If you have chest pain (angina) or heart disease (e.g., coronary artery disease, ischemic heart disease, high blood pressure), do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped. If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions.

When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness or pressure in the chest, chest pain spreading to the jaw/neck/arm, sweating, trouble breathing or fast/irregular heartbeat.

This medication is a beta-blocker used to treat chest pain (angina), heart failure, and high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This results in a lowering of heart rate, blood pressure, and strain on the heart.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used for irregular heartbeats, migraine headache prevention, and after an acute heart attack to improve survival.

Take this medication by mouth, usually once daily or as directed by your doctor. Some brands of this medication (those containing metoprolol tartrate) may be better absorbed when you take them with or right after a meal. Follow your doctor's directions for your brand, and take it the same way at the same time each day. Take this medication regularly to get the most benefit from it.

Do not crush or chew the tablet. Do not break tablets unless they have a score line. You may split scored tablets if your doctor instructs you to do so. However, swallow the whole or half tablet without crushing or chewing.

This drug is not effective if you use it only when chest pain or a migraine headache occurs. It is very important to take this medication regularly as prescribed to help prevent these conditions.

The dosage is based on your medical condition and response to therapy. It may take 1 or 2 weeks before the full benefit of this drug takes effect. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Refer to the Warning section.

You may experience dizziness, lightheadedness, drowsiness, tiredness, diarrhea, unusual dreams, trouble sleeping, or vision problems as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.

With some brands of this medication, an empty tablet shell may appear in your stool. This is harmless.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: symptoms of a very slow heartbeat (e.g., persistent dizziness, fainting, unusual fatigue), bluish discoloration of the fingers and toes, numbness/tingling/swelling of the hands or feet, decreased sexual ability, reversible hair loss, mental/mood changes, trouble breathing, cough, unexplained or sudden weight gain, increased thirst, increased urination.

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: easy bruising or bleeding, persistent sore throat or fever, yellowing skin or eyes, stomach pain, dark urine, persistent nausea.

In the unlikely event you have a serious allergic reaction to this drug, seek medical attention immediately. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking metoprolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain types of irregular heartbeats (e.g., sinus bradycardia, second or third degree atrioventricular block, sick sinus syndrome), cardiogenic shock, severe heart failure (overt or decompensated type).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart failure (treated, compensated type), breathing problems (e.g., asthma, chronic obstructive lung disease), diabetes, overactive thyroid disease (hyperthyroidism), liver disease, blood circulation problems (e.g., Raynaud's disease), skin conditions (e.g., psoriasis), mental/mood disorders (e.g., depression), certain muscle disease (myasthenia gravis), a certain type of tumor (pheochromocytoma).

Before having surgery, tell your doctor or dentist that you are taking this medication.

If you have diabetes, this medication may mask the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of a low blood sugar level such as dizziness or sweating are unaffected by this drug.

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

This medication should be used only when clearly needed during pregnancy. Discuss the risks (e.g., low birth weight) and benefits with your doctor.

This drug passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anti-diabetic drugs (e.g., glipizide, glyburide, insulin), calcium channel blockers (e.g., diltiazem, verapamil), digoxin, epinephrine, non-steroidal anti-inflammatory drugs (e.g., indomethacin, ibuprofen), other drugs to treat high blood pressure (e.g., clonidine, hydralazine, reserpine), medications for overactive thyroid disease (e.g., methimazole, propylthiouracil), drugs affecting liver enzymes that remove metoprolol from your body (such as amiodarone, barbiturates including phenobarbital, certain antidepressants including bupropion/fluoxetine/paroxetine, cimetidine, propafenone, quinidine, rifampin, ritonavir, St. John's wort).

Check the labels on all your medicines (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include unusually slow heartbeat, severe dizziness, slow or shallow breathing, weakness, or fainting.

Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store at room temperature (77 degrees F or 25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.