Metoprolol – A Beta-Blocker


The beta-blockers is used to treat , certain heart rhythm disorders, coronary heart disease, and Acute and long – term treatment of myocardial infarction. In addition, the active ingredient may also be used for the prevention of migraine attacks. While you are taking Metoprolol, side effects such as fatigue, dizziness and headache can occur. In rare cases, it can also lead to a sharp drop in or a significant decrease in the heart rate. Learn more here to effect, side effects and dosage of Metoprolol.

As Metoprolol works

Metoprolol belongs to the group of beta-blockers. The active substance is blocked in the body, the so-called Beta-1 receptors, the second messengers such as adrenaline and noradrenaline bind. Metoprolol weakens the effect, and thus provides for a reduction in blood pressure, the beat frequency of the heart, the heart stroke volume and the conduction velocity.

Metoprolol is prescribed, therefore, similar to Ramipril or amlodipine for the treatment of hypertension. Characterized in that the active substance also leads to a conservation of the heart, it is also used for the relief of the heart after a heart attack, as well as for the prevention of heart attacks. Also, it is suitable for the treatment of tachykarden heart rhythm disturbances (tachycardia), weak heart failure or coronary heart disease.

In addition, Metoprolol is used but also for the prevention of migraine attacks. According to the latest findings in the blood during a migraine attack blood vessels in the meninges greatly expanded. By taking Metoprolol, there is a narrowing of the blood vessels and relieve the symptoms.

Side effects of Metoprolol

Taking Metoprolol can be associated with a variety of side effects. At the beginning of Central nervous disorders such as fatigue, dizziness, headache, confusion, sweating, sleep disturbances, depressive moods, and hallucinations occur.

Occasionally side effects in the gastro-intestinal tract such as diarrhea and constipation as well as Nausea and vomiting can be caused. Also, occasionally, the skin also rashes, skin observed for redness and itching. In addition, side effects such as muscle weakness and muscle cramps, and abnormal sensations can occur on the limbs.

In rare cases, can occur as a result of taking Metoprolol is also more severe side effects. Including a strong drop in blood pressure, a strong decrease in the heart rate, heart palpitations, strengthening the heart muscle weakness, disorders of conduction of excitation, as well as shortness of breath under stress.

For a detailed Overview of all the side effects, please take a look in the package insert of your medication or ask your doctor or pharmacist for advice.

Dosage of Metoprolol

How exactly to dose, Metoprolol is always depends on the respective underlying disease. Please talk with your doctor about the exact dosage and consider the following information as General guidelines only.

  • High blood pressure and coronary heart disease: Take either once or twice a day, each of 50 milligrams or once a day, 100 milligrams of Metoprolol. The dose may be increased to up to twice a day, 100 milligrams.
  • Heart rhythm disorders: Take once or twice daily with 100 milligrams of Metoprolol.
  • Heart attack (Acute – and long-term treatment): Like Metoprolol during acute treatment of myocardial infarction to take, please talk with your doctor. After the Acute treatment you take twice a day 100 milligrams of.
  • Migraine prophylaxis: Take once or twice daily with 100 milligrams of Metoprolol.

If you have taken too high a dose, you should immediately inform a doctor or emergency doctor. Depending on the dose it may come to a sharp drop in blood pressure and a low heart rate, or even a cardiac arrest. Moreover, difficulty in breathing, loss of consciousness, vomiting, and cramps of the bronchial, can occur muscles.

Metoprolol weaning

In General, the dosage of Metoprolol should be changed only after consultation with the attending physician. After a prolonged treatment of the drug should be discontinued and never all of a sudden, as otherwise dangerous side effects can occur. So it may come to a rapid rise in blood pressure or a decreased blood flow to the heart muscle. This may aggravate existing Angina pectoris, or a heart attack to occur. Therefore, the dose should be reduced slowly, step by step, before the active ingredient may eventually be dropped completely.


Metoprolol should not be used if Hypersensitivity to the active substance. In addition, the active ingredient should not be taken with certain heart problems, including

  • a severe, not treated heart muscle weakness
  • a cardiogenic shock
  • a slow heart rate (bradycardia)
  • Conduction disturbances

In addition, Metoprolol should not be taken in a number of other diseases. These include pulmonary diseases such as bronchial Asthma, low blood pressure, untreated diseases of the adrenal medulla, an Acidification of the blood or other disturbance of acid-base balance as well as circulatory disorders such as Raynaud’s syndrome.

Only after a careful risk-Benefit analysis by the treating physician is allowed to values of Metoprolol in diabetic patients with fluctuating blood sugar, patients with a thyroid be used for hyperthyroidism, renal impairment, cramps of the bronchial muscles, or Psoriasis. The same is true for patients treated with inhalation anesthetics, or just a desensitization.

The risk for diabetics

In the case of diabetics, while taking the blood sugar level should be checked on a regular basis. Because the application of Metoprolol, the risk of hypoglycaemia may increase. This is because the effect of Insulin or other antidiabetic agents, can be extended or strengthened. Also warning signs for low blood sugar, such as muscle tremor, or palpitations are veiled.

Also in patients with hepatic or renal impairment, caution is advised: In patients with Hepatic impairment: may need the dosage reduced, since the active ingredient is worse removed. In the case of a reduced renal function, a periodic monitoring of the kidneys is recommended. May worsen due to intake of beta blockers, namely, the kidney function.


To prevent interactions, should be administered while taking Metoprolol, no other beta-blockers. Also to the administration of other antiarrhythmic drugs, particularly Calcium channel blockers (including Verapamil, Diltiazem, or from the nifedipine-type) – should better be avoided.

Problems can also occur with the simultaneous intake of tricyclic antidepressants, neuroleptics, antihistamines, ACE inhibitors (for example Ramipril), narcotics, diuretics, vasodilators, Phenothiazines, and barbiturates. Also, the Floctafenin, Sultopride and Nitroglycerin should not be taken together with Metoprolol. Depending on the medication, it can come otherwise to a sharp drop in blood pressure, a reduction in the heart rate or heart rhythm disorders.

Interactions can glycosides with Heart as well as the active ingredients of reserpine, Guanfacine, Guanethidine, alpha-Methyldopa and may occur. As the interactions a decrease in the heart rate as well as problems with the appeal of reconciliation is also possible. In case of simultaneous intake of MAO inhibitors, adrenaline, or noradrenaline, a strong increase of the blood pressure can be triggered. Cimetidine may increase, the effect of Metoprolol.

High Blood Pressure (Hypertension) Amlodipine lowers blood pressure Ramipril: the prevention of heart attack

Pregnancy and lactation

Whether you are taking Metoprolol during pregnancy, there are risks for the unborn child, is not yet explored enough. That’s why you should avoid during pregnancy on the intake of the active ingredient, or at least only after a careful risk-Benefit analysis by the attending physician.

Under certain circumstances, Metoprolol can reduce the blood flow to the placenta and growth disorders in the unborn child. The active ingredient must be taken during pregnancy, it should be at least two to three days prior to the expected date of delivery discontinued to avoid severe side effects for the infant. This is not possible, it must be monitored the child for two to three days after the birth of strictly.

Metoprolol should be used during lactation as not taken, since the active ingredient is excreted in breast milk. A taking is necessary, breastfeeding should be discontinued or the child to be breastfed for three to four hours after taking. Then, the concentration of the drug is decreased. The infant should be monitored in such a case, regularly by a physician with regard to a Blockade of Beta-receptors.

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