatment with metoprolol can often be long-term. Continue to take the tablets unless your doctor tells you to stop. Stopping treatment suddenly can cause problems in some people, so your doctor may want you to reduce your dose gradually if this becomes necessary.

• If you are due to have an operation or dental treatment, it is important to tell the person carrying out the treatment that you are taking a beta-blocker. This is because some anaesthetics may increase the risk of unwanted effects.

• If you drink alcohol, ask your doctor for advice about taking metoprolol and alcohol. Alcohol will add to the blood pressure-lowering effect of metoprolol and so may not be recommended for you.

• If you buy any medicines, check with a pharmacist that they are suitable for you to take. Some medicines (including some cough, cold and flu remedies) may not be.

• Your doctor may give you dietary and lifestyle advice about eating a healthy diet, not smoking, and taking regular exercise. If so, it is important that you follow the advice you are given.

• If you have diabetes, metoprolol can block the symptoms of low blood sugar. Your doctor will advise you about this.

How to store metoprolol

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Frequently asked questions

Are there any long-term side effects of metoprolol?

Metoprolol is usually safe long term and often works best when taken when it is taken for long periods of time.

What is the best time to take metoprolol?

The best time to take metoprolol depends on the condition being treated and the type prescribed. Standard metoprolol is usually taken two or three times a day with food, while extended-release versions are taken once daily, often in the morning. Always take it at the same time each day, and follow your doctor’s instructions.

Can metoprolol cause coughing?

Metoprolol is not commonly associated with coughing, though some people may notice mild respiratory symptoms. Coughing is more typical with a different class of blood pressure medicines called ACE inhibitors.

Will I need to stop metoprolol before surgery?

Metoprolol is usually continued before surgery to maintain heart and blood pressure control. Follow your doctor’s instructions for dosing on the day.