10 Common Side Effects of Metoprolol — And What You Should Know

Metoprolol is a beta blocker commonly prescribed for high blood pressure, angina, certain heart-rhythm problems and, depending on the formulation, heart failure. It works partly by slowing the heart rate and reducing the workload on the heart.

Like any medication, metoprolol can cause side effects. Many are mild and improve as your body adjusts, but some symptoms deserve medical attention.

1. Tiredness or fatigue

Feeling unusually tired is one of the more common effects of metoprolol. Because the medicine slows the heart rate and reduces the heart’s workload, some people notice reduced energy, particularly after starting treatment or increasing the dose. (MedlinePlus)

If fatigue is severe or doesn’t improve, tell your healthcare professional.

2. Dizziness or lightheadedness

Metoprolol can lower blood pressure and slow the heart, which may cause dizziness or lightheadedness. This can be particularly noticeable when treatment begins or the dose changes. (MedlinePlus)

Get up slowly from a sitting or lying position and be cautious with activities requiring alertness until you know how the medicine affects you.

3. Slow heartbeat

A slower heart rate is an expected effect of a beta blocker, but occasionally it can become too slow.

If you experience fainting, severe weakness, chest discomfort or a noticeably abnormal heartbeat, contact your healthcare professional promptly.

4. Low blood pressure

Because metoprolol lowers blood pressure, some people may experience hypotension. Symptoms can include dizziness, weakness or fainting. (DailyMed)

Don’t change your dose simply because a blood-pressure reading is lower than usual. Discuss persistent symptoms or unusual readings with your prescriber.

5. Shortness of breath

Shortness of breath is listed among the adverse effects of metoprolol. (DailyMed)

New or worsening breathing difficulty should not automatically be assumed to be a harmless medication side effect, particularly in someone with heart or lung disease. Seek medical advice.

6. Diarrhea

Diarrhea can occur while taking metoprolol. If it is severe or persistent, dehydration can make dizziness and low blood pressure worse. (MedlinePlus)

Contact your healthcare professional if significant diarrhea continues.

7. Dry mouth

Some people taking metoprolol experience dry mouth. (MedlinePlus)

Staying adequately hydrated and maintaining good oral hygiene can help. Persistent dry mouth should be discussed with a healthcare professional, particularly if it interferes with eating or causes mouth problems.

8. Skin rash or itching

Rash and itching are recognized adverse effects. (MedlinePlus)

A mild rash should be reported if it persists or worsens. However, swelling of the face, lips or throat or difficulty breathing could indicate a serious allergic reaction and requires emergency medical attention.

9. Depression or mood changes

Depression is listed among the common adverse reactions in the prescribing information for metoprolol. (DailyMed)

If you notice persistent sadness, loss of interest, major changes in sleep or other concerning mood changes after starting treatment, tell your doctor.

10. Cold hands and feet

Some people taking beta blockers notice that their hands or feet feel unusually cold. Metoprolol can also aggravate symptoms in people with certain peripheral circulation problems. (DailyMed)

Persistent pain, color changes or worsening circulation symptoms should be evaluated.

When should you seek urgent help?

Some symptoms shouldn’t simply be watched at home. Contact a healthcare professional promptly or seek emergency care for fainting, severe breathing difficulty, swelling, rapid or irregular heartbeat, severe weakness, or other serious or rapidly worsening symptoms. (MedlinePlus)

Never stop metoprolol suddenly

One of the most important precautions is not stopping metoprolol abruptly unless a healthcare professional specifically tells you to do so. Sudden withdrawal can cause serious heart problems, and official prescribing information warns about this risk. (MedlinePlus)

If you think metoprolol is causing troublesome side effects, your doctor can determine whether the dose should be adjusted or whether another treatment is appropriate.

The bottom line

Metoprolol can cause fatigue, dizziness, a slow heart rate, low blood pressure and several other side effects. Many are manageable, but persistent or severe symptoms deserve medical attention.

Don’t stop or change your metoprolol dose on your own. The medication may be controlling an important heart or blood-pressure condition, so any change should be made with professional guidance.

Note: the exact side-effect profile can differ between metoprolol tartrate and metoprolol succinate extended-release, as well as by dose and individual circumstances. (DailyMed)