Metoprolol-tartrate: 7 things you should know
Medically reviewed by C. Fookes, BPharm Last updated on Aug 2, 2019.
1. How it works
- Metoprolol tartrate is a heart medication that works by blocking the effects of epinephrine on beta-1 receptors within the heart tissue, causing the heart to pump more slowly and with less force. At high doses, metoprolol also blocks beta-2 receptors within the lungs and breathing tubes (which may affect breathing).
- Metoprolol is available as two different salts: metoprolol tartrate and metoprolol succinate. These two salts are not interchangeable because they have different dosages, durations of action, and indications for use.
- Metoprolol tartrate belongs to the class of drugs known as beta-blockers.
- Lowers blood pressure and may be used in the treatment of high blood pressure.
- Relieves symptoms of angina in people with coronary heart disease.
- Immediate-release metoprolol tartrate has been shown to reduce the risk of death or another heart attack when given immediately following a heart attack.
- May also be used to decrease the risk of a first heart attack in people with heart disease.
- An injectable form is available which may be given by healthcare providers for people with unstable angina or arrhythmia.
- May be used off-label for other conditions such as migraine prevention and to treat certain arrhythmias.
- Classified as a "selective" beta-blocker meaning it is less likely, particularly at low dosages, to affect breathing and insulin response than other nonselective beta-blockers.
- Generic metoprolol tartrate is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Heart rate slowing, depression, diarrhea, skin rash and shortness of breath. Side effects are similar for both metoprolol tartrate and metoprolol succinate because they both contain the same active drug, metoprolol.
- Dry eyes; blurred vision; dizziness, particularly when rising from a sitting to standing position; fatigue; nightmares; slow heartbeat; and sweating are common.
- Less common side effects include facial and limb swelling, headache, visual disturbances, and tingling of the hands or feet.
- Avoid abrupt discontinuation; stopping metoprolol (both tartrate and succinate) suddenly can exacerbate angina and may increase the risk of a heart attack. Reduce dosage gradually over a few weeks as instructed by your doctor.
- May interfere slightly with laboratory cholesterol results.
- 8% of the Caucasian population and approximately 2% of other populations have a reduced ability to metabolize metoprolol and they may require a lower dosage to reduce side effects.
- May not be suitable for some people including those with heart block greater than 1st degree, pheochromocytoma, poor circulation, sick sinus syndrome, a thyroid disorder, overt or decompensated heart failure, or who are under the age of 18.
- Should be used with caution in people with pre-existing respiratory disease.
- May decrease symptoms of hypoglycemia (low blood sugar), such as a fast heart rate, palpitations, tremor, feelings of anxiety, and potentiate the hypoglycemic effects of insulin.
- May also mask signs of hyperthyroidism (such as a fast heart rate). May precipitate a thyroid storm if abruptly stopped.
- May interact with some other medications including antidepressants, antipsychotics, ergot alkaloids, or some other blood pressure medications.
- Only available as an immediate release tablet which means it must be taken several times per day.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- Take tablets at the same time each day.
- Food can affect absorption. Take tablets with or immediately following food.
- Report any shortness of breath or facial swelling immediately to your doctor.
- Also, talk to your doctor if you develop a very slow heartbeat or a cold feeling in your hands or feet.
- If you are diabetic, talk to your doctor about the possibility that metoprolol may reduce symptoms of hypoglycemia.
- Talk to you doctor if you are having any side effects that are interfering with your quality of life. Do not stop taking metoprolol suddenly.
- Do not substitute metoprolol tartrate with metoprolol succinate.
- Always check that your prescription is correct. There have been a number of dosing errors involving metoprolol tablets.
- Your doctor will need to regularly monitor your blood pressure and possibly other markers. Keep your appointments.
- Metoprolol may impair your thinking or reaction time and affect your ability to drive. Drinking alcohol may enhance these effects. Do not drive if you think your driving ability is being compromised by metoprolol.
6. Response and Effectiveness
- With oral metoprolol tartrate, significant effects on heart rate are seen within an hour, and the effects last for six to 12 hours depending on the dose.
- With injectable metoprolol tartrate, significant effects are seen within 20 minutes, and a single injection lasts for approximately 5 to 8 hours, depending on the dose.
- The duration of metoprolol tartrate's effect is dependent on the dose (this means that larger doses have a longer duration of action).
Medicines that interact with metoprolol may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with metoprolol. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with metoprolol include:
- Antidepressants, such as fluoxetine, paroxetine, St John’s Wort, and monoamine oxidase inhibitors
- Antifungals, such as terbinafine
- Antihistamines, such as diphenhydramine
- Bupropion, which may be used for the treatment of depression and as a stop-smoking aid
- Antimalaria agents, such as hydroxychloroquine
- Fingolimod, which may be used for the treatment of multiple sclerosis
- HIV medications such as ritonavir
- Indigestion and heartburn medications, such as cimetidine and ranitidine
- Some medications used to treat mental illness, such as thioridazine
- Some heart medications, such as amiodarone, clonidine, digoxin, diltiazem, propafenone, quinidine, and verapamil
- Other medications including celecoxib, clonidine, hydralazine, and rifampicin
- NSAIDs, such as diclofenac, ibuprofen, and indomethacin, may decrease the blood pressure-lowering capabilities of metoprolol.
People taking oral medications for diabetes may need to talk to their doctor about adjusting the dose of their medicine.
Note that this list is not all-inclusive and includes only common medications that may interact with metoprolol. You should refer to the prescribing information for metoprolol for a complete list of interactions.
- Metoprolol tartrate. 12/2018. Drugs.com https://www.drugs.com/monograph/metoprolol-tartrate.html
- Parsekyan D. Migraine prophylaxis in adult patients. Western Journal of Medicine. 2000;173(5):341-345.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metoprolol-tartrate only for the indication prescribed.
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More about Metoprolol Tartrate (metoprolol)
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
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- 19 Reviews
- Drug class: cardioselective beta blockers
- FDA Alerts (1)