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.

Is metoprolol (Lopressor, Toprol XL) available as a generic drug?

Yes

Do I need a prescription for metoprolol (Lopressor, Toprol XL)?

Yes

Why is metoprolol (Lopressor, Toprol XL) prescribed to patients?

What are the side effects of metoprolol (Lopressor, Toprol XL)?

Metoprolol is generally well tolerated. Side effects include

Possible serious adverse effects include

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

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 However, long-term therapy with metoprolol should not be routinely withdrawn prior to major surgery.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.

Quick GuideHow to Lower Blood Pressure: Exercise Tips

How to Lower Blood Pressure: Exercise Tips

What is the dosage for metoprolol (Lopressor, Toprol XL)?

  • Metoprolol should be taken before meals or at bedtime.
  • The dose for treating hypertension is 100-450 mg daily in single or divided doses.
  • Angina is treated with 100-400 mg daily in two divided doses.
  • Heart attack (acute myocardial infarction) is treated with three 5 mg injections administered 2 minutes apart followed by treatment with 50 mg oral metoprolol every 6 hours for 48 hours. After 48 hours, patients should receive 100 mg orally twice daily for at least 3 months.
  • The dose for congestive heart failure is 25 mg/daily initially. Then the dose is increased every 2 weeks to reach a target dose of 200 mg/daily orally.
  • Hyperthyroidism is treated with 25 to 30 mg by mouth every 6 hours.

Which drugs or supplements interact with metoprolol (Lopressor, Toprol XL)?

name="interact">

Which drugs or supplements interact with metoprolol (Lopressor, Toprol XL)?

Is metoprolol (Lopressor, Toprol XL) safe to use during pregnancy or while breastfeeding?

Safe use of metoprolol during pregnancy has not been established.

Small quantities of metoprolol are excreted in breast milk and may potentially cause adverse effects in the infant.

What else should I know about metoprolol (Lopressor, Toprol XL)?

What preparations of metoprolol (Lopressor, Toprol XL) are available?
  • Tablets: 25, 50, and 100 mg.
  • Tablets (extended release): 25, 50, 100, and 200 mg.
  • Injection: 1 mg/ml
How should I keep metoprolol (Lopressor, Toprol XL) stored?
  • Tablets should be stored between 15 C and 30 C (59 F and 86 F).
  • They should be protected from moisture and dispensed in tight, light-resistant containers.
How does metoprolol (Lopressor, Toprol XL) work?
  • Metoprolol blocks the action of the sympathetic nervous system, a portion of the involuntary nervous system, by blocking beta receptors on sympathetic nerves. Since the sympathetic nervous system is responsible for increasing the rate with which the heart beats, by blocking the action of these nerves metoprolol reduces the heart rate and is useful in treating abnormally rapid heart rhythms.
  • Metoprolol also reduces the force of contraction of heart muscle and thereby lowers blood pressure. By reducing the heart rate and the force of muscle contraction, metoprolol reduces the need for oxygen by heart muscle. Since heart pain (angina pectoris) occurs when oxygen demand of the heart muscle exceeds the supply of oxygen, metoprolol, by reducing the demand for oxygen, is helpful in treating heart pain.
When was metoprolol approved by the FDA?
  • The FDA approved metoprolol in August 1978.

Reference: FDA Prescribing Information

Quick GuideHow to Lower Blood Pressure: Exercise Tips

How to Lower Blood Pressure: Exercise Tips

Summary

Metoprolol (Lopressor, Toprol XL) is a beta-adrenergic blocking agent drug, which blocks the action of the sympathetic nervous system (a portion of the involuntary nervous system). Metoprolol is prescribed to treat high blood pressure (hypertension), heart pain (angina), heart rhythm disorders, and some neurological conditions. Side effects include:

Drug interactions, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Subscribe to MedicineNet's Heart Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

See more info: metoprolol on RxList
Reviewed on 11/1/2016
References
Reference: FDA Prescribing Information

Health Solutions From Our Sponsors