Product Details

Who should NOT take this medication?

Do not take metoprolol if you:

• are allergic to metoprolol or any ingredients of the medication
• are allergic to other beta blockers
• are scheduled to have anesthesia with an agent that causes myocardial depression (e.g., ether)
• have a condition known as right ventricular failure caused by excessive blood pressure in the lungs
• have a condition known as “sick sinus syndrome”
• have a slow heartbeat caused by heart rhythm problems
• have asthma or other obstructive respiratory diseases (for the intravenous form of metoprolol only)
• have an untreated pheochromocytoma (a tumour of the adrenal glands)
• have cardiogenic shock
• have overt heart failure
• have serious heart block
• have severe circulatory disorders
• have had a heart attack accompanied by:
  • a heart rate less than 45 beats per minute
  • significant heart block
  • very low blood pressure
  • moderate to severe cardiac failure

• Are there any other precautions or warnings for this medication?

  Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

  Breathing conditions: In general, people who have asthma and certain other lung problems should avoid taking a beta-blocker such as metoprolol, as it can cause breathing difficulty. If you have breathing problems and your doctor prescribed metoprolol for you, it may be at a lower dose, and your doctor will monitor you regularly while you are taking this medication. If you have breathing problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

  Diabetes: The signs of low blood sugar may not be as noticeable when taking metoprolol. This medication may make it more difficult for people with diabetes to control their blood sugar. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor will monitor you while you are taking this medication and may need to adjust the doses of antidiabetes medications.

  Dizziness or fainting: Dizziness or fainting are side effects of metoprolol and may occur after first starting this medication. Avoid driving and other potentially hazardous tasks until you have determined how this medication affects you.

  Heart disease: Beta-blockers, such as metoprolol, can worsen existing heart failure. It is important to take metoprolol exactly as prescribed by your doctor to decrease the chance of this happening. If you have a history of heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

  Hyperthyroidism (high level of thyroid hormones): Metoprolol can mask the symptoms that occur when you have hyperthyroidism (high levels of thyroid hormones). If you have hyperthyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Stopping the medication suddenly could worsen this condition.

  Kidney function: Kidney function may change as a result of taking metoprolol. Your doctor will monitor for this, and may adjust your dose if necessary. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

  If you experience puffy hands, face or feet, high blood pressure, unusual muscle cramping, or darkened urine, this medication may be affecting how well your kidneys are working. If you notice any of these symptoms, contact your doctor as soon as possible.

  Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

  If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

  Pheochromocytoma: This medication can worsen the symptoms of pheochromocytoma (a tumour of the adrenal gland) if it is taken alone. If you have a pheochromocytoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

  Severe allergies: If you have allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe), discuss with your doctor about what to do if you have an allergic reaction. Metoprolol may make it more difficult to treat severe allergic reactions with epinephrine.

  Stopping the medication: People with heart disease who stop taking this medication abruptly may experience severe effects, such as chest pain, irregular heartbeat, or heart attack. If you have heart disease, do not stop taking this medication without checking with your doctor first. When this medication needs to be stopped, it should be done gradually under supervision of your doctor.

  Surgery: If you are scheduled for surgery, inform all health care professionals involved in your care that you are taking metoprolol.

  Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

  Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking metoprolol, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

  Children: The safety and effectiveness of using this medication have not been established for children.

  Seniors: Normal adult doses of metoprolol may cause a drop in blood pressure that is larger than anticipated. Lower doses may be necessary for seniors.

  What other drugs could interact with this medication?

  There may be an interaction between metoprolol and any of the following:

  • abiraterone acetate
  • acetylcholine
  • alcohol
  • aldesleukin
  • aliskiren
  • alpha agonists (e.g., clonidine, methyldopa)
  • alpha-1 blockers (e.g., doxazosin, prazosin, tamsulosin)
  • amiodarone
  • amifostine
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • anesthetic agents
  • angiotensin-converting enzyme inhibitors (ACEIs; e.g., captopril, ramipril)
  • angiotensin II receptor blockers (ARBs; e.g., irbesartan, losartan)
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, diphenhydramine)
  • antimalarials (e.g., chloroquine, hydroxychloroquine, mefloquine, quinine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzepine, quetiapine, risperidone)
  • asunaprevir
  • atomoxetine
  • azelastine
  • barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
  • beta-agonists (asthma medications; e.g., salbutamol, salmeterol, formoterol)
  • bortezomib
  • brimonidine
  • buprenorphine
  • bupropion
  • calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, amlodipine)
  • celecoxib
  • ceritinib
  • cholecalciferol
  • cimetidine
  • cinacalcet
  • clobazam
  • clotrimazole
  • cobicistat
  • cocaine
  • cyproterone
  • darifenacin
  • delavirdine
  • dextromethorphan
  • digoxin
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
  • dipyridamole
  • disopyramide
  • disulfiram
  • donepezil
  • doxorubicin
  • dronedarone
  • entacapone
  • epinephrine
  • ergot derivatives (e.g., bromocriptine, ergotamine, methylergonovine)
  • fentanyl
  • fingolimod
  • flecainide
  • floctafenine
  • galantamine
  • ginger
  • ginseng
  • grass pollen allergen extract
  • guanfacine
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • imatinib
  • insulin
  • isoniazid
  • ketoconazole
  • lacosamide
  • lanreotide
  • levodopa
  • lidocaine
  • lomustine
  • methacholine
  • methadone
  • methimazole
  • methoxsalen
  • methylphenidate
  • metoclopramide
  • midodrine
  • mifepristone
  • milk thistle
  • mirabegron
  • moclobemide
  • nefazodone
  • nevirapine
  • nilotinib
  • nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
  • nonsteroidal anti-inflammatories (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • norepinephrine
  • octreotide
  • orphenadrine
  • other beta-blockers (e.g., atenolol, pindolol, propranolol)
  • oxybutynin
  • pasireotide
  • pazopanib
  • peginterferon alfa-2b
  • pentoxifylline
  • phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
  • pilocarpine
  • pimozide
  • praziquantel
  • propafenone
  • proton pump inhibitors (e.g., lansoprazole, omeprazole, rabeprazole)
  • quinidine
  • quinine
  • ranitidine
  • regorafenib
  • rifabutin
  • rifampin
  • rituximab
  • rivastigmine
  • ropinirole
  • selective serotonin reuptake inhibitors (e.g., fluoxetine, paroxetine, sertraline)
  • serotonin antagonists (anti-emetic medications; e.g., dolasetron, granisetron, ondansetron)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • sodium phenylbutyrate
  • “statin” cholesterol medications (e.g., pravastatin, simvastatin)
  • sulfonylureas (e.g., gliclazide, glyburide, tolbutamide)
  • temsirolimus
  • terbinafine
  • theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
  • ticagrelor
  • ticlopidine
  • tizanidine
  • tofacitinib
  • tolcapone
  • tranylcypromine
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • yohimbine

  If you are taking any medications containing this drug, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

  An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.