Metoprolol side effects
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Side effects
The following adverse events were observed and have been reported in patients using Metoprolol.
Hypertension and Angina
Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Hypersensitive Reactions
Miscellaneous
Myocardial Infarction
Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Dermatologic
Potential Adverse Reactions
Central Nervous System
Cardiovascular
Hematologic
Hypersensitive Reactions
Hypertension and Angina
Most adverse effects have been mild and transient.
Central Nervous System
Tiredness and dizziness have occurred in about 10 of 100 patients. Depression has been reported in about 5 of 100 patients. Mental confusion and short-term memory loss have been reported. Headache, nightmares, and insomnia have also been reported.
Cardiovascular
Shortness of breath and bradycardia have occurred in approximately 3 of 100 patients. Cold extremities; arterial insufficiency, usually of the Raynaud type; palpitations; congestive heart failure; peripheral edema; and hypotension have been reported in about 1 of 100 patients. Gangrene in patients with pre-existing severe peripheral circulatory disorders has also been reported very rarely.
Respiratory
Wheezing (bronchospasm) and dyspnea have been reported in about 1 of 100 patients. Rhinitis has also been reported.
Gastrointestinal
Diarrhea has occurred in about 5 of 100 patients. Nausea, dry mouth, gastric pain, constipation, flatulence, and heartburn have been reported in about 1 of 100 patients. Vomiting was a common occurrence. Postmarketing experience reveals very rare reports of hepatitis, jaundice and non-specific hepatic dysfunction. Isolated cases of transaminase, alkaline phosphatase, and lactic dehydrogenase elevations have also been reported.
Hypersensitive Reactions
Pruritus or rash have occurred in about 5 of 100 patients. Very rarely, photosensitivity and worsening of psoriasis has been reported.
Miscellaneous
Peyronie’s disease has been reported in fewer than 1 of 100,000 patients. Musculoskeletal pain, blurred vision, and tinnitus have also been reported.
There have been rare reports of reversible alopecia, agranulocytosis, and dry eyes.
Discontinuation of the drug should be considered if any such reaction is not otherwise explicable. There have been very rare reports of weight gain, arthritis, and retroperitoneal fibrosis (relationship to Metoprolol has not been definitely established).
The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with Metoprolol.
Myocardial Infarction
Central Nervous System
Tiredness has been reported in about 1 of 100 patients. Vertigo, sleep disturbances, hallucinations, headache, dizziness, visual disturbances, confusion, and reduced libido have also been reported, but a drug relationship is not clear.
Cardiovascular
The following adverse reactions were reported: Hypotension, Bradycardia, Second or third degree heart block, First degree heart block, Heart failure
Respiratory
Dyspnea of pulmonary origin has been reported in fewer than 1 of 100 patients.
Gastrointestinal
Nausea and abdominal pain have been reported in fewer than 1 of 100 patients.
Dermatologic
Rash and worsened psoriasis have been reported, but a drug relationship is not clear.
Miscellaneous
Unstable diabetes and claudication have been reported, but a drug relationship is not clear.
Potential Adverse Reactions
A variety of adverse reactions not listed above have been reported with other beta-adrenergic blocking agents and should be considered potential adverse reactions to Metoprolol.
Central Nervous System
Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics.
Cardiovascular
Intensification of AV block.
Hematologic
Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura.
Hypersensitive Reactions
Fever combined with aching and sore throat, laryngospasm, and respiratory distress.
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Adapted from the FDA Package Insert.