Side Effects of metoprolol

In Summary

Commonly reported side effects of metoprolol include: cardiac failure, bradycardia, and hypotension. Other side effects include: bradycardia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to metoprolol: oral tablet, oral tablet extended release

Other dosage forms:

• intravenous solution

In addition to its needed effects, some unwanted effects may be caused by metoprolol. In the event that any of these side effects do occur, they may require medical attention.

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Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking metoprolol:
More common:

• Blurred vision
• chest pain or discomfort
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• shortness of breath
• slow or irregular heartbeat
• sweating
• unusual tiredness or weakness

Less common:

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• cough
• decreased urine output
• difficult or labored breathing
• difficulty with speaking
• dilated neck veins
• disturbed color perception
• double vision
• extreme fatigue
• fast, pounding, or racing heartbeat or pulse
• halos around lights
• headache
• inability to move the arms, legs, or facial muscles
• inability to speak
• irregular breathing
• loss of vision
• night blindness
• noisy breathing
• overbright appearance of lights
• pain, tension, and weakness upon walking that subsides during periods of rest
• paleness or cold feeling in the fingertips and toes
• rapid weight gain
• seeing, hearing, or feeling things that are not there
• short-term memory loss
• slow speech
• swelling of the face, fingers, feet, or lower legs
• tightness in the chest
• tingling of the hands or feet
• tingling or pain in the fingers or toes when exposed to cold
• troubled breathing
• tunnel vision
• unusual weight gain or loss

Rare

• Bluish color skin of the fingers or toes
• chills
• clay-colored stools
• continuing loss of appetite
• continuing or severe abdominal or stomach pain
• continuing or severe nausea and vomiting
• dark urine
• difficulty with moving
• fever
• general tiredness and weakness
• hoarseness
• increased frequency of urination
• itching skin
• light-colored stools
• lower back or side pain
• muscle pain or stiffness
• numbness of the fingers or toes
• pain, swelling, or redness in the joints
• rash
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• unpleasant breath odor
• unusual bleeding or bruising
• upper right abdominal or stomach pain
• vomiting of blood
• weakness
• yellow eyes and skin

Incidence not known:

• Black, tarry stools
• bleeding gums
• blood in the urine or stools
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• cool, sweaty skin
• pinpoint red spots on the skin

If any of the following symptoms of overdose occur while taking metoprolol, get emergency help immediately:
Symptoms of overdose:

• Bluish color of the fingernails, lips, skin, palms, or nail beds
• change in consciousness
• loss of consciousness
• no blood pressure or pulse
• stopping of heart
• unconsciousness
• very drowsy or sleepy

Minor Side Effects

Some of the side effects that can occur with metoprolol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
Less common:

• Belching
• bloated
• decreased interest in sexual intercourse
• difficulty having a bowel movement (stool)
• discouragement
• dry mouth
• excess air or gas in stomach or intestines
• feeling of constant movement of self or surroundings
• feeling of indigestion
• feeling sad or empty
• full feeling
• inability to have or keep an erection
• irritability
• loss in sexual ability, desire, drive, or performance
• loss of interest or pleasure
• nightmares
• pain in the chest below the breastbone
• passing gas
• redness or other discoloration of the skin
• runny nose
• sensation of spinning
• sneezing
• stuffy nose
• tiredness
• trouble concentrating
• trouble sleeping

Rare

• Bone pain
• continuing ringing or buzzing or other unexplained noise in the ears
• dry eyes
• hair loss or thinning of the hair
• hearing loss
• increased sensitivity of the skin to sunlight
• pain of penis on erection
• severe sunburn

Incidence not known:

• Change in taste or bad, unusual, or unpleasant (after) taste
• fear or nervousness
• hives or welts

For Healthcare Professionals

Applies to metoprolol: compounding powder, injectable solution, oral tablet, oral tablet extended release

General

The most common adverse reactions were tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, and rash.^[Ref]

Cardiovascular

Very common (10% or more): Heart failure (up to 27.5%), hypotension (systolic blood pressure less than 90 mmHg) (up to 27.4%), bradycardia (heart rate less than 40 beats per minute) (up to 15.9%),
Common (1% to 10%): Cold extremities, arterial insufficiency, palpitation, first degree heart block (P-R interval 0.26 seconds or greater), second or third degree heart block, postural disorders
Uncommon (0.1% to 1%): Cardiogenic shock in patients with acute myocardial infarction
Rare (0.01% to 0.1%): Disturbances of cardiac conduction, cardiac arrhythmia
Very rare (less than 0.01%): Intermittent claudication increased
Frequency not reported: Claudication^[Ref]

Gastrointestinal

Common (1% to 10%): Diarrhea, nausea, dry mouth, gastric pain, constipation, flatulence, heartburn, abdominal pain, vomiting
Frequency not reported: Retroperitoneal fibrosis^[Ref]

Other

Common (1% to 10%): Tiredness, peripheral edema, accident and/or injury, death, fatigue
Uncommon (0.1% to 1%): Edema, precordial pain
Frequency not reported: Lactic dehydrogenase elevated
Postmarketing reports: Chest pain^[Ref]

Nervous system

Common (1% to 10%): Dizziness, vertigo, stroke, headache
Uncommon (0.1% to 1%): Paresthesia, somnolence, impaired concentration
Rare (0.01% to 0.1%): Alertness decreased
Very rare (less than 0.01%): Amnesia/memory impairment, tinnitus, taste disturbance
Frequency not reported: Short-term memory loss
Postmarketing reports: Syncope^[Ref]

Respiratory

Common (1% to 10%): Shortness of breath, wheezing, dyspnea
Rare (less than 0.1%): Rhinitis^[Ref]

Dermatologic

Common (1% to 10%): Pruritus, rash
Uncommon (0.1% to 1%): Sweating increased
Rare (0.01% to 0.1%): Loss of hair
Very rare (less than 0.01%): Photosensitivity reactions, psoriasis aggravated, gangrene in patients with preexisting severe peripheral circulatory disorders, hyperhidrosis, alopecia^[Ref]

Psychiatric

Common (1% to 10%): Depression
Uncommon (0.1% to 1%): Insomnia, nightmare
Rare (0.01% to 0.1%): Nervousness, anxiety
Very rare (less than 0.01%): Confusion, hallucination, personality disorder, disturbances of libido
Frequency not reported: Sleep disturbance^[Ref]

Musculoskeletal

Uncommon (0.1% to 1%): Muscle cramps
Very rare (less than 0.01%): Arthralgia, arthritis
Frequency not reported: Musculoskeletal pain^[Ref]

Metabolic

Uncommon (0.1% to 1%): Weight gain
Frequency not reported: Unstable diabetes
Postmarketing reports: Blood triglycerides increased, high density lipoprotein (HDL) decreased^[Ref]

Ocular

Rare (less than 0.1%): Visual disturbance, dry and/or irritated eyes, conjunctivitis
Frequency not reported: Blurred vision^[Ref]

Hepatic

Rare (0.01% to 0.1%): Liver function test abnormalities
Very rare (less than 0.01%): Hepatitis
Frequency not reported: Transaminase elevated, alkaline phosphatase elevated
Postmarketing reports: Jaundice, non-specific hepatic dysfunction^[Ref]

Genitourinary

Rare (0.01% to 0.1%): Impotence/sexual dysfunction
Very rare (less than 0.01%): Peyronie's disease^[Ref]

Immunologic

Rare (less than 0.1%): Positive antinuclear antibodies^[Ref]

Hematologic

Very rare (less than 0.01%): Thrombocytopenia
Frequency not reported: Agranulocytosis^[Ref]

References

1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. Cerner Multum, Inc. "Australian Product Information." O 0

Not all side effects for metoprolol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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More about metoprolol

• Side Effects
• During Pregnancy or Breastfeeding
• Dosage Information
• Drug Images
• Drug Interactions
• Support Group
• En Español
• 291 Reviews – Add your own review/rating
• Drug class: cardioselective beta blockers

Consumer resources

• Metoprolol
• Metoprolol succinate extended-release tablets
• Metoprolol (Advanced Reading)
• Metoprolol Intravenous (Advanced Reading)

Other brands: Metoprolol Tartrate, Metoprolol Succinate ER, Toprol-XL, Lopressor

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