Metoprolol and beta blockers
A beta blocker that slows the heart and reduces its oxygen demand, used for angina, after heart attacks, in heart failure and to control fast heart rhythms.
- Generic name
- Metoprolol and beta blockers
- Active ingredient
- Metoprolol and beta blockers (variants: metoprolol tartrate, metoprolol succinate)
- Product type
- Small-molecule medicine
- Drug class
- Beta blockers
- Brand names
- UK Lopresor · US Lopressor, Toprol-XL
- Routes
- Oral, Intravenous
- Dosage forms
- Tablet, Extended-release (modified-release) tablet, Injection
- Forms
- Tablets (metoprolol 25-100 mg twice daily or modified release once daily; bisoprolol 1.25-10 mg once daily); intravenous for rapid rate control
- Onset and duration
- Heart rate falls within an hour; heart failure benefit builds over months.
- Terminology
- RxNorm RxCUI 6918 · ATC C07AB02 · FDA EPC beta-Adrenergic Blocker [EPC]
- Monitoring
- Pulse and blood pressure; ECG if the rate falls below 50 or symptoms occur.
Availability by country
| Country | Status | Note | Source |
|---|---|---|---|
| UK | Prescription only | UK |
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
- Angina and after a heart attack (reduce the heart's oxygen demand and the risk of dangerous rhythms)
- Heart failure with reduced ejection fraction (bisoprolol, carvedilol: improve survival when started low and slow)
- Controlling the rate in atrial fibrillation and other fast rhythms
- High blood pressure (no longer first line unless another indication)
- Propranolol for migraine prevention, tremor, anxiety symptoms and thyroid storm
How it works in the body
Occupies beta-1 receptors on heart muscle and the conducting system so adrenaline and noradrenaline cannot stimulate them. The heart beats more slowly and less forcefully, uses less oxygen, and the AV node lets fewer atrial impulses through. Non-selective agents (propranolol) also block beta-2 receptors in airways and blood vessels, which is why they can trigger asthma.
Common side effects
- Tiredness, cold hands and feet, slow pulse
- Dizziness on standing, vivid dreams, sleep disturbance
- Erectile dysfunction
- Masking the warning signs of low blood sugar in diabetes
Serious: seek help
- Severe bradycardia or heart block
- Worsening of heart failure if started at too high a dose
- Bronchospasm in asthma (especially non-selective agents)
- Rebound angina, fast rhythms or blood pressure surge if stopped abruptly
Cautions and interactions
- Never stop suddenly: taper over one to two weeks
- Asthma (relative contraindication), severe peripheral arterial disease, uncontrolled heart failure, second- or third-degree heart block
- Caution with verapamil and diltiazem (additive slowing), and in diabetes
Interactions
Check interactions
Taking Metoprolol and beta blockers with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
No pair records for this medicine are in the sources currently represented by Anatomy Nexus. Absence from this list does not mean no interaction exists.
Same-class and related medicines
Same class: Beta blockers
Medicines that share the class of Metoprolol and beta blockers. They are separate medicines with their own licences, doses and interactions, not alternative names for Metoprolol and beta blockers.
Related medicines
Medicines often discussed alongside Metoprolol and beta blockers: used together, compared with it, or acting on the same problem by a different route.