Метопролол

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Метопролол

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Метопролол

Property Description
Active Ingredient Metoprolol (Tartrate or Succinate salt)
Form Oral tablets (IR and ER), Intravenous Solution
Pharmacological Class Beta-blocker (eta-Adrenergic Antagonist)
Common Use Cardiovascular agent
Origin Synthetic

What Type of Medicine is Метопролол?

Метопролол (Metoprolol) is a synthetic pharmaceutical agent belonging to the pharmacological classification of eta-Adrenergic Antagonists, widely recognized as a beta-blocker. This medication is fundamentally distinguished by its cardioselectivity, a property where its primary action is directed toward the beta-1 (eta1) receptors predominantly found in the heart muscle.

The drug's activity has been clinically recognized for its role in modifying sympathetic nervous system responses, particularly in the cardiovascular system. Its core purpose is to stabilize and regulate cardiac rhythm and activity, positioning it as a critical cardiovascular agent.


Composition and Available Forms: Understanding Metoprolol’s Structure and Delivery

The active component, Metoprolol, is compounded into two critical salt forms: Metoprolol tartrate and Metoprolol succinate. The key differentiation lies in their release kinetics: the tartrate salt is designed for immediate-release (IR) kinetics, while the succinate salt is specially engineered for extended-release (ER) kinetics, ensuring a gradual and consistent effect over a prolonged period.

This medication is typically taken through the oral route as tablets (IR and ER types). However, a sterile aqueous solution is also manufactured for intravenous injection (parenteral administration) in acute situations. This versatility supports both immediate stabilization and stable, long-term maintenance of the heart's function.


General Therapeutic Purpose: What Does Метопролол Primarily Do?

The core therapeutic purpose of Метопролол is to promote controlled cardiac performance by stabilizing the heart's activity against physiological stress. Its action is achieved by competitively blocking the effects of stimulating hormones, which consequently reduces both the heart’s rate (negative chronotropic effect) and the force of contraction (negative inotropic effect). This physiological effect provides effective protection and reduces the oxygen demand placed upon the heart muscle.

Regulatory References

  1. Metoprolol: MedlinePlus Drug Information

What side effects are possible with Метопролол?

Possible Side Effects and Safety Information

This section outlines the officially documented adverse effects and safety constraints for Metoprolol, based strictly on government regulatory documents, including frequency classifications and population-specific warnings.

Frequency-Classified Adverse Reactions

The following are examples of adverse effects grouped by their documented frequency in clinical data:

Frequency Classification Examples of Documented Side Effects System-Organ Class (SOC)
Common (ge 1/100 to < 1/10) Fatigue, Dizziness, Bradycardia, Diarrhea, Headache, Shortness of breath Nervous System, Cardiac, Gastrointestinal
Uncommon (ge 1/1,000 to < 1/100) Depression, Edema (swelling), Bronchospasm, Sleep disturbances Psychiatric, Respiratory, General
Rare (ge 1/10,000 to < 1/1,000) Thrombocytopenia, Visual disturbances, Erectile dysfunction Blood, Eye, Reproductive
Very Rare (< 1/10,000) Gangrene (in severe circulatory disorders), Agranulocytosis Vascular, Blood

Serious Adverse Reactions and Key Safety Constraints

Official labeling documents highlight several serious adverse reactions, including Cardiac Arrest, the Worsening of Pre-existing Heart Failure, and the development of High-Grade Heart Block.

Abrupt Cessation Risk: Regulatory information explicitly warns that suddenly stopping Metoprolol therapy, particularly in individuals with pre-existing heart conditions, may exacerbate myocardial ischemia (lack of blood flow to the heart) and increase the risk of myocardial infarction and sudden death.

Population-Specific Considerations: Safety statements exist for specific patient groups:

  • Hepatic Impairment: Dose adjustments may be necessary in cases of severely impaired hepatic function.
  • Diabetic Patients: The medication may mask the symptoms of acute hypoglycemia, specifically the rapid heartbeat.
  • Pregnancy/Lactation: Use during pregnancy is associated with risks of fetal/neonatal bradycardia and requires monitoring of the newborn for beta-blocking effects.

Overdose and Emergency Response

Overdose Scope

Domain Official Regulatory Statements
Documented overdose presentations Overdose of metoprolol may present with severe bradycardia, hypotension, second- or third-degree heart block, and worsening heart failure. Non-cardiac manifestations include bronchospasm and central nervous system effects such as reversible mental depression, catatonia, disorientation, and temporary memory loss.
Physiological systems affected (as stated in label) Cardiovascular, Central Nervous System, and Respiratory.
Dose-related or exposure-related factors (if applicable) Overdose manifestations are a result of exaggerated pharmacological effects, requiring treatment tailored to the specific observed clinical signs.
Population-specific overdose notes (if applicable) The official prescribing information does not explicitly document population-specific differences in overdose severity for pediatric or elderly patients.
Emergency-response statements (as written in official documents) Immediate discontinuation of metoprolol is required. Hospital-based interventions are mandatory due to the need for specific pharmacological and procedural support.
When immediate medical help is required (label-derived phrasing only) Urgent medical attention must be sought immediately when symptomatic overdose is suspected, particularly for severe bradycardia, heart block, or profound hypotension.

Overdose Classifications (High-Level)

Classification Official Regulatory Statements
Severity classification (as defined in official documents) Documented manifestations include severe and life-threatening events such as cardiac arrest and cardiogenic shock, requiring critical care.
Regulatory basis (EMA / FDA / etc.) Based on official Prescribing Information.
Overdose-context constraints (as defined in official documents) Management is primarily supportive and symptomatic; no single specific antidote is known for metoprolol overdose.

Resulting Overdose Structure

Official overdose statements:

  • Documented cardiovascular signs include severe bradycardia, heart block, and the potential for life-threatening cardiogenic shock.
  • Documented central nervous system signs include mental depression, disorientation, and short-term memory loss.
  • Mandatory interventions include intravenous Atropine, Glucagon, and specialized adrenergic support to manage the effects.

Connection to the overall overdose profile (2–4 sentences): The regulatory documents define the overdose profile of metoprolol by detailing the specific, potentially life-threatening cardiovascular and central nervous system manifestations resulting from exaggerated effects. This documented severity mandates immediate medical attention and hospital-based management, which includes a specific list of supportive and pharmacological interventions explicitly described in the official prescribing information.

Therapeutic Uses of Метопролол

This medication is commonly used to help with long-term cardiovascular management and rhythm control. The core purpose is to provide consistent systemic support, which in turn offers symptomatic relief for patients dealing with chronic heart conditions. This medication is applied across several therapeutic domains.

Stabilization of Heart Activity and Blood Pressure

This area covers the treatment of High Blood Pressure (Hypertension) and long-term Chronic Stable Angina Pectoris. The key benefit involves consistent support to reduce physical strain, which may assist with lowering systemic pressure and is used for managing episodes of chest discomfort. This helps manage conditions characterized by heightened symptoms and may be part of a plan to support overall cardiovascular health.

Management of Acute and Irregular Heart Rhythms

Метопролол is commonly applied in settings where stabilization is needed following a Myocardial Infarction (heart attack) and for managing various abnormally rapid or irregular heart rhythms (Tachyarrhythmias, Atrial Fibrillation). The key benefit includes maintaining cardiac stability and assisting with controlling the heart's rate.


Quick Fact: Relief for Recurrent Symptom Patterns

The medication is used as a preventative measure (prophylaxis) to reduce the frequency and intensity of severe, episodic headaches known as Migraine. This usage may assist with reducing the overall burden of recurrent pain.

Regulatory References

  1. NIH MedlinePlus overview of Metoprolol uses

Eligibility and Restrictions for Use

Who Can and Cannot Use Metoprolol: Official Regulatory Information

Metoprolol eligibility is strictly governed by regulatory labeling, which defines both allowed and prohibited use across different patient populations.

Populations for Whom Use is Contraindicated

Metoprolol is contraindicated and must not be used in patients with acute or severe cardiac compromise, including cardiogenic shock, decompensated (overt) heart failure, severe bradycardia (very slow heart rate), and second- or third-degree heart block (unless a pacemaker is present). Known hypersensitivity to metoprolol or other components is also an absolute exclusion.

Age- and Condition-Based Restrictions

Use is established for adults and for pediatric patients ge 6 years of age for hypertension. However, use is not established for children younger than six years. Conditional use is required for several conditions. Patients with hepatic impairment (liver disease) must use the medicine with caution due to reduced clearance, which can increase drug concentration. Individuals with bronchospastic disease (e.g., asthma) generally avoid metoprolol, and if used, the lowest effective dose is mandated.

Reproductive Status

Use during pregnancy is permitted only after evaluating whether the potential benefit justifies the risk to the fetus. Metoprolol is present in human milk, and its use during lactation is generally not recommended or requires strict assessment.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Metoprolol's interaction profile is significantly influenced by medicines that affect its metabolism or its therapeutic effects. Official regulatory documents categorize these interactions based on pharmacokinetics (how Metoprolol concentrations are altered) and pharmacodynamics (how the drug's effects are changed by co-administered agents).

Interactions Affecting Metoprolol Concentrations

Metoprolol is primarily metabolized by the CYP2D6 enzyme. Co-administration with strong inhibitors of this enzyme, such as certain antidepressants (Paroxetine, Fluoxetine, Bupropion) or antiarrhythmics (Quinidine, Propafenone), can substantially increase Metoprolol's concentration. Caution and potential monitoring are required with these combinations, as documented by official labels.

Interactions Affecting Pharmacological Effects

Interacting Product Category Example Medicines Interaction Implication
Other Heart-Rate Depressants Verapamil, Diltiazem Risk of severe bradycardia and/or heart block due to additive effects.
Catecholamine-Depleting Drugs Reserpine, MAOIs Potential for additive hypotensive or bradycardic effects.
Anti-hypertensives Clonidine Risk of severe rebound hypertension if Clonidine is abruptly withdrawn; Metoprolol must be discontinued several days prior.
Anti-inflammatory Drugs NSAIDs May reduce the antihypertensive effect of Metoprolol.

In specific clinical contexts, such as treating Pheochromocytoma, Metoprolol must be initiated only after an alpha-blocker is established. Diabetic patients using insulin or oral hypoglycemic agents should be aware that Metoprolol may mask the symptoms of hypoglycemia, such as tachycardia.

Mechanism of Action

Metoprolol works as a competitive antagonist primarily targeting the beta1-Adrenergic Receptors (beta1-ARs) located in the heart. By blocking the binding of stimulating hormones like Norepinephrine and Epinephrine, the drug interrupts the sympathetic nervous system's signal transmission. The resulting receptor blockade leads to a sharp reduction in the formation of the intracellular messenger cAMP, which in turn decreases the influx of Calcium ions ( Ca^2+) into cardiac cells. This molecular cascade results in two main physiological changes: a slowing of the heart rate (negative chronotropy) and a reduction in the strength of contraction (negative inotropy), resulting in reduced mechanical activity and myocardial energy expenditure. Metoprolol also engages beta1-ARs in the kidney's juxtaglomerular apparatus. Blocking these receptors suppresses the release of Renin, a key enzyme in the RAAS (Renin-Angiotensin-Aldosterone System). This mechanism alters the regulation of systemic vascular resistance and blood vessel tension.

Dosage and Administration Information

The administration of Metoprolol is defined by distinct protocols for its two primary routes. It is prescribed for long-term support as an oral medication, available in both Immediate-Release (IR) and Extended-Release (ER) tablet forms. A sterile solution is also approved for intravenous (IV) injection, which is typically reserved for acute stabilization in supervised, monitored settings.

Dosing schedules are highly dependent on the formulation. The ER metoprolol succinate form is generally administered once daily (QD), providing a controlled release of the active agent. Conversely, the IR metoprolol tartrate form is scheduled for use two to three times per day to maintain adequate systemic levels. Treatment typically begins at a low starting dose, such as 25 mg to 50 mg daily, and the dose is titrated at intervals of one week or longer until the intended maintenance range is achieved, which may be up to 400 mg per day.

To optimize drug availability, oral tablets should be taken consistently with or immediately following a meal. The extended-release tablets must be swallowed whole and should not be crushed, broken, or chewed, as this action bypasses the controlled-release mechanism. Specific population rules include a recommendation to consider dose adjustments in patients with severely impaired hepatic function. When the medication is discontinued, the label explicitly requires the dosage to be gradually reduced over a period of 1 to 2 weeks before full cessation.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Метопролол


Evidence for Use in High Blood Pressure and Chronic Chest Discomfort

Research examining the use of Метопролол for high blood pressure (hypertension) has relied heavily on large-scale Randomized Controlled Trials (RCTs) and systematic reviews. These studies were applied in research contexts involving both adult and older adult populations to monitor outcomes related to systemic or functional imbalance. Studies reported measurements of pressure in the observed populations, and research describes that the measured responses may vary across different racial and age subgroups. Comparative evidence is limited for its use alongside all other available treatments in specific patient profiles.

For chronic stable angina pectoris—a condition characterized by fluctuating or episodic manifestations of physical discomfort—short-term and intermediate-term randomized controlled trials were used. Findings describe patterns observed in the studies related to the measured frequency of chest discomfort episodes. Research describing long-term outcomes for patients without a history of heart attack are not fully established. Follow-up durations were limited in some of the original comparative trials.


Evidence for Stabilization Following a Heart Attack

Studies exploring the use of Метопролол following a Myocardial Infarction (heart attack) were initially established through large-scale, controlled clinical trials. Outcomes studied included all-cause death and the recurrence of a heart attack. Findings describe patterns observed in the studies related to measurements of all-cause mortality and reinfarction during follow-up periods of several years. However, data show patterns related to certain short-term complications being observed in some studies when the medicine was administered very early in patients who were hemodynamically unstable. The certainty remains low regarding the extent of these measured outcomes in the context of modern cardiac care.


Research Gaps and Areas of Uncertainty

The research describes areas where the evidence landscape is still developing. Comparative evidence is lacking for certain uses, particularly in head-to-head trials against newer medications for high blood pressure or rapid heart rhythms. The data for certain groups remain insufficient (e.g., pregnant populations and specific subgroups of patients with chronic, rapid heart rhythms). Long-term effects are not fully established for certain indications, meaning there is limited information for long-term outcomes regarding the patterns observed over many decades of use.

Frequently Asked Questions (FAQ)

Common questions about Метопролол (FAQ)

Q: What happens if I miss a dose of Метопролол?

A: Official dispensing guidance often describes that if a dose is missed, it may be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped to maintain the regular schedule. Official prescribing information advises against taking two doses at the same time to compensate for a forgotten dose.

Q: Can I drink coffee or caffeine while taking Метопролол?

A: Official information advises caution regarding caffeine intake. Regulatory warnings indicate that excess caffeine may be avoided while taking Метопролол, as this stimulant could potentially counteract the medication's effects. This is a common consideration when using beta-blockers.

Q: Are there specific foods or supplements that interact with Метопролол?

A: Regulatory documents state that Метопролол should be taken with or immediately following a meal to help increase its absorption. Official documents describe that patients should discuss the use of all supplements, including multivitamins, with their healthcare provider, as some may decrease the medication's effectiveness.

Q: Can I take cold and flu medicines while using Метопролол?

A: Official drug labels warn that cold and flu medications containing sympathomimetic agents, such as pseudoephedrine, can potentially cause an increase in blood pressure due to the combined effects with Метопролол. Official information emphasizes the need for discussion with a healthcare provider when considering this combination.

Q: Can I take anti-acids or stomach medicines with Метопролол?

A: Official documents describe that certain antacids, specifically those that contain calcium carbonate, may reduce how effectively Метопролол works. Regulatory information indicates that separating the administration time of Метопролол and certain antacids by at least two hours may be necessary to minimize reduced absorption.

Q: Does Метопролол interact with cannabis or CBD products?

A: Official sources indicate that products containing cannabis may have additive effects when combined with Метопролол, which could lead to further lowering of blood pressure. This combination could potentially increase the risk of side effects like lightheadedness or dizziness.

Q: Does Метопролол cause dizziness or fatigue?

A: Yes, dizziness and fatigue are listed in the official product information as common side effects associated with Метопролол, meaning they are observed in approximately 1% to 10% of patients. These are among the most frequently documented adverse effects in clinical data.

Q: Can Метопролол be used for anxiety or panic attacks?

A: The official product information from regulatory bodies lists specific cardiovascular conditions, such as high blood pressure and angina, as the approved uses for Метопролол. It is not approved by the FDA for treating generalized anxiety disorder, panic disorder, or other primary anxiety conditions.

Q: Is it common to feel tired when starting Метопролол?

A: Tiredness, or fatigue, is a documented common side effect often experienced when therapy is first initiated. Official adverse reaction data indicates that fatigue is one of the most frequently reported occurrences for people using this medication.

Q: Does Метопролол interact with common pain relievers like ibuprofen?

A: Official drug interaction summaries state that ibuprofen, which belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), may potentially reduce the blood pressure-lowering effect of Метопролол. This reduction is noted particularly when ibuprofen is used frequently or on a regular basis.

Q: Is Метопролол a blood thinner?

A: No, Метопролол is a beta-blocker that works primarily to slow the heart rate and reduce blood pressure. It is not classified as an anticoagulant (blood thinner). Its purpose is focused on regulating cardiac activity, not on preventing blood clots.

Q: How long do people usually need to take Метопролол?

A: For its approved uses, treatment with Метопролол is typically considered long-term or chronic. If the medication is discontinued, regulatory labels state the dosage must be gradually reduced over one to two weeks before full cessation.

Q: Are there any long-term effects of taking Метопролол for many years?

A: Official research summaries indicate that long-term outcomes and effects extending beyond several years of use are not fully established for all approved indications. Regulatory bodies note limitations in the available comparative evidence regarding its effects over many decades of use.

Q: What happens if I accidentally take two doses of Метопролол?

A: Taking more Метопролол than prescribed is described in official safety information as potentially dangerous, leading to an overdose. Symptoms can include an excessively slow heart rate, difficulty breathing, dizziness, or trembling. Regulatory documents state that an overdose requires immediate consultation with a healthcare professional.

Q: Does Метопролол have an effect on sexual function?

A: Yes, official adverse reaction reports list erectile dysfunction as a documented rare side effect associated with the use of Метопролол. This is the primary effect on sexual function noted in the drug's regulatory information.

Q: Is it safe to use alcohol in moderation while on Метопролол?

A: Official safety documents warn that the use of alcohol may be avoided while taking this medicine, as it can increase the risk of side effects such as drowsiness and dizziness. Alcohol may also contribute to further lowering of blood pressure.

Q: What is the pregnancy safety category for Метопролол?

A: The FDA classifies Метопролол as Pregnancy Category C. This indicates that animal studies have shown potential harm, but human data is limited. The drug is permitted for use only when the potential benefit is determined to outweigh the risk to the fetus, as documented in the label summary.

Q: What kind of studies have been done on the use of Метопролол in children?

A: The use of Метопролол for treating high blood pressure in children aged six years and older is based on studies conducted under the Best Pharmaceuticals for Children Act (BPCA). These studies were designed to evaluate appropriate dosing and effectiveness of the medication within this specific pediatric age group.

Q: Does the effectiveness of Метопролол decrease over time?

A: Official drug labels do not explicitly state that a loss of effectiveness, or tolerance, develops over time. Instead, the medication is often used in long-term therapy to maintain a controlled response by inhibiting the progressive, harmful activation of the sympathetic nervous system.

Q: What is the difference between beta-blockers and ACE inhibitors?

A: Метопролол is a beta-blocker that works primarily to slow down the heart rate and reduce the heart’s force of contraction. ACE inhibitors are a different drug class that works by blocking a hormone (Angiotensin II) to relax blood vessels, which in turn helps to lower blood pressure.

Q: Can I take herbal remedies or vitamins while on Метопролол?

A: Regulatory documents note the importance of discussing all concurrent medications, including vitamins and herbal products, with a healthcare provider. This is necessary because some supplements, such as certain multivitamins, may interact with Метопролол, potentially requiring the administration times to be spaced out.

Q: What are the signs of a serious, but rare, allergic reaction to Метопролол?

A: Official safety information lists potential signs of a severe allergic reaction (hypersensitivity) which may include skin rash, itchiness, or swelling, particularly of the face, tongue, or throat, as well as difficulty breathing. These reactions are rare but require immediate attention.

Q: What research exists about Метопролол and migraine prevention?

A: In addition to its primary heart-related uses, official information from some regulatory bodies notes that Метопролол is approved for the prevention of migraine headaches. Its efficacy for this use has been established and supported by evidence from clinical trials.

Q: Is Метопролол used to treat different types of heart rhythm problems?

A: Yes, the official indications for Метопролол include the treatment of certain types of cardiac arrhythmias (irregular heartbeats) and other heart rhythm disorders, demonstrating its role in stabilizing and regulating the heart's electrical activity.

Q: What is the difference between selective and non-selective beta-blockers?

A: Метопролол is classified as a cardioselective beta-blocker because its main action is targeted specifically toward the beta1 receptors found predominantly in the heart. This contrasts with non-selective beta-blockers, which target both beta1 and beta2 receptors throughout the body, affecting a wider range of organs.

Q: Why are people often asked about other heart conditions before taking Метопролол?

A: Regulatory documents list several severe heart conditions, such as decompensated heart failure, severe bradycardia (very slow heart rate), and heart block, as contraindications. These conditions must be evaluated beforehand because taking Метопролол could potentially worsen these pre-existing issues.

Q: Is Метопролол a drug that causes weight gain?

A: Official adverse event reports show that weight gain has been very rarely reported with the use of Метопролол. However, it is also noted that sudden or excessive weight gain could be a sign of a more serious side effect, such as the worsening of heart failure due to fluid retention (edema).

Q: Is there a generic version of Метопролол available?

A: Yes, regulatory records, such as the FDA's Approved Drug Products list, confirm that generic versions of both Metoprolol Succinate (extended-release) and Metoprolol Tartrate (immediate-release) are available for consumer use.

How should Метопролол be stored and disposed of?

How to Store and Dispose of Metoprolol

Metoprolol must be stored at Controlled Room Temperature, defined as 20 C to 25 C (68 F to 77 F), with permitted fluctuations between 15 C and 30 C. The product must be kept in its original container and the container must remain tightly closed to protect the medicine from moisture and maintain stability. It is mandatory to keep this medicine, and all medicines, out of the reach of children.

For disposal, unused or expired Metoprolol should be discarded safely. The recommended method is to use a local authorized medicine take-back program if one is available. Otherwise, disposal must comply with local laws and requirements for pharmaceutical waste.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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