Experiences with
Metoprolol

Metoprolol belongs to a group of medicines called beta blockers.

It's used to:

treat high blood pressure (hypertension)
treat conditions that cause an irregular heartbeat (arrhythmia)
help prevent future heart disease, heart attacks and strokes
help prevent chest pain caused by angina
prevent migraines
reduce your symptoms if you have too much thyroid hormone in your body (thyrotoxicosis). You'll usually take it together with other medicines to treat your symptoms

Metoprolol is only available on prescription and it comes as tablets. It can also be given by injection, but this is usually done in hospital.

Who can take metoprolol

Most adults and children can take metoprolol. It's sometimes used for treating high blood pressure in children under 12 years old.

Who may not be able to take metoprolol

Metoprolol is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting metoprolol if you have:

ever had an allergic reaction to metoprolol or any other medicine
low blood pressure (hypotension) or a slow heart rate
lung disease or severe asthma
metabolic acidosis – when there's too much acid in your blood
an overactive thyroid (hyperthyroidism or thyrotoxicosis) – metoprolol may make it more difficult to recognise the warning signs of having too much thyroid hormone in your body
severe blood circulation problems in your limbs (such as Raynaud's phenomenon), which may make your fingers and toes tingle or turn pale or blue, although this may be less obvious on black or brown skin
a liver condition

Dosage and strength

Metoprolol tablets come in strengths of 50mg and 100mg.

How much you take depends on why you need it:

high blood pressure – 50mg to 100mg, taken twice a day
chest pain – 50mg to 100mg, taken 2 to 3 times a day
an irregular heartbeat – 50mg, taken 2 to 3 times a day
preventing migraine – 50mg to 100mg, taken twice a day
too much thyroid hormone (thyrotoxicosis) – 50mg, taken 4 times a day

How to take it

You can take metoprolol with or without food.

Swallow the tablets whole with a drink of water.

Some tablets have a score line to help you break them in half and make it easier to swallow. Check the information leaflet for your brand to see if you can do this.

Your doctor may advise you to take your first dose before bedtime because it could make you feel dizzy.

If you do not feel dizzy after the first dose, take metoprolol in the morning.

If you have metoprolol more than once a day, try to space the doses evenly throughout the day.

How long to take it for

Treatment with metoprolol is usually long term, possibly even for the rest of your life.

Stopping metoprolol suddenly can make your condition worse, so talk to your doctor first.

If you're bothered by any side effects, your doctor may be able to prescribe a different medicine for your heart problems.

If you stop taking metoprolol, it will take 1 to 2 days for it to be completely out of your body.

Take metoprolol even if you feel well, as you will still be getting the benefits of the medicine.

If you miss a dose, take your metoprolol as soon as you remember, unless it's nearly time for your next dose. If this happens, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

The amount of metoprolol that can lead to an overdose varies from person to person.

Taking too much metoprolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.

you take more than your prescribed dose of metoprolol

Get help from 111 online or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the metoprolol packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of metoprolol happen in more than 1 in 100 people. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches usually go away after the first week of taking metoprolol. Talk to your doctor if the headaches are severe or last longer than a week.

If metoprolol makes you feel dizzy or weak, stop what you're doing, and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you're feeling tired. Try not to drink alcohol, as it may make your symptoms worse.

Put your hands or feet under warm running water, massage them, and wiggle your fingers and toes. Try not to smoke or have drinks with caffeine in – these can make your blood vessels narrower and restrict your blood flow. Smoking also makes your skin colder. Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.

Stick to simple meals and avoid rich or spicy food. It might help to take your metoprolol after you have eaten.

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.

If you're in a lot of pain, speak to your pharmacist or doctor.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.

Serious side effects

It's rare, but some people have serious side effects when taking metoprolol.

Call a doctor or call 111 straight away if:

you get shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
you get shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
you have a fast heart rate, high temperature, trembling and confusion – these are signs of too much thyroid hormone in the blood
the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – these can be signs of liver problems
you get unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

you have any heavy bleeding or bleeding that you cannot stop, such as cuts or nosebleeds that do not stop within 10 minutes

Find your nearest A&E

you get chest pain that does not stop after a few minutes or is new or worse if you already have angina

Chest pain is a possible sign of a heart attack and needs to be checked out as soon as possible.

A&E safety messaging (for 999 only)

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to metoprolol.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of metoprolol. For a full list, see the leaflet inside your medicine packet.

Metoprolol and pregnancy

Metoprolol can be taken in pregnancy. If you are taking metoprolol for heart problems then it is likely that you will be advised to stay on it during pregnancy.

Metoprolol can sometimes affect your baby's growth and you will need to have extra growth scans (usually from 32 weeks onwards) to monitor this.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about whether metoprolol is right for you.

Metoprolol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take metoprolol while breastfeeding.

Metoprolol passes into breast milk in very small amounts. It has not been known to cause any side effects in breastfed babies.

It is important to keep taking metoprolol to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, or looks much paler than normal, or if you have any other concerns about your baby, then talk to your doctor or health visitor.

Metoprolol and fertility

There's no evidence to suggest that taking metoprolol reduces fertility in either men or women.

If you're trying for a baby or having problems getting pregnant while on metoprolol, then speak to your doctor.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

There are some medicines that may affect the way metoprolol works.

Tell your doctor if you're taking:

other medicines for high blood pressure (hypertension) – the combination with metoprolol can sometimes lower your blood pressure too much, which may make you feel dizzy or faint. Tell your doctor if this keeps happening as they may change your dose
other medicines that can lower your blood pressure and cause hypotension – these include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), tamsulosin (for an enlarged prostate), and co-careldopa and levodopa (for Parkinson's disease)
non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen – these medicines may increase your blood pressure, so it's best to keep them to a minimum
cough medicines that contain pseudoephedrine or xylometazoline
medicines for diabetes – metoprolol may make it more difficult to recognise the warning signs of low blood sugar
medicines for allergies – such as ephedrine, noradrenaline or adrenaline
medicines for asthma or chronic obstructive pulmonary disease (COPD)

Mixing metoprolol with herbal remedies and supplements

There's not enough information to say that herbal remedies and supplements are safe to take with metoprolol. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert