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Metoprolol (Lopressor) comes as a tablet and an extended-release tablet to take by mouth. The regular tablet is usually taken once or twice a day with meals or immediately after meals. The extended-release tablet is usually taken once a day. To help you remember to take metoprolol, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metoprolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The long-acting tablet may be split. Swallow the whole or half tablets whole; do not chew or crush them.

Your doctor may start you on a low dose of metoprolol and gradually increase your dose.

Metoprolol controls high blood pressure and angina but does not cure them. Extended-release metoprolol controls heart failure but does not cure it. It may take a few weeks before you feel the full benefit of metoprolol. Continue to take metoprolol even if you feel well.

Metoprolol is also used sometimes to prevent migraine headaches and to treat irregular heartbeat and movement disorders caused by medications for mental illness. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking metoprolol,

• tell your doctor and pharmacist if you are allergic to metoprolol or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: fluoxetine (Prozac, Sarafem); paroxetine (Paxil); propafenone (Rythmol); quinidine (Quinidex); and reserpine (Serpalan, Serpasil, Serpatab). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had asthma or other lung disease; a slow heart rate; heart or liver disease; diabetes; or an overactive thyroid gland (hyperthyroidism).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking metoprolol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoprolol.
• you should know that metoprolol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using metoprolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

Metoprolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness or lightheadedness
• cold hands and feet
• upset stomach
• gas or bloating
• rash or itching
• stomach pain
• constipation
• depression
• dry mouth
• heartburn
• tiredness

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• swelling of the hands, feet, ankles, or lower legs
• rapid, pounding, or irregular heartbeat
• unusual weight gain
• shortness of breath
• wheezing
• fainting

Metoprolol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Symptoms of overdose may include:

• swelling of the hands, feet, ankles, or lower legs
• difficulty breathing or swallowing
• dizziness
• fainting

Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to metoprolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.