Metoprolol (patient information)

IMPORTANT WARNING
Do not stop taking metoprolol without talking to your doctor. Suddenly stopping metoprolol may cause chest pain or heart attack. Your doctor will probably decrease your dose gradually.

Why this medication is prescribed
Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to prevent angina (chest pain) and to treat heart attacks. Extended-release (long-acting) metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by slowing the heart rate and relaxing the blood vessels so the heart does not have to pump as hard.

How this medication should be used
Metoprolol comes as a tablet and an extended-release tablet to take by mouth. The regular tablet is usually taken once or twice a day with meals or immediately after meals. The extended-release tablet is usually taken once a day. To help you remember to take metoprolol, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metoprolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The long-acting tablet may be split. Swallow the whole or half tablets whole; do not chew or crush them.

Your doctor may start you on a low dose of metoprolol and gradually increase your dose.

Metoprolol controls high blood pressure and angina but does not cure them. Extended-release metoprolol controls heart failure but does not cure it. It may take a few weeks before you feel the full benefit of metoprolol. Continue to take metoprolol even if you feel well.

Other uses for this medicine
Metoprolol is also used sometimes to prevent migraine headaches and to treat irregular heartbeat and movement disorders caused by medications for mental illness. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special Precautions
Before taking metoprolol:

remember that alcohol can add to the drowsiness caused by this medication.
 * tell your doctor and pharmacist if you are allergic to metoprolol or any other medications.
 * tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: fluoxetine (Prozac, Sarafem); paroxetine (Paxil); propafenone (Rythmol); quinidine (Quinidex); and reserpine (Serpalan, Serpasil, Serpatab). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
 * tell your doctor if you have or have ever had asthma or other lung disease; a slow heart rate; heart or liver disease; diabetes; or an overactive thyroid gland (hyperthyroidism).
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking metoprolol, call your doctor.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoprolol.
 * you should know that metoprolol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
 * you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using metoprolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

Special dietary instructions
If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Minor Side Effects
Metoprolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:


 * dizziness or lightheadedness
 * tiredness
 * depression
 * upset stomach
 * dry mouth
 * stomach pain
 * gas or bloating
 * heartburn
 * constipation
 * rash or itching
 * cold hands and feet

Severe Side Effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:


 * shortness of breath
 * wheezing
 * swelling of the hands, feet, ankles, or lower legs
 * unusual weight gain
 * fainting
 * rapid, pounding, or irregular heartbeat

Metoprolol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:


 * dizziness
 * fainting
 * difficulty breathing or swallowing
 * swelling of the hands, feet, ankles, or lower legs

Other information
Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to metoprolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Lopressor®
 * Lopressor® HCT
 * Toprol XL®