metoprolol
Brand names: Lopressor, Toprol-XL
Metoprolol is a beta-blocker medicine. It can lower blood pressure, reduce chest pain, and improve survival after a heart attack.
Drug Shortage Alert
metoprolol is currently listed as to be discontinued by the FDA. Affected manufacturer: Aurobindo Pharma USA.
View all drug shortages →Drug Pricing (NADAC)
Brand Price
$2.42/unit
Generic Price
$0.10/unit
Generic Savings
96%
Generic Available
Yes (30 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Metoprolol treats high blood pressure (hypertension).
Common side effects
Tiredness, Dizziness, Depression
Key warnings
Stopping metoprolol suddenly can make chest pain worse or cause a heart attack.
How It Works
Metoprolol blocks the effects of adrenaline on the heart. This makes the heart beat slower and with less force. As a result, blood pressure is lowered and the heart does not need as much oxygen.
How to Take It
Take metoprolol once or twice a day with food or right after eating. Your doctor may adjust your dose every week until your blood pressure is under control. The usual starting dose for high blood pressure or angina is 100 mg per day. Do not stop taking this medicine suddenly.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant or plan to become pregnant. Metoprolol can cross the placenta, and may cause low blood pressure, low blood sugar, and a slow heart rate in the newborn. Talk to your doctor about the risks and benefits.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store metoprolol at room temperature, away from moisture and heat.
Side Effects (from patient reports)
Based on 119,396 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 246,252 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2001–2025.
Total Reports
246,252
Death-Related Reports
27,931
Hospitalization Reports
96,962
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | FATIGUE | 15,966 |
| 2 | DYSPNOEA | 14,128 |
| 3 | DIARRHOEA | 13,635 |
| 4 | NAUSEA | 13,398 |
| 5 | DRUG INEFFECTIVE | 12,522 |
| 6 | DIZZINESS | 11,699 |
| 7 | OFF LABEL USE | 9,794 |
| 8 | DEATH | 9,738 |
| 9 | ASTHENIA | 9,410 |
| 10 | PAIN | 9,111 |
| 11 | FALL | 9,084 |
| 12 | HEADACHE | 8,835 |
| 13 | HYPOTENSION | 7,535 |
| 14 | VOMITING | 7,128 |
| 15 | PNEUMONIA | 7,103 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Stopping metoprolol suddenly can make chest pain worse or cause a heart attack. If you have heart failure, it could get worse. If you have asthma or other lung problems, avoid beta-blockers if possible.
Known Drug Interactions
albuterol, systemic and inhaled mebendazole amoxicillin medroxyprogesterone ampicillin, with or without sulbactam methylprednisolone atenolol metronidazole azithromycin metoprolol caffeine, dietary ingestion nadolol cefaclor nifedipine co-trimoxazole (trimethoprim and sulfamethoxazole) nizatidine diltiazem norfloxacin dirithromycin ofloxacin enflurane omeprazole famotidine prednisone, prednisolone felodipine ranitidine finasteride rifabutin hydrocortisone roxithromycin isoflurane Sorbitol (purgative doses do not inhibit theophylline absorption) isoniazid sucralfate isradipine terbutaline, s...
Mechanism: Metoprolol is a beta-blocker that can block the airway-opening effects of theophylline. This combination can make it harder for you to breathe and may change the amount of medicine in your blood.
What to do: Your doctor may need to adjust your dosages or monitor your blood levels closely. Report any new breathing difficulties to your healthcare provider immediately.
( 7.3 ) Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. ( 7.4 ) Beta-blockers including metoprolol, may exacerbate the rebound hypertension that can follow the withdrawal of clonidine. 7.4 Negative Chronotropes Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate.
Mechanism: Both drugs work to slow down your heart rate, which can cause your heart to beat too slowly when taken together. Additionally, stopping one of these drugs suddenly can cause a dangerous rise in blood pressure.
What to do: Your doctor should monitor your heart rate and blood pressure regularly. Do not stop taking either medication without first consulting your healthcare provider.
( 7.3 ) Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. 7.4 Negative Chronotropes Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate.
Mechanism: Both of these medicines slow down your heart rate and the electrical signals that tell your heart when to beat. Taking them together can make your heart beat much slower than it should.
What to do: Your doctor should monitor your heart rate and pulse closely while you are taking both medications. Tell your healthcare provider if you feel dizzy, weak, or faint.
( 7.3 ) Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. 7.4 Negative Chronotropes Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate.
Mechanism: These drugs both work to lower your heart rate and slow down the electrical conduction in your heart. Using them at the same time increases the risk of your heart rate becoming dangerously slow.
What to do: Your healthcare provider should check your heart rhythm regularly. Your doctor may need to adjust your dosages to ensure your heart rate stays in a safe range.
7.3 CYP2D6 Inhibitors Drugs that are strong inhibitors of CYP2D6 such as quinidine, fluoxetine, paroxetine, and propafenone were shown to double metoprolol concentrations.
Mechanism: Fluoxetine blocks the liver from breaking down metoprolol, which can cause the amount of metoprolol in your blood to double.
What to do: Your doctor may need to lower your metoprolol dose and monitor your heart rate closely.
Common Questions
Can I drink alcohol while taking metoprolol?
Will metoprolol make me gain weight?
Can I exercise while taking metoprolol?
Does metoprolol interact with other medications?
Can I take metoprolol if I have diabetes?
What should I do if I feel dizzy while taking metoprolol?
How long does it take for metoprolol to start working?
Can I stop taking metoprolol if I feel better?
Does metoprolol cause erectile dysfunction?
Can metoprolol affect my cholesterol?
What are the common side effects of metoprolol?
Does metoprolol interact with other medications?
What drug class is metoprolol?
Is there a generic version of metoprolol?
Is metoprolol safe during pregnancy?
Has metoprolol been recalled?
Is metoprolol currently in shortage?
Active Recalls
Presence of Foreign Substance: metal in tablet
Rubicon Research Private Limited
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for metoprolol
The FDA label for metoprolol (sold under brand names such as Lopressor, Toprol-XL) classifies it as a prescription-only medication in the Beta-Blocker class. Metoprolol treats high blood pressure (hypertension). Official labeling lists 9 commonly reported side effects, including Tiredness, Dizziness, Depression.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 119,396 voluntary reports. The database also lists 18 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.10 versus $2.42 for the brand — a 96% generic savings.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 10, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages