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Metoprolol side effects and how to avoid them

Metoprolol side effects may go away once your body adjusts to the medication
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By | Updated on Dec. 18, 2025 Medically reviewed by Karen Berger, Pharm.D.
Rx pill bottle: Metoprolol side effects

Key takeaways

  • Metoprolol is a beta blocker commonly used to lower blood pressure and manage chest pain. Depending on the form, it is also used in people with heart failure (metoprolol succinate) or to improve survival after a heart attack (metoprolol tartrate).

  • Common side effects of metoprolol include tiredness, dizziness, depression, low blood pressure, and diarrhea. Side effects are similar for metoprolol tartrate and metoprolol succinate.

  • Some side effects may start relatively quickly, although mild side effects often go away as your body adjusts to the medicine.

In this article:

Metoprolol is a beta blocker that healthcare professionals often prescribe for high blood pressure and other heart-related conditions. There are two forms of metoprolol: 

Most common side effects of metoprolol

According to the prescribing information for metoprolol succinate and metoprolol tartrate, the most common side effects include:

  • Tiredness
  • Dizziness and lightheadedness
  • Depression
  • Shortness of breath
  • Bradycardia (slowed heartbeat)
  • Hypotension (low blood pressure)
  • Diarrhea
  • Itching and rash

Other common side effects, according to MedlinePlus, may include:

  • Nausea and vomiting
  • Dry mouth
  • Gas and bloating
  • Heartburn
  • Constipation
  • Cold hands and feet
  • Runny nose

Does metoprolol cause swelling?

Swelling is not a common side effect of metoprolol. In studies done after the drug was approved, patients reported edema (fluid retention). However, this data didn’t measure the frequency of occurrence or find a cause-and-effect relationship between the drug and reported side effects. 

Swelling may occur in people who have heart disease or heart failure and are experiencing a worsening of their condition. In these cases, people may have swelling around the legs or ankles along with weight gain and shortness of breath. 

Swelling can also be a sign of a serious allergic reaction. Get emergency medical help if you’re taking metoprolol and notice swelling of the face, lips, tongue, or throat, or any other symptoms of an allergic reaction, such as hives or trouble breathing. 

Does metoprolol cause constipation?

MedlinePlus reports constipation as a common side effect, along with other stomach-related side effects (see section above). Some people will experience constipation from metoprolol, although it only occurs in about 1% of people taking metoprolol.  

Are there any major side effects of metoprolol?

As with any drug, serious side effects are less common but possible, and may include:

  • Allergic reaction, which may appear as hives, rash, itching, trouble breathing, or swelling of the face, lips, tongue, or throat 
  • Swelling of the legs or ankles, sudden weight gain, or shortness of breath, which may be due to fluid retention or worsening heart failure
  • Fainting
  • A slow, fast, pounding, or irregular heartbeat

While these side effects are less common, you should call your healthcare provider right away for any concerning symptoms or seek emergency medical help for urgent symptoms, including an allergic reaction. 

Side effects of metoprolol succinate vs. side effects of metoprolol tartrate 

Common side effects are similar for both drugs, as noted above. Both forms of metoprolol contain the same drug, but are formulated slightly differently: Metoprolol tartrate is immediate-release, while metoprolol succinate is extended-release. Because of this, their differences are more related to how long they work in the body rather than their actual effects on the body. 

Metoprolol 50 mg side effects vs. 25 mg side effects

The prescribing information for both forms of metoprolol does not specify the occurrence of side effects by dosage. However, higher doses may make certain side effects more likely. For example, metoprolol lowers blood pressure, so higher doses are likely to affect the heart and blood pressure more than lower doses, which could cause side effects like slowed heart rate and low blood pressure. To minimize the risk of dose-related side effects, healthcare providers typically start the drug at a lower dose and gradually adjust to an effective dose that produces minimal side effects. 

How soon do metoprolol side effects start?

Metoprolol starts working relatively quickly, reaching its highest levels in the body within one or two hours. However, the timing of side effects may vary. Some common side effects, like drowsiness, dizziness, tiredness, and diarrhea, occur relatively soon. Other side effects, like depression, sexual problems, and memory problems, may take longer to develop.  

How long do metoprolol side effects last?

Some side effects may be temporary and start to lessen or go away as your body adjusts to the medicine. This often happens with stomach-related side effects, like nausea or diarrhea, or mild dizziness and fatigue. Other side effects may take longer to develop or have longer-lasting effects, like memory problems, depression, or joint pain. Always communicate this information to your healthcare provider so they can make adjustments to your medicine regimen, if needed.

Metoprolol long-term side effects

Metoprolol is often prescribed as a long-term medicine. Beta blockers like metoprolol have been used safely for many years. However, any drug can cause side effects. And some people may be at higher risk, such as older adults, people with liver disease, and people with memory or thinking problems. Although many people tolerate metoprolol well, long-term use can still cause side effects. Talk to your healthcare provider regarding any concerns about long-term use of metoprolol.  

Metoprolol drug interactions

Before you take metoprolol, it is important to review your medication list with your healthcare provider, including prescription and over-the-counter medicines, vitamins, and supplements. It’s important to let your healthcare provider know if you take any of the following medications:

You can read more about metoprolol interactions here. 

Safety measures while using metoprolol

Tell your healthcare provider about any medical conditions you have, and be sure to tell them if you are pregnant, planning to become pregnant, or breastfeeding. Metoprolol is not safe for everyone. You should not take metoprolol if:

  • You are allergic to metoprolol or any ingredient in the medication
  • You have certain heart problems, such as severe bradycardia, sick sinus syndrome, second or third-degree heart block, severe hypotension, or worsening heart failure

Metoprolol is not habit-forming and is not a controlled substance. However, stopping the medication abruptly can cause problems, including heart attack, a worsening of chest pain, high blood pressure, or a fast heart rate. Always follow your healthcare provider’s instructions for use and do not stop taking metoprolol abruptly.  

If you or someone else may have taken too much metoprolol, you should call Poison Control at 1-800-222-1222. Some of the symptoms of overdose may include nausea,  vomiting, irregular heartbeat, chest pain, dizziness, fainting, trouble breathing, or swelling. If the person cannot wake up or has a seizure, call 911. 

How to prevent metoprolol side effects

While you may not be able to prevent side effects, there are some steps you can take to lower your risk of experiencing certain side effects: 

  1. Tell your healthcare provider about all medical conditions, medical and family history, and all the medications you take. This will help your healthcare provider determine whether metoprolol is safe for you. 
  2. Take metoprolol exactly as directed. Typically, metoprolol tartrate should be taken with food or after a meal, while metoprolol succinate can be taken without regard to food.
  3. Establish a pattern so you remember to take your medicine around the same time(s) every day. You can set a reminder on your phone or use a medication organizer to help you keep track of your medication schedule. 
  4. If you miss a dose, skip the missed dose and take your next dose at the usual time. Do not double up on doses. Check with your healthcare provider if you have any questions about missing a dose of metoprolol. 
  5. Talk to your healthcare provider about alcohol consumption. For high blood pressure and many heart conditions, it is best to avoid alcohol. If you are taking the metoprolol succinate extended-release capsules (Kapspargo Sprinkle), you should never drink alcohol. This is because alcohol can interfere with the way the medicine is released from the capsule, and possibly cause dangerous side effects.
  6. Metoprolol can cause drowsiness, dizziness, and low blood pressure. Do not drive a car or operate machinery until you know how metoprolol affects you. Move carefully and stand up slowly if you are experiencing dizziness. 
  7. Metoprolol can mask symptoms of low blood sugar and can also increase the risk of severe or prolonged episodes of low blood sugar. Talk to your healthcare provider about monitoring and treating low blood sugar, especially if you have diabetes.
  8. During treatment with metoprolol, if you are sick, such as with a cold or flu, check with your healthcare provider before taking over-the-counter medicines, as some may not be safe for your condition. 
  9. Follow your healthcare provider’s recommendations for dietary modifications and monitoring blood pressure, and keep all appointments for follow-up care and blood work. 
  10. Report side effects to your healthcare provider, especially if they are bothersome or do not go away. For serious side effects, get emergency or urgent medical help. 

Side effects of missing a dose of metoprolol

Missing one dose should not cause any side effects or problems. However, stopping metoprolol abruptly can cause problems. If you miss one dose of metoprolol, it is recommended to skip the missed dose and continue with your next regular dose. Do not take an extra or double dose. If you miss more than one dose, call your healthcare provider for medical advice. 

How to treat side effects of metoprolol

Here are some tips for managing some of the common side effects of metoprolol:

  • For an upset stomach, stick to smaller meals and eat mild foods, avoiding heavy, greasy, and spicy foods. If you have diarrhea, be sure to stay hydrated. If you experience constipation, try to eat more fiber and increase fluid intake. 
  • If you have a dry mouth, try sucking on sugar-free candies, using a saliva substitute, and staying hydrated.
  • If you feel fatigued or tired, try to get enough rest until your body adjusts to the medicine.
  • If you have dizziness or lightheadedness, be sure to get up slowly from a sitting or lying position and move carefully. 

Often, side effects improve as your body gets used to the medication. If you have side effects that bother you or do not go away, check with your healthcare professional. Do not stop taking metoprolol suddenly, as doing so can cause serious problems.

Expert takeaway 

“I have been a pharmacist for over 20 years, and metoprolol has always been one of the most commonly prescribed drugs,” says Karen Berger, Pharm.D., member of the SingleCare Medical Board. “Most people tolerate it very well. It’s important to follow your healthcare provider’s instructions for use, and always keep follow-up appointments.” 

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