Metoprolol is commonly prescribed for high blood pressure, heart conditions, and certain rhythm problems. Learn about 10 possible side effects, which ones are usually mild, and which symptoms require prompt medical attention.
Metoprolol is a beta-blocker that slows the heart rate and reduces the heart’s workload. It can be an important medication for people with high blood pressure, angina, certain heart-rhythm problems, and other cardiovascular conditions.
Like any medication, however, metoprolol can cause side effects. Not everyone experiences them, and some symptoms may be caused by the underlying condition rather than the medication itself.
1. Tiredness or Fatigue
Feeling unusually tired is one of the more commonly reported effects of beta-blockers.
Because metoprolol slows the heart rate and reduces the body’s response to adrenaline, some people may initially feel less energetic.
This can improve as the body adjusts, but persistent or severe fatigue should be discussed with your healthcare professional.
2. Dizziness or Lightheadedness
Metoprolol can lower blood pressure and heart rate, which may cause dizziness, particularly when standing up quickly.
If you’re frequently lightheaded or feel as though you might faint, tell your doctor. Your dose or other medications may need to be reviewed.
3. Slow Heart Rate
Because metoprolol deliberately slows the heart, a lower pulse can be an expected effect.
However, an excessively slow heart rate accompanied by weakness, dizziness, fainting, confusion, or shortness of breath requires medical attention.
4. Cold Hands and Feet
Some people taking beta-blockers notice that their hands or feet feel colder than usual.
This occurs because beta-blockers can affect circulation and the body’s response to adrenaline.
If you develop significant pain, color changes, numbness, or other concerning circulation symptoms, seek medical advice.
5. Sleep Disturbances
Some people report sleep-related effects while taking beta-blockers, including:
- Difficulty sleeping
- Unusual dreams
- Nightmares
- Changes in sleep quality
If sleep problems begin after starting or changing your dose, mention them to your healthcare professional.
6. Headache
Headaches can occur while taking metoprolol, although there are many other possible causes of headaches.
If headaches are persistent, severe, or accompanied by neurological symptoms, they shouldn’t simply be attributed to the medication.
7. Nausea or Digestive Problems
Some people experience nausea, diarrhea, constipation, or other digestive symptoms.
Mild symptoms may improve as your body adjusts, but persistent or severe digestive problems deserve medical evaluation.
8. Shortness of Breath or Wheezing
This symptom deserves particular attention.
Although metoprolol is relatively beta-1 selective at usual doses, beta-blockers can sometimes affect the airways, particularly at higher doses or in susceptible individuals.
New or worsening breathing difficulty should be discussed promptly with a healthcare professional.
Severe difficulty breathing is an emergency.
9. Depression or Mood Changes
Mood changes have been reported by some people taking beta-blockers, although the relationship isn’t always straightforward.
If you develop persistent sadness, significant changes in mood, or other concerning psychological symptoms after starting the medication, talk with your doctor rather than stopping the medicine yourself.
10. Sexual Side Effects
Some people taking beta-blockers report decreased libido or erectile difficulties.
There can be many causes of sexual problems—including cardiovascular disease itself, stress, diabetes, and other medications—so don’t automatically assume metoprolol is responsible.
A healthcare professional can help determine the likely cause and discuss alternatives if appropriate.
Don’t Stop Metoprolol Suddenly
This is one of the most important points.
Do not suddenly stop taking metoprolol without medical advice.
Abrupt withdrawal can cause a dangerous increase in heart rate and blood pressure and may worsen angina or increase the risk of serious cardiovascular complications in some people.
If you want to stop or change the medication, your doctor can determine whether the dose needs to be reduced gradually.
When Should You Seek Urgent Help?
Get urgent medical attention for symptoms such as:
- Fainting or loss of consciousness
- Severe difficulty breathing
- Severe or unusual chest pain
- A very slow heartbeat accompanied by symptoms
- Severe weakness or confusion
- Signs of a serious allergic reaction
And remember that chest pain, sudden weakness on one side of the body, difficulty speaking, or other possible heart attack or stroke symptoms should never be assumed to be a medication side effect.
The Bottom Line
Metoprolol can cause fatigue, dizziness, a slower heart rate, cold extremities, sleep changes, digestive symptoms, and other effects. Most people don’t experience every side effect, and many tolerate the medication well.
The key is to recognize new or troublesome symptoms without becoming frightened by them. If you suspect metoprolol is causing a problem, talk with your prescriber or pharmacist before changing the dose or stopping treatment.
A medication that is helping protect your heart shouldn’t be discontinued based on an alarming headline alone.