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Avatar universal

Metoprolol side effects

Hi, I'm dealing with tachycardia arrhytmia since more than 2 years now. My Cardilogist at first said it was dysautonomia and POTS and blame also my severe anxiety and was put on a beta blocker, propranolol 20 mg day. At first it was working on to stop the tachycardia but with time the effect wear off and had to increase my dose and then it was lowering too much my blood pressure so my Cardiologist switch me on another beta blocker... I try several ones, bisoprolol, nadolol, timolol, pindolol, acebutolol... All of those fails to control the tachycardia.

In those 2 years, I start having more and more heart related symptoms. Chest pain, jaw pain, left arm pain, exercise intolerance, dizziness, vertigo, intestine problems, low energy physically and mentally...

I have severe anxiety (panic with agoraphobia, somatisation, GAD, social anxiety). My anxiety is not well control, I'm med sensitive and can't take antidepressants like Paxil, Lexapro or even older ones like imipramine... 1 mg of Paxil send me to the ER and same for Lexapro, didn't had problem with both drugs before and took them for my anxiety for years. I'm on a high dose of clonazepam 7 mg day, I'm addicted and do a very slow tapering withdrawal... Will take years to get off the clonazepam. I also deal with many panic attacks every day, can't get out th house, can't stay alone, everything trigger heart related symptoms like tachycardia or chest pain, a loud sound, music, too much people's around me... My nervous system seem to be overactive... I'm always sick, have chronic headache, heart is pounding in my chest all the time even when my heart rate is normal, droop of blood pressure or high blood pressure, feeling very hot all the time but can't sweat, can't exercise or just walk cause of my low energy and no physical endurance...

I saw my Cardiogist 2 weeks ago, he look at my last holter monitor results and said it was anxiety and said that I may have dysautonomia but probably cause of the anxiety... I was stable on 10 mg x 3 of propranolol day for the last 7 months but the tachycardia was not under control at all... He suggest to RX 25 mg x 2 day of metoprolol.

I start taking the metoprolol 2 weeks ago. I feel awful! Not only its not helping the tachycardia, but it make my anxiety worse. I have a migraine with throbbing pain in my head since I start it 2 weeks ago. I have more chest pain and left arm and hand are numb most of the time. My jaw hurt and all my teeth also. I have insomnia, have some vision change, my energy level is even lower than on the propranolol. I also feel depression... The propranolol don't do that... I feel so awful that I decrease the dose to 12.5 mg every 12 hours insistead of 25 mg every 12 hours but even with a lower dose I feel very bad.

I'm the only one here who have problems with the metoprolol or brand name lopressor? It's the immediate release one, not the XL...

I call my Cardio Doc and ask to be put again on the Propranolol but he don't return my phone call back.

The only one beta blocker that I never try is the bystolic, it's new in the Canada but too expensive for me. I also hear that for anxiety it's bad?

Well share you're experiences with the metoprolol vs propranolol... It can't be all in my head, I mean the side effects from the metoprolol are horrible...
13 Responses
1423357 tn?1511085442
Metoprolol is like the Tic-Tac of beta blockers.   Lots of people take it with little aide effects.  I take 75 milligrams per day, but have been on as high as 200 milligrams per day.The dose you have put yourself on is extremely small. Metoprolol's half life is approximately 5 hours.  If you do the math, you will see there is very little left of the drug in your blood when you take your next dose.  I suffer no side effects on 75 milligrams however I notice that it may take a little time for my heart to get up to speed when I work out.  At thisblevel and higher there can occur a residual build up off the drug in your system.  so occasionally I will withhold 2 days of medication in order to completely metabolize the drug before starting up again.  I would venture a guess and say that your physician realizes the size of the dose he has put you on and feels that the side effects should be minimal to nothing.
Avatar universal
    I'm glad that the Lopressor (metoprolol) work great for you!!! Can I know why you take it?

What I understand is that beta blocker have usually mild side-effects when they are give to people with high blood pressure... BUT in my case, my blood pressure is lower to normal only and rarely in the high range (only when i'm in a middle of a panic attack or in a situation where I feel trap). So when the blood pressure is already low to normal, then the beta blockers have more side-effects for sure.

For someone with high blood pressure a dose of 5 mg of Bisoprolol will be a mild dose with few or no side-effects but for me 1.25 mg was enough to lower my blood pressure to 70/40 and faint! Almost all beta-blockers that I tried lead to low blood pressure with no effect on the tachycardia and arrhythmia...

My usual heart rate at rest and sit is around 110-130... when I get up it can go anywhere from 130-160... Minimal exercise or physical task like taking a shower will lead to heart rate of 180... and the time to recover (time that it will take for my heart rate to decrease) after that minimal physical task will be as long as 30 minutes to 1 h.

The only one beta-blocker that I can use without affecting too much my blood pressure is the Propranolol, that's what I call a Tic-Tac beta-blocker since it's working ok to reduce the heart rate and adrenaline effect on the heart without decreasing too much the blood pressure and without all the nasty side-effects like the ones I have with the Metoprolol right now. I used up to 160 mg of Propranolol before my anxiety kick in to manage my migraine headache and I had no side-effects at all... For the tachycardia, low dose of 10-20 mg x 3 a day will be enough for me. That dose seem probably ridiculous for someone with high blood pressure, but for me it's what I need, taking more will just lower the blood pressure and lowering too much the blood pressure is as bad as having hign blood pressure...

Also, the Metoprolol, like the Propranolol, is highly lipophilic so it enter into the CNS and have more side-effects like the ones I have right now with the metoprolol, but with the Propranolol it's different, I guess it's effect in the CNS is better for anxiety related tachycardia. The Metoprolol make me feel so bad if I compare it to the Propranolol, I feel like I was hit by a car... IF the Metoprolol is the Tic-Tac of beta-blocker, than maybe beta-blocker are not for me at all !

I did try the Atenolol, Nadolol, they are not lipophilic and apparently do not produce CNS side-effects but they lower too much my blood pressure and didn't see a lot of difference between the side-effects from the water solube and lipophilic ones... They all make me tired, some of them are worse and the Bisoprolol and Metoprolol are the worse for me in term of side-effects.

The half-life of the Metoprolol is between 3 to 7 hours... some people are fast metabolizer and the effect will not last 7 hours and the drug will tend to not accumulate that much in the body and blood... I'm a fast metabolizer and with the Metoprolol it's even faster. I wake up around 7 AM and take 12.5 mg of Metoprolol and 30 minutes later I can feel my heart rate decreasing to a more normal rate but at 10 AM my heart rate will start increasing and the effect of the Metoprolol will wear off completely after 3:30 hours maximum... With the Propranolol, who have an even sorther half-life, the effect will last 4 hours...

I agree with you, I guess my Cardiologist was thinking that 50 mg day of Metoprolol will not have a lot of side-effects on me...

Well, I will wait for a phone call from my Cardiologist and will hope he will change the Metoprolol to the Propranolol but in higher dose than before. The side-effects of the Metoprolol, even if i'm taking a very low dose, are not tolerable or acceptable. Nightmares, insomnia, jaw and teeth pain, back pain, dizziness, extreme fatigue, worse than before intolerance to exercise, dry mouth, eyes pain, worse migraine of my life who don't want to stop, feeling depress (i'm an anxious person, not depress and I never had depression in my life), visual change like seeing white and black spots in my vision and seeing things that are not there for real (I guess it's call hallucinations in English), left arm and hand numbness, constipation, heartburn...

For me the Metoprolol is the worse beta-blocker I try so far... I Can deal with some dizziness when I stand up from the Bisoprolol or Nadolol, I can deal with a little bit more difficulty to fall asleep with the Atenolol or the Propranolol, but I can't live with all the side-effects from the metoprolol and I don't see how people can handle it especially in high dose? I guess everyone is different and react differently to a specific med...

Thanks for you're answer ;-)

Take care  
my blood pressure and rhythum are normal  yet my pcp wanted to start me on propanolol  which i refused after my pharmacist said i would have to take my pulse everytime i took it  now my cardiologist wants me to take  a 25mg dose of metopolol  i hesitate. its so my blood will flow better through my aorta which has some swelling  and a bicuspid valve which has issues.  so is this really necessary. why should  take something that will lower my normal blood pressure and give me side effects.  what good will it do to mess with my normal blood pressure and rhythm  will it not cause problems which i do not have now
1423357 tn?1511085442
I took metoprolol for SVT prior to my cardiac ablation in 2010.  I continue to take it at a little lower dose for blood pressure control, and for heart attack survivability should one occur.
Avatar universal
Hi again tom_h,
                         Oh ok I see and it's really helping you? Apparently beta-blocker are not increasing the chance to survive after a heart attack and better antihypertensive drugs like the Ace inhibitor are better?

Anyway, my cardiologist put me again on the Propranolol and increase my dose to 40 mg day. I was on 50 mg day of Metoprolol.

I did 2 days on 40 mg of Propranolol and I had the same side-effects than on the metoprolol... and I guess it's not side-effects but anxiety symptoms that I experience.

Also when I return on the Propranolol for 2 days at a bigger dose, my blood pressure and pulse rate wasn't under control at all, heart rate was in the high 80 sit at rest and 150 and more just walking in the house...

I'm back on the metoprolol for now, I will monitor my blood pressure and pulse rate cause I want to see the difference between the Propranolol and Metoprolol. So far on the Metoprolol  the only side-effect I feel who is different than the Propranolol is more facial muscles tension, jaw pain, neck pain... Also my blood pressure is a lot lower on the Metoprolol and pulse rate is also lower... I feel safer on the Metoprolol, probably because my Pharmacist told me it was better than the Propranolol to protect the heart?

Will see how things is going on the Metoprolol and will have to choose between the Metoprolol or the Propranolol... Also I need to find the good dose for me... 25 mg of Metoprolol in the morning and 25 mg 12 hours later is not working for me, I don't feel that the effect of the Metoprolol last more than 5 hours... so taking lower dose every 6 hours, like I do with the Propranolol, is by far better for me...Also a bigger dose in the morning and lower in the evening is better for me since the tachycardia and high blood pressure are at their peak in the morning...

I did ask the Pharmacist about having the Metoprolol 50 mg XL but in the Canada they don't do 25 or 50 XL dose... the XL dose are 100 mg and 200 mg only...

Well thanks for your answer ;-) Take care of you!!!
the last response the reply here cut off the first part of my reply.  
my pcp wanted me to take propanolol which i refused  now my cardiologist wants me to take metoprolol which i hesitate, i do not have high blood pressure nor do i have any issue with my heart rhythum  its to ease flow through my heart as i have the beginnings of an enlarged aorta. should i really take this.
1423357 tn?1511085442
You are correct.  Metoprolol has become a second line medication for hypertension.  Nonetheless, it still can be used for treatment of high blood pressure, and it works very well for me. So I choose to,stay on it.  While on 75mg/day, my last BP readimg at my physicians office was 105/60.  This was a bit low for me, so I did a "reset" to completely metabolize the drug, then began my dosage again.
Avatar universal
Hi ;-)
       Yeah, I agree, why change a med who work great for you, I think the beta-blocker are second line or even third or now fourth line agent in the management of hypertension because of the bad reputation of the Atenolol and it's link to provoking type 2 diabetes and increase LDL and lowering HDL effect... as well as performing less well than a simple diuretic to lowering the blood pressure...

I think some of the beta-blockers are still very good to prevent heart attack and heart damage especially the newer ones like the Bystolic, Bisoprolol, Carvedilol and the metoprolol XL...

I did a full day on the Metoprolol yesterday... My blood pressure is running very low on it and my pulse rate is a lot lower than on the Propranolol, BUT the side-effects are not anxiety symptoms like I was saying yesterday, I had very bad muscles tension on my face, jaw pain, throbbing headache and more dizziness than on the Propranolol.

Today I try the Propranolol again, will try to reset my dosage like you... I mean that tweaking my dosage insistead of taking higher dose less often... I took 20 mg when I wake up this morning since the tachycardia is far worse in the morning... in the afternoon will take a dose of 10 mg and in the evening another 10 mg and maybe 5 mg before bedtime since I wake up often in the middle of the night with chest pain and fast heart rate... I will monitor my blood pressure and also write on a paper my symptoms...

Tomorrow will try again the Metoprolol and adjust my dose with higher dose in the morning and lower dose for the rest of the day and 4 doses, not 2 doses like the Cardio Doc say...I feel more comfortable with lower dose more often than higher dose who hit me like a truck and wear off faster... I will also monitor my blood pressure and symptoms ...

I will choose the best med for me... My Pharmacist will call me at the end of the week and I have to pick up the best for me and the exact dose I need...

My blood pressure run in the same range than you... At rest it's around 110/55... For me it's low... Before I was put on beta-blocker my normal blood pressure at rest was 140/90, in the Canada it's consider pre-hypertension... AT the time my weight was 220 pounds... i'm now weight only 168 pounds cause of the anxiety and some intestine problems I have (ISB, 2 intestinal obstructions with 2 surgeries to repair them and enteral feeding with a jejunostomy tube for some months...)...

Well, have a nice day, take care of you!!!
Avatar universal
Was on Metoprolol Succinate ER for about 3 months. It worked well at controlling heart rate and BP and reducing a-fib, but the side-effects were terrible, including:  hair thinning, memory problems, inability to concentrate, digestion troubles, hearing/vision problems, eye pain, extreme exhaustion, and probably others that've been forgotten now. However, many of these problems occurred at the higher dosage (100mg/day); when at lower dosage (25/mg day) felt much better. Considering going back on Metoprolol since current Calcium Channel Blocker is causing similar problems and not really solving A-fib.
Avatar universal
    Sorry if I didn't answer before... Don't come here often since a while...

Yes, I experiences the same side-effects than you on metoprolol. Mostly extreme fatigue, insomnia but can stay in bed all day long, headache, anxiety who is worse than before, legs pain and muscles pain all over my body, chest pain, back pain, eyes pain. I'm so weak that just taking a shower is the best I can do in 1 day!

I will see my Cardio Doc soon and will ask to try something else. Also will ask for more tests since recently I start having severe chest pain and it's happening each day and it's not GERD, muscular pain or something like that... I Can feel it from my heart, like my heart flip flop in my chest and someone is sit on my chest, can't breath and start sweating. Also have more arrhytmia than before...

The main problem is that the next option from my Cardio Doc was to try a calcium channel blocker... but I read awful experiences about those meds... and they have the same side-effects... So I don't know what are my other options???

Can ask to try the Bystolic, but the vasodilatation effect don't reduce the heart rate as much as older beta-blocker.

I'm on 25 mg x 3 day of immediate release Metoprolol so 75 mg/day... Didn't stop the fast heart rate especially from anxiety and still have bad panic attacks even on 75 mg day... it's suppose to stop the adrenaline effect on the heart but I have big surge of adrenaline from panic attack and the metoprolol can't stop that...

Anyway, did you return on the Metoprolol? If not, what is the name of the calcium channel blocker you take? Is it the Verapamil? Apparently it's slow down the digestive track badly and cause constipation... and it's another one of my problem, I have a very slow digestive system and can't have normal bowel movement without using 5-10 glycerin suppositories and lactulose to soft the stools... and even if my stools are liquid, they don't get out by themself... I have dammage to the 2 sphincters muscles from a previous surgery and since then I can't have normal bowel movement... (sorry for the too much informations here)... lol

So like I was saying, I hope you are doing well!!!

Give some news ;-)
Avatar universal
It sounds like you have POTS. It often gets misdiagnosed as anxiety disorder. I would look into that, it could explain all of your symptoms. If you do think you have POTS, it's very important to find a doctor with some knowledge of it. Good luck.
Avatar universal

I have had chronic migraines for 3 years and any loud noise, sudden change (even emotional) would get my heart racing along with a bad migraine. I was on propranolol 60 mg a day, which worked well. I switched to metropolol which isnt working as well but I still have not fixed the dose.

More importantly, I have finally got to the root cause of my migraines. I moved to Canada in 2009 and a year later my chronic migraines started (didnt even know what they were before ). I had copper toxicity- canada/US use copper pipes for drinking water. Usually, your body could get rid of the excess copper but some people have a deficient enzyme, which leads to overload/ deposits in the brain- which cause your symptoms actually. I am taking zinc now which is depleting the copper deposits (the first few months, you feel horrible and then you get better). Read about it and get tested.  Beware, many doctors do not think it to be an issue so ask for Cu, Pb, Hg tests just to rule out all the heavy metals.

Wishing you well,

Avatar universal
Dear Vincent,  I had  all the troubles you have,  solution was SEROTONINA,  PDIQUIATRYC  GAVE IT,  PLEASE ASK,  HEALTH TO YOU
Avatar universal
My doctor also prescribed me metoprolol.  It actually caused me to have rage.  It only took a couple of days for me to recognize.  It's a very rare side effect, but it does happen.  It's very important to advise your doctor of ANY changes that you experience with a new drug.  With me, it was easy.  Totally outside my personality.  
Avatar universal
Hi my 18 yr old son started to have same problem with tachycardia and pots
We didnt know about till later.they gave him metoprolol and it caused him to go into a psycosis then they gave him zoloft because of the depression and psycosis symptoms .t.they double wammed him zoloft or antidepressant increase the milgrams of metoprolol
Not intil we researced ourself they would of had him in phyc ward hospital probably tied down and locked up on these meds .had i not listen to my son and gut feeling .
I had to lock myself in a room not listened to cardiologist and
Remove  him off both meds .
3 days off metoprolol my son was back to himself its be a slow process getting hom back to himself .all the cardiologist did was apologise said the never read the fda reports which clearly states side effects pycosis and mood dosorder .lots of repost of patients hospitalized and expired off that medication please becareful wirh it
...there is a beta blocker called beta xalol it doesnt cross the brain barrier only treats the heart issues been told this would be last choice if needed for my son ..ive been treating him with salt water and liquorice root and
Folic acid and passion flower tea or any calming tea lavendor etc .so far its helped and feels alot better please becareful with metoprolol
Betaxolol does indeed penetrate the blood-brain barrier just as Metoprolol and others do.  A beta blocker which does not penetrate the blood-brain barrier is Atenolol.  Metoprolol psychosis is an extremely uncommon side effect.
Also, please be careful with the "natural" remedies.  There is a dark side to licorice root. When consumed regularly or in large quantities, there can be profound metabolic consequences.  Fluid and sodium are retained, blood pressure goes up and potassium may drop to dangerously low levels.   Excessive intake of liquorice root can cause hypokalemia, a low level of potassium. Symptoms may include feeling tired, leg cramps, weakness, and constipation.  It can also increase the risk of an abnormal heart rhythm,  and can even cause cardiac arrest.  Another well known symptom is the lowering of testosterone levels in males.  The use of salt water combined with the licquorice root sounds like a scary combination.
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