Metoprolol
Pronunciation: met-oh-PROH-lol.
- Generic name
- metoprolol (as tartrate or succinate salt)
- Drug class
- Beta-1 selective (cardioselective) beta-blocker
- Form
- Immediate-release tablet (tartrate), extended-release tablet (succinate), or injection, in a range of strengths depending on brand and market
- Route
- Oral (tablet, extended/prolonged/controlled-release tablet) or intravenous injection (hospital use)
- Legal status
- Prescription-only
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand
Australia: Betaloc (5) · Full directory
Boxed warning: Do not stop this medicine abruptly or without your prescriber's involvement
Following abrupt cessation of therapy with certain beta-blocking medicines including metoprolol, worsening of angina (chest pain) and, in some cases, heart attack have occurred. If metoprolol needs to be stopped, this must always be planned with your prescriber, who will typically reduce the dose gradually over 1-2 weeks (or longer if you have ischaemic heart disease), with careful monitoring throughout. Never stop metoprolol on your own or skip doses to stop taking it without your prescriber's guidance. (1) (2)
What metoprolol (as tartrate or succinate salt) is and how it works
Metoprolol is a prescription-only beta-blocker that slows the heart rate and reduces the heart's workload. It is used for high blood pressure, chest pain (angina), certain abnormal heart rhythms, after a heart attack, and, in an extended-release form, for some types of chronic heart failure. (1) (2)
Take metoprolol exactly as your prescriber directs, at the same time(s) each day, and never change your dose or stop taking it without your prescriber's guidance -- stopping abruptly can be dangerous for your heart. Your exact dose is individually worked out and adjusted over time by your prescriber based on your condition and response.
Mechanism of action: how metoprolol (as tartrate or succinate salt) works
Metoprolol is a beta-1-selective (cardioselective) adrenergic receptor antagonist that reduces heart rate, myocardial contractility, and cardiac output through competitive blockade of catecholamine effects at cardiac beta-1 receptors, lowering blood pressure and myocardial oxygen demand. (1) (2)
What metoprolol (as tartrate or succinate salt) is used for
High blood pressure (hypertension)
Used to lower blood pressure, which reduces the long-term risk of stroke and heart attack. (1) (2)
Angina pectoris (chest pain)
Used to reduce the frequency of angina attacks and improve exercise tolerance. (1) (2)
Chronic heart failure (extended-release succinate form)
Used for stable, symptomatic heart failure of ischaemic, hypertensive, or cardiomyopathic origin, alongside other heart failure treatments. (1)
Abnormal heart rhythms and after a heart attack
Used for certain fast heart rhythms (particularly supraventricular arrhythmias) and to help prevent a further heart attack or cardiac death after a prior heart attack. (2)
Migraine prevention
Used by some prescribers to help reduce the frequency of migraine headaches. (2)
Before taking metoprolol (as tartrate or succinate salt)
Do not take / not appropriate for
- Do not take metoprolol if you have severe slow heart rate (bradycardia), certain heart block (second- or third-degree, without a pacemaker), cardiogenic shock, decompensated heart failure, or sick sinus syndrome without a pacemaker. (all countries) (1) (2)
- Do not take metoprolol if you have severe asthma or severe chronic obstructive pulmonary disease (COPD), very low blood pressure, or untreated phaeochromocytoma (a rare adrenal gland tumour) -- this is UK label detail; your prescriber will assess whether any of these apply to you. (United Kingdom label detail, generally applicable) (2)
Tell your clinician about
- Any history of asthma, COPD, or other breathing problems.
- Diabetes, especially if you use insulin or medicines that can cause low blood sugar.
- Any circulation problems in your arms or legs (peripheral vascular disease).
- Thyroid problems.
- Any upcoming surgery, including dental surgery requiring anaesthesia.
- All other medicines you take, especially other heart or blood pressure medicines, antidepressants, and medicines for irregular heartbeat.
- Pregnancy, plans for pregnancy, or breastfeeding.
How to take metoprolol (as tartrate or succinate salt)
- Take exactly the strength and formulation (immediate-release or extended-release) your prescriber has chosen, at the same time(s) each day.
- Extended-release tablets are usually swallowed whole and not crushed or chewed unless your prescriber or pharmacist tells you otherwise.
- Never change your dose, and never stop taking metoprolol, without first talking to your prescriber -- see the boxed warning above.
- If you are due to have surgery, tell the surgical and anaesthesia team that you take metoprolol.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)
Missed dose
Take a missed dose as soon as you remember, unless it is close to the time of your next dose, in which case skip the missed dose and continue your normal schedule. Do not take a double dose to make up for a missed one. Contact your prescriber or pharmacist if you are unsure.
Overdose
Seek emergency medical help immediately if an overdose is suspected. Symptoms can include very slow heart rate, severe low blood pressure, fainting, breathing difficulty, or seizures, and can appear within 20 minutes to 2 hours and last for days. This needs hospital-level cardiac monitoring and treatment. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Tiredness or fatigue.
What to notice: Tiredness or fatigue.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)
Dizziness, headache, or balance disturbances.
What to notice: Dizziness, headache, or balance disturbances.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)
Slow heart rate (bradycardia) or low blood pressure.
What to notice: Slow heart rate (bradycardia) or low blood pressure.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)
Shortness of breath.
What to notice: Shortness of breath.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Nausea, abdominal pain, diarrhoea, or constipation.
What to notice: Nausea, abdominal pain, diarrhoea, or constipation.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)
Low mood (depression).
What to notice: Low mood (depression).
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Serious warnings
Worsening chest pain or signs of a heart attack after any change in metoprolol treatment — boxed_warning
Symptoms: Worsening chest pain, tightness, or pressure, especially after a dose is missed, reduced, or stopped without medical guidance.
Action: Seek emergency medical help immediately. Metoprolol must only ever be reduced or stopped gradually and under your prescriber's direction -- never abruptly or on your own. (1) (2)
Signs of a very slow heart rate or heart block — emergency
Symptoms: Severe dizziness, fainting, extreme tiredness, or a very slow or irregular pulse.
Action: Seek emergency medical help immediately -- a clinician will assess your heart rhythm and decide on any change to treatment. (1) (2)
Signs of worsening heart failure — high caution
Symptoms: Increasing shortness of breath, swelling of the legs or ankles, or sudden weight gain.
Action: Contact your prescriber promptly -- a clinician will assess whether your treatment needs adjustment. (1)
Breathing difficulty in people with asthma or COPD — high caution
Symptoms: Wheezing, chest tightness, or worsening shortness of breath.
Action: Seek prompt medical attention -- a clinician will assess whether metoprolol is appropriate for you and whether an adjustment is needed. (1) (2)
Masked low blood sugar symptoms in people with diabetes — high caution
Symptoms: Metoprolol can hide the fast heartbeat that normally warns of low blood sugar, while other symptoms like sweating or shakiness may still occur.
Action: Monitor your blood sugar closely as advised by your prescriber, especially when starting or adjusting metoprolol. (1) (2)
Signs of a severe allergic reaction — emergency
Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives. Metoprolol can also make standard adrenaline treatment for a severe allergic reaction less effective.
Action: Seek emergency medical help immediately and make sure emergency responders know you take a beta-blocker. (2)
Interactions
- Certain antidepressants and other medicines that inhibit the CYP2D6 liver enzyme (such as fluoxetine, paroxetine, propafenone, quinidine) can raise metoprolol levels in the blood. (1) (2)
- Other heart-rate-slowing medicines (digitalis, diltiazem, verapamil, amiodarone) can increase the risk of a very slow heart rate when combined with metoprolol. (1) (2)
- Clonidine: if you take both clonidine and metoprolol and need to stop both, your prescriber will plan the specific order and pace of tapering, because stopping the beta-blocker first can worsen the rebound high blood pressure that can occur when clonidine is withdrawn. (1) (2)
- NSAIDs (such as ibuprofen) may reduce metoprolol's blood-pressure-lowering effect. (2)
- Insulin and oral diabetes medicines: metoprolol can enhance their blood-sugar-lowering effect and mask warning signs of low blood sugar. (2)
- Alcohol can raise blood alcohol levels and slow its clearance when combined with metoprolol. (2)
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Beta-blockers can reduce blood flow to the placenta and may affect the baby, including growth, heart rate, and blood sugar around birth. Metoprolol is used in pregnancy only if your prescriber judges the benefit outweighs the risk, usually at the lowest effective dose, with the newborn monitored after delivery. (1) (2) (3) (4) (5) (6)
Breastfeeding
Metoprolol passes into breast milk at a higher concentration than in the mother's blood. Discuss with your prescriber; if breastfeeding, the infant may be monitored for signs such as unusual sleepiness or a slow heart rate. (1) (2) (3) (4) (5) (6)
Children
Not generally recommended in children due to limited data, per the sources reviewed. (1) (2) (3) (4) (5) (6)
Elderly
No specific dose reduction is required based on age alone, but caution is advised regarding blood pressure and heart rate effects. (1) (2) (3) (4) (5) (6)
Hepatic_impairment
Liver problems, especially cirrhosis, can raise metoprolol levels -- your prescriber may start with a lower dose and increase it more gradually. (1) (2) (3) (4) (5) (6)
Renal_impairment
People with kidney problems generally do not need a dose change for metoprolol itself, based on the sources reviewed, but overall clinical monitoring still applies. (1) (2) (3) (4) (5) (6)
Source_ids
US-DAILYMED-METOPROLOL-SUCCINATE-ER-2026,UK-EMC-METOPROLOL-TARTRATE-2026 (1) (2) (3) (4) (5) (6)
Monitoring
Before starting
- Baseline heart rate and blood pressure
- Review of heart conduction/rhythm where relevant
- Review of asthma/COPD, diabetes, and thyroid history
During treatment
- Regular heart rate and blood pressure checks, especially after any dose change.
- Blood sugar monitoring in people with diabetes.
- Watching for signs of worsening heart failure, breathing difficulty, or very slow heart rate.
Storage
Store at room temperature in the original container, protected from light and moisture, following the specific instructions for your exact product.
Study the drug class: Beta blockers
Professional information
Clinician-facing context only, sourced from the current US FDA prescribing information and UK SmPC reviewed; verify against the current full label for the exact salt form and product before prescribing.
United States
Indication: Hypertension, angina, heart failure (extended-release succinate)
Dose summary: Hypertension: 25-100 mg once daily, titrated weekly (studied to 400 mg/day). Angina: 100 mg once daily, titrated weekly (studied to 400 mg/day). Heart failure: NYHA II starts at 25 mg once daily, more severe heart failure at 12.5 mg once daily, doubled approximately every 2 weeks toward tolerated target (up to 200 mg).
Renal context: No specific renal dose adjustment described in the source reviewed for metoprolol succinate ER; general clinical monitoring applies. (1)
United Kingdom
Indication: Hypertension, angina, arrhythmias, post-MI prophylaxis, migraine prophylaxis (immediate-release tartrate)
Dose summary: Hypertension: 100 mg daily, may increase to 200 mg daily. Angina: 50-100 mg twice daily. Arrhythmias: 100-200 mg daily. Post-MI: 100 mg twice daily. Migraine prophylaxis: 50-100 mg twice daily. Maximum 400 mg/day.
Renal context: Not specifically adjusted for renal impairment per the source reviewed; hepatic impairment (especially cirrhosis) requires lower starting doses and slower titration. (2)
Hepatic guidance
Hepatic cirrhosis significantly increases metoprolol bioavailability (up to sixfold in portocaval shunt patients); start with lower doses and titrate gradually with close monitoring.
Overdose note
Overdose management includes continuous cardiac monitoring, gastric decontamination where appropriate, atropine for bradycardia/vagal effects, beta-1 agonists or glucagon for refractory hypotension/bradycardia, and pacing if needed; effects can persist for days despite falling plasma levels. (1) (2)
Frequently asked questions
Why can't I just stop taking metoprolol when I feel better?
Suddenly stopping metoprolol can cause your heart condition to rebound and worsen, including a risk of chest pain flare-up or heart attack. If you and your prescriber decide treatment should end, it is done as a gradual, supervised dose reduction over one to two weeks or longer, never abruptly. (1) (2)
Can I take metoprolol if I have asthma?
This needs careful clinician assessment. Even though metoprolol is more heart-selective than older beta-blockers, it can still worsen asthma or COPD symptoms in some people, so your prescriber will weigh the risks and benefits for you specifically. (1) (2)
Does metoprolol affect diabetes management?
It can mask some of the early warning signs of low blood sugar, particularly a fast heartbeat, so people with diabetes on metoprolol are usually advised to monitor blood sugar more closely, especially when starting or changing the dose. (1) (2)
Is metoprolol available in the US, UK, Europe, Canada, Australia, and New Zealand?
Yes, it is approved and available in all of these regions, though the specific brand and salt form (tartrate vs succinate) varies by country. (1) (2) (3) (4) (5) (6)
What is the mechanism of action of metoprolol (as tartrate or succinate salt)?
Metoprolol is a beta-1-selective (cardioselective) adrenergic receptor antagonist that reduces heart rate, myocardial contractility, and cardiac output through competitive blockade of catecholamine effects at cardiac beta-1 receptors, lowering blood pressure and myocardial oxygen demand. (1) (2)
References
- METOPROLOL SUCCINATE Extended-Release Tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-29 · source 1
- Metoprolol Tartrate 100mg Film-Coated Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-29 · source 2
- Metoprolol Medical Valley prolonged-release tablet -- Public Assessment Report, Scientific DiscussionSwedish Medical Products Agency (Lakemedelsverket/MPA) -- EU/EEA national-procedure Public Assessment Report, representative of EU-wide nationally authorised status · European Union · accessed 2026-07-29 · source 3
- LOPRESOR (metoprolol tartrate) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-29 · source 4
- BETALOC (metoprolol tartrate) -- ARTG registrations and Consumer Medicine InformationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
- LOPRESOR (metoprolol tartrate) New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-29 · source 6
Brand names by country
Single-ingredient metoprolol (as tartrate or succinate salt) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- TOPROL XL50 mg, 25 mg, 200 mg, 100 mg · melinta therapeutics, llc
- KAPSPARGO50 mg, 25 mg, 200 mg, 100 mg · sun pharmaceutical industries, inc.
- Lopressor50 mg, 100 mg, 10 mg/mL, 12.5 mg · validus pharmaceuticals llc
United Kingdom
Canada
- METOPROLOL-L
- LOPRESOR
- LOPRESOR SR
- METOPROLOL SR
- LOPRESOR INJ
- PMS-METOPROLOL-L
- DOM-METOPROLOL-L
- RIVA-METOPROLOL L
- JAMP-METOPROLOL-L
- PMS-METOPROLOL-B TABLETS -
Australia
- Betaloc (5)TGA ARTG registered confirmed · 50 mg, 100 mg, 5 mg/5 mL injection · AstraZeneca Pty Ltd
New Zealand
View brands in additional countries.
European Union
Beloc-Zok / Seloken / Selokeen / national generics (3)