Table of ContentsView AllTable of ContentsHow It WorksEnding Metoprolol UseWhen to Take MetoprololWhen to Avoid MetoprololSide EffectsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
How It Works
Ending Metoprolol Use
When to Take Metoprolol
When to Avoid Metoprolol
Side Effects
Frequently Asked Questions
Specifically, it is used alone or with other medicines to improve blood flow and decreasehypertension (high blood pressure). It also treats chronic (long-term)angina (chest pain)and heart stress following aheart attack.
Metoprolol is often a first-line drug of choice for people with heart conditions. However, starting and stopping the use of metoprolol should be done carefully and as prescribed.
This article will explain the steps and precautions needed to safely wean off metoprolol and other relevant information about the safe use of this commonly prescribed medication.
Getty Images / Skynesher.
How Does Metoprolol Work?
Beta-blockers, like metoprolol, are also referred to as beta-adrenergic blocking agents.
This inhibitory effect causes the blood vessels to relax. The relaxation of blood vessels slows the heart rate and reduces the heart’s need for oxygen. This, in turn, helps to lower blood pressure and relieve chest pain.
Metoprolol is available in generic and brand-name form, including Lopressor (metoprolol tartrate), an immediate-release (IR; a formulation designed to be swallowed whole where the drug instantaneously disintegrates) tablet,and Toprol-XL (metoprolol succinate), an extended-release (ER; a formulation intended to dissolve slower in the body, therefore meant to last longer and require fewer dosages) capsule.
Metoprolol is also combined with adiuretic (water pill)hydrochlorothiazide. The combination is available under Lopressor HCT to treat high blood pressure.
How to Stop Taking Metoprolol
Most significantly, the sudden discontinuation of metoprolol may lead to withdrawal syndrome (with the potential for accompanyingtachycardia [increased heart rate] and hypertension), worsening chest pain, irregular heartbeat, and an increased risk of a heart attack.
As you complete your prescription, the FDA warns you to slowly taper (reduce) the dose over one week or two before stopping it altogether.Your healthcare provider will gradually decrease the quantity under close supervision to avoid severe adverse effects.
Also, your healthcare provider will determine the metoprolol dose considering age, body weight, and health condition.
You must ensure not to discontinue metoprolol on your own even if your symptoms are improving or you are feeling well. It can be highly life-threatening.
Who Should Use Metoprolol?
Beta-blockers like metoprolol are widely prescribed for people with heart disease in combination with other drugs to treat people with the following conditions:
Hypertension causes the heart to pump blood harder. An average blood pressure level is less than 120/80 millimeters of mercury (mmHg). If hypertension is not controlled and treated, it can be life-threatening.
In comparison, angina pectoris causes pain, pressure, squeezing, or discomfort in the center of the chest or neck, jaw, shoulder, back, or arm. It is caused when the heart muscle doesn’t get enough oxygen-rich blood as it needs.
Angina is not a disease but a symptom of an underlying cardiac problem such as ischemic heart disease. A major cause of angina is the blockage or narrowing of one or more of the heart’s arteries, also called ischemia (low oxygen supply due to decreased blood flow).
Who Shouldn’t Take Metoprolol?
Various formulations of metoprolol (such as Lopressor HCT, Toprol XL, or Lopressor) are discouraged in people with the following preexisting conditions:
Furthermore, be sure to discuss with your healthcare provider before taking metoprolol if you have any of the following conditions:
Pregnant people or those planning to become pregnant should consult with their healthcare provider before starting metoprolol, including those currently breastfeeding.
Side Effects & Safety
Like all drugs, metoprolol carries the potential for adverse effects.
Therefore, discuss with your healthcare provider what side effects you may be personally susceptible to before starting treatment and what can be done to strengthen the odds of healthily and effectively completing the entire duration of your prescription.
Common Side Effects
Some common side effects of metoprolol include:
If any of these side effects appear and continue to worsen, reach out to your healthcare provider immediately.
Severe Side Effects
Metoprolol may cause some severe side effects. Immediately call your healthcare provider if you experience any of the following symptoms:
Abrupt discontinuation of the metoprolol may lead to a withdrawal syndrome that could cause angina or myocardial infarction.
As explained earlier, tachycardia and hypertension are common in withdrawal syndrome. To avoid this, a healthcare provider will slowly reduce the dosage before stopping the drug to prevent withdrawal symptoms.
What Drugs Interact With Metoprolol?
Metoprolol interacts with certain drugswhen used together. Call your healthcare provider before taking these drugs alongside metoprolol:
These drugs may cause an additive effect with metoprolol and can causelow blood pressure (hypotension),bradycardia (a slowed heartbeat),vertigo,sudden fainting (vasovagal syncope), orpostural hypotension (sudden drop in blood pressure when standing from a sitting position).
Such examples include:
Potent inhibitors of CYP2D6:
Inhibitors of CYP2D6 (an enzyme found in the liver that plays a role in the effectiveness of certain drugs, such as antidepressants or neuroleptics) may hinder metoprolol’s ability to work effectively. Closely monitor when taking these drugs together.
Always tell your healthcare provider about all your drugs before starting metoprolol. Your healthcare provider may alter the dose of these medicines to avoid any interactions.
Summary
Metoprolol is widely prescribed to manage and treat various cardiovascular disorders.
It is available in multiple brand and generic names in different dosage forms. Metoprolol is used alone and in combination with other cardiovascular drugs.
Metoprolol is generally safe and effective but must only be used as prescribed. The most critical warning regarding using metoprolol is how to stop taking it.
All brands and generic version of metoprolol comes with a boxed warning about the sudden discontinuation of the drug.
Premature discontinuation may lead to a withdrawal syndrome that can worsen chest pain and arrhythmias, hypertension, and increase the risk of a heart attack.
It is necessary to slowly reduce the dose over some time and then stop the drug. Your healthcare provider will taper the dose and monitor you for side effects.
In many treatment plans, you may need to take metoprolol for a long time or even for the rest of your life.
Frequently Asked QuestionsStore metoprolol between 68 to 77 degrees F. Moreover, always keep it away from excess heat and moisture (such as in a bathroom). Keep all medication out of sight and reach of children and pets. Discard unneeded medications.However, do not flush your medicines down the toilet. The best way to discard unwanted medication is through a drug take-back program.Some common brand names of drugs that include variations of the active ingredient metoprolol currently available in the United States include: Kapspargo Sprinkle (metoprolol succinate), Lopressor (metoprolol tartrate), Toprol XL (metoprolol succinate), and Lopressor HCT (containing metoprolol, hydrochlorothiazide).
Store metoprolol between 68 to 77 degrees F. Moreover, always keep it away from excess heat and moisture (such as in a bathroom). Keep all medication out of sight and reach of children and pets. Discard unneeded medications.However, do not flush your medicines down the toilet. The best way to discard unwanted medication is through a drug take-back program.
Store metoprolol between 68 to 77 degrees F. Moreover, always keep it away from excess heat and moisture (such as in a bathroom). Keep all medication out of sight and reach of children and pets. Discard unneeded medications.
However, do not flush your medicines down the toilet. The best way to discard unwanted medication is through a drug take-back program.
Some common brand names of drugs that include variations of the active ingredient metoprolol currently available in the United States include: Kapspargo Sprinkle (metoprolol succinate), Lopressor (metoprolol tartrate), Toprol XL (metoprolol succinate), and Lopressor HCT (containing metoprolol, hydrochlorothiazide).
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: metoprolol succinate- metoprolol succinate er tablets tablet, film coated, extended release.Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065MedlinePlus.Metoprolol.Chan You S, Krumholz HM, Suchard MA, et al.Comprehensive comparative effectiveness and safety of first-line β-blocker monotherapy in hypertensive patients: a large-scale multicenter observational study.Hypertension. 2021;77(5):1528-1538. doi:10.1161/HYPERTENSIONAHA.120.16402National Health Service Inform.Beta-blockers.American Heart Association.Types of blood pressure medications.DailyMed.Label: Lopressor- metoprolol tartrate tablet.Food and Drug Administration.Toprol-XL (metoprolol succinate) prescribing information.Food and Drug Administration.Lopressor HCT (metoprolol tartrate and hydrochlorothiazide) prescribing information.Prakash A, Markham A.Metoprolol: a review of its use in chronic heart failure.Drugs. 2000;60(3):647-678. doi:10.2165/00003495-200060030-00011Food and Drug Administration.FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.Chatterjee S, Biondi-zoccai G, Abbate A, et al.Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis.BMJ. 2013;346:f55. doi:10.1136/bmj.f55Centers for Disease Control and Prevention.About high blood pressure.American Heart Association. Heart Attack and Stroke Symptoms.Angina Pectoris (Stable Angina).Prescribers' Digital Reference.Metoprolol tartrate - drug summary.Food and Drug Administration.Drug disposal: drug take back locations.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: metoprolol succinate- metoprolol succinate er tablets tablet, film coated, extended release.Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065MedlinePlus.Metoprolol.Chan You S, Krumholz HM, Suchard MA, et al.Comprehensive comparative effectiveness and safety of first-line β-blocker monotherapy in hypertensive patients: a large-scale multicenter observational study.Hypertension. 2021;77(5):1528-1538. doi:10.1161/HYPERTENSIONAHA.120.16402National Health Service Inform.Beta-blockers.American Heart Association.Types of blood pressure medications.DailyMed.Label: Lopressor- metoprolol tartrate tablet.Food and Drug Administration.Toprol-XL (metoprolol succinate) prescribing information.Food and Drug Administration.Lopressor HCT (metoprolol tartrate and hydrochlorothiazide) prescribing information.Prakash A, Markham A.Metoprolol: a review of its use in chronic heart failure.Drugs. 2000;60(3):647-678. doi:10.2165/00003495-200060030-00011Food and Drug Administration.FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.Chatterjee S, Biondi-zoccai G, Abbate A, et al.Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis.BMJ. 2013;346:f55. doi:10.1136/bmj.f55Centers for Disease Control and Prevention.About high blood pressure.American Heart Association. Heart Attack and Stroke Symptoms.Angina Pectoris (Stable Angina).Prescribers' Digital Reference.Metoprolol tartrate - drug summary.Food and Drug Administration.Drug disposal: drug take back locations.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
DailyMed.Label: metoprolol succinate- metoprolol succinate er tablets tablet, film coated, extended release.Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065MedlinePlus.Metoprolol.Chan You S, Krumholz HM, Suchard MA, et al.Comprehensive comparative effectiveness and safety of first-line β-blocker monotherapy in hypertensive patients: a large-scale multicenter observational study.Hypertension. 2021;77(5):1528-1538. doi:10.1161/HYPERTENSIONAHA.120.16402National Health Service Inform.Beta-blockers.American Heart Association.Types of blood pressure medications.DailyMed.Label: Lopressor- metoprolol tartrate tablet.Food and Drug Administration.Toprol-XL (metoprolol succinate) prescribing information.Food and Drug Administration.Lopressor HCT (metoprolol tartrate and hydrochlorothiazide) prescribing information.Prakash A, Markham A.Metoprolol: a review of its use in chronic heart failure.Drugs. 2000;60(3):647-678. doi:10.2165/00003495-200060030-00011Food and Drug Administration.FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.Chatterjee S, Biondi-zoccai G, Abbate A, et al.Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis.BMJ. 2013;346:f55. doi:10.1136/bmj.f55Centers for Disease Control and Prevention.About high blood pressure.American Heart Association. Heart Attack and Stroke Symptoms.Angina Pectoris (Stable Angina).Prescribers' Digital Reference.Metoprolol tartrate - drug summary.Food and Drug Administration.Drug disposal: drug take back locations.
DailyMed.Label: metoprolol succinate- metoprolol succinate er tablets tablet, film coated, extended release.
Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065
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American Heart Association.Types of blood pressure medications.
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Food and Drug Administration.Toprol-XL (metoprolol succinate) prescribing information.
Food and Drug Administration.Lopressor HCT (metoprolol tartrate and hydrochlorothiazide) prescribing information.
Prakash A, Markham A.Metoprolol: a review of its use in chronic heart failure.Drugs. 2000;60(3):647-678. doi:10.2165/00003495-200060030-00011
Food and Drug Administration.FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.
Chatterjee S, Biondi-zoccai G, Abbate A, et al.Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis.BMJ. 2013;346:f55. doi:10.1136/bmj.f55
Centers for Disease Control and Prevention.About high blood pressure.
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Prescribers' Digital Reference.Metoprolol tartrate - drug summary.
Food and Drug Administration.Drug disposal: drug take back locations.
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