- High blood pressure (hypertension)
- Angina (chest pain)
- Certain abnormal heart rhythms
- Heart failure (in some people)
- Recovery after a heart attack
It works by blocking the effects of adrenaline on the heart, causing the heart to beat more slowly and with less force. This lowers blood pressure and reduces the heart’s workload.
Most people tolerate metoprolol well, but like all medicines, it can cause side effects.
1. Tiredness or fatigue
This is one of the most common side effects, especially during the first few weeks of treatment. Many people find it improves as their body adjusts.
2. Dizziness or light-headedness
Because metoprolol lowers blood pressure, some people feel dizzy, particularly when standing up quickly. Rising slowly from sitting or lying down may help.
3. Slow heart rate (bradycardia)
Metoprolol is intended to slow the heart, but if it becomes too slow, you may experience:
- Dizziness
- Fatigue
- Fainting
- Shortness of breath
Contact your healthcare professional if these symptoms occur.
4. Cold hands and feet
Reduced blood flow to the extremities can make your fingers and toes feel unusually cold.
5. Digestive problems
Some people experience:
- Nausea
- Diarrhoea
- Constipation
- Stomach discomfort
These symptoms are usually mild and often improve with time.
6. Sleep disturbances
Some people report:
- Difficulty sleeping
- Vivid dreams
- Nightmares
This doesn’t affect everyone but is a recognised side effect.
7. Shortness of breath
Metoprolol can occasionally worsen breathing problems in people with asthma or other lung conditions. Tell your doctor if you notice wheezing or increasing breathlessness.
8. Sexual side effects
Some people experience:
- Reduced sex drive
- Difficulty achieving or maintaining an erection
If this is affecting your quality of life, discuss it with your healthcare professional. Alternative medicines may be available.
9. Mood changes
Less commonly, some people report:
- Low mood
- Depression
- Reduced energy
Mood changes can have many causes, so it’s important to discuss persistent symptoms rather than assuming the medication is responsible.
10. Masking signs of low blood sugar
For people with diabetes, metoprolol can make it harder to notice some symptoms of hypoglycaemia, such as a rapid heartbeat. Other signs, like sweating or confusion, may still occur.
Seek medical help immediately if you experience:
- Chest pain that is new or worsening
- Fainting or severe dizziness
- Very slow heartbeat with symptoms
- Difficulty breathing or swelling of the face, lips, or throat (possible allergic reaction)
