metoprolol, Lopressor, Toprol XL

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: metoprolol

BRAND NAMES: Lopressor, Toprol XL

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

USES: Metoprolol is prescribed for patients with high blood pressure (hypertension). It also is used to treat congestive heart failure and angina pectoris (heart pain) related to coronary artery disease. Metoprolol is also useful in slowing and regulating certain types of abnormally rapid heart rates (tachycardias). Other uses for metoprolol include the prevention of migraine headache, hyperthyroidism, and the treatment of certain types of tremors (familial or hereditary essential tremors).

WARNING: In patients with existing slow heart rates (bradycardias) and heart blocks (defects in the electrical conduction of the heart), metoprolol can cause dangerously slow heart rates, and even shock. Metoprolol reduces the force of heart muscle contraction and can aggravate symptoms of heart failure. In patients with coronary artery disease, abruptly stopping metoprolol can suddenly worsen angina, and occasionally precipitate heart attacks. If it is necessary to discontinue metoprolol, its dosage should be reduced gradually over several weeks.

Initiation of high-dose extended release metoprolol in patients undergoing non-cardiac surgery is associated with bradycardia (slow heart rate), hypotension, stroke, and death. However, long-term therapy with metoprolol should not be routinely withdrawn prior to major surgery. Impaired ability of the heart to respond to reflex adrenergic stimuli may increase the risks of general anesthesia and surgery.

SIDE EFFECTS: Metoprolol is generally well tolerated. Side effects include:

Metoprolol can aggravate breathing difficulties in patients with asthma, chronic bronchitis, or emphysema.

Medically Reviewed by a Doctor on 3/31/2016

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