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Common brand names: Lopressor, Toprol XL
Why is this drug prescribed?
Metoprolol controls high blood pressure and heart failure but does not cure
either condition. This medication is classified as a beta blocker. This class of
drugs works by decreasing the amount of and blocking the effects of the hormone
norepinephrine. When given, it causes a decrease in heart rate, a decrease in
heart pumping and a decrease in the work of the heart. It has effects on the
heart, blood vessels and the nervous system.
How and when should metoprolol be taken?
Metoprolol comes in tablets and is usually taken once (long-acting Toprol
XL) or twice a day (Lopressor). For heart failure your doctor will prescribe
metoprolol in addition to your other heart medications, and you will receive
specific instructions on how to take it. Generally, we increase the dose slowly
(every few weeks) until you are at the right dose.
Metoprolol should be taken with food or immediately after you have eaten to
help avoid nausea. The amount of the dosage will vary from person to person.
Follow the directions on the prescription label carefully. If there is any part
that you do not understand, ask your doctor or pharmacist. Do not take any more
or less than prescribed and do not take it more often than prescribed. NEVER stop taking metoprolol without first consulting your doctor.
What special instructions should I follow before using this drug?
This drug can cause dizziness, drowsiness and/or fatigue and may make heart
failure symptoms worse (such as fluid retention, weight gain and shortness of
breath) while your heart adjusts to it. It usually takes 3 to 10 weeks for your
heart to adjust to metoprolol. Take metoprolol as prescribed and call your
doctor to report your symptoms. Your doctor may decrease your dose or change the
dose of other heart failure medications. Once your heart adjusts, you will feel
better.
Your doctor may ask you to check your pulse (heart rate) daily while taking
this drug and will tell you how rapid it should be. Ask your doctor or
pharmacist to teach you how to take your pulse. If your pulse is slower than it
should be, contact your doctor about taking the drug that day.
Your doctor may prescribe a low-salt or low-sodium diet and tell you to stop
smoking, follow a daily exercise program and restrict your intake of alcohol. To
obtain the greatest benefit from this drug, you must follow these instructions.
What should I do if I forget a dose?
If a dose is missed, simply take it as soon as you remember. However, if it
is almost time to take your next dose, skip the missed dose and proceed with
your regular schedule. Do not take a double dose.
What are the common side effects? When should I call my doctor?
Although side effects from metoprolol are difficult to predict, the most
common side effects are:
- Sleep disturbances
- Dizziness
- Nausea
- Cold hands and feet
- Sexual dysfunction
- Slower heart rate (even during exercise)
- Fatigue
Sit or lie down when dizziness or tiredness occurs after standing. This
will increase your blood pressure. Then, get up more slowly. Contact your doctor
if these symptoms are severe or persist.
If you experience any of the following side effects, your doctor should be
called immediately:
- Shortness of breath
- Wheezing
- Difficulty breathing
- Skin rash
- Slow or irregular pulse (heartbeat)
- Swelling of feet or lower legs
- Sudden weight gain
- Chest (heart) pain
If you experience any other side effects that you think could be caused by
this medication and/or are of concern to you, call your doctor.
What special precautions should I follow before using this drug?
Before taking metoprolol, tell your doctor:
- If you have asthma, chronic obstructive pulmonary disease, heart block,
low heart rate, insulin dependent diabetes mellitus or peripheral vascular
disease
- the names of any other medicines you may be taking, including vitamins,
herbals, dietary supplements, and other prescription and nonprescription
(over-the-counter) medications. (Also tell your pharmacist.)
- If you are pregnant, trying to become pregnant, or become pregnant while
taking metoprolol.
What storage conditions are necessary for this drug?
Metoprolol should be kept in its original container, tightly sealed and away
from children. It should be stored in room temperature, away from excess heat
and moisture (not in the bathroom) and out of direct sunlight.
Never share your medication with anyone. Never take outdated medications.
Some medication prescription labels list an expiration date. If such a date is
not on your medication label or if you are unsure how old a medication is, call
your pharmacy.
This handout summarizes information to help you understand
and safely take your medication. Other information--not included in this
handout--may be important for you to know because of your unique health status.
Ask your doctor and/or pharmacist for more information on the medications
prescribed for you and your unique health care needs.
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