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Metoprolol

Generic Name: metoprolol (me TOE pro lol)
Brand Names: Kapspargo Sprinkle, Lopressor, Toprol-XL

Medically reviewed on September 5, 2018

What is metoprolol?

See also: Pradaxa

Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure).

Metoprolol is also used to lower your risk of death or needing to be hospitalized for heart failure.

Important Information

You should not use metoprolol if you have a serious heart problem (heart block, sick sinus syndrome, slow heart rate), severe circulation problems, severe heart failure, or a history of slow heart beats that caused fainting.

Before taking this medicine

You should not use this medicine if you are allergic to metoprolol, or other beta-blockers (atenolol, carvedilol, labetalol, nadolol, nebivolol, propranolol, sotalol, and others), or if you have:

  • a serious heart problem such as heart block, sick sinus syndrome, or slow heart rate;

  • severe circulation problems;

  • severe heart failure (that required you to be in the hospital); or

  • a history of slow heart beats that have caused you to faint.

To make sure this medicine is safe for you, tell your doctor if you have:

Do not give this medicine to a child without medical advice.

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether metoprolol will harm an unborn baby. However, having high blood pressure during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating hypertension may outweigh any risks to the baby.

Ask a doctor before using this medicine if you are breast-feeding. Metoprolol can pass into breast milk and may cause dry skin, dry mouth, diarrhea, constipation, or slow heartbeats in your baby.

How should I take metoprolol?

Take metoprolol exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Metoprolol should be taken with a meal or just after a meal.

Take the medicine at the same time each day.

Swallow the capsule whole and do not crush, chew, break, or open it.

A Toprol XL tablet can be divided in half if your doctor has told you to do so. Swallow the half-tablet whole, without chewing or crushing.

You will need frequent medical tests, and your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using this medicine.

You should not stop using this medicine suddenly. Stopping suddenly may make your condition worse.

If you have high blood pressure, keep using metoprolol even if you feel well. High blood pressure often has no symptoms. You may need to use this medicine for the rest of your life.

Store at room temperature away from moisture and heat.

Metoprolol dosing information

Usual Adult Dose for Hypertension:

Metoprolol tartrate immediate release tablets:
Initial dose: 100 mg orally per day in single or divided doses

Maintenance dose: 100 to 450 mg orally per day

Comments:
-May increase dose at weekly, or longer, intervals.
-Doses above 450 mg per day have not been studied.
-Lower once-daily doses may not maintain full effect at the end of the 24-hour period; larger or more frequent daily doses may be required. Beta-1 selectivity diminishes as the dose is increased.

Metoprolol succinate extended release tablets:
Initial dose: 25 to 100 mg orally once a day

Maintenance dose: 100 to 400 mg orally once a day

Comments:
-May increase dose at weekly, or longer, intervals.
-Doses above 400 mg per day have not been studied.

Usual Adult Dose for Angina Pectoris:

Initial dose:
-Metoprolol tartrate immediate release tablets: 50 mg orally twice a day
-Metoprolol succinate extended release tablets: 100 mg orally once a day

Maintenance dose: 100 to 400 mg per day.

Usual Adult Dose for Congestive Heart Failure:

Metoprolol succinate extended release tablets:
25 mg orally once a day (12.5 mg orally once a day in patients with more severe heart failure); double dose every 2 weeks to highest tolerated dose or up to 200 mg orally once a day

Usual Pediatric Dose for Hypertension:

Metoprolol succinate extended release tablets:
6 Years or Older:
Initial dose: 1 mg/kg orally once a day (not to exceed 50 mg orally once a day)

Maximum dose: 2 mg/kg (or 200 mg) orally once a day

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking metoprolol?

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Drinking alcohol can increase certain side effects of metoprolol.

Metoprolol side effects

Get emergency medical help if you have signs of an allergic reaction to metoprolol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • very slow heartbeats;

  • a light-headed feeling, like you might pass out;

  • shortness of breath (even with mild exertion), swelling, rapid weight gain; or

  • cold feeling in your hands and feet.

Common metoprolol side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect metoprolol?

Tell your doctor about all your current medicines. Many drugs can interact with metoprolol, especially:

This list is not complete and many other drugs may interact with metoprolol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metoprolol only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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