Common questions about metoprolol

Metoprolol is a type of medicine called a beta blocker.

Like other beta blockers, metoprolol works by changing the way your body responds to some nerve impulses, especially in the heart.

It slows down your heart rate and makes it easier for your heart to pump blood around your body.

Metoprolol starts to work after about 2 hours, but it can take up to 1 week to take full effect.

You may not feel any different when you take metoprolol, but this does not mean it's not working.

It's important to keep taking your medicine.

Metoprolol is generally safe to take for a long time. In fact, it works best when taken for long periods of time.

Metoprolol works as well as other beta blockers for reducing high blood pressure, but is less likely to cause side effects. That's because metoprolol works mainly on the heart. Other beta blockers, such as propranolol, work on the heart but affect other parts of the body as well.

There are lots of other medicines to lower blood pressure and treat chest pain that work in a different way from beta blockers.

They include:

• angiotensin-converting enzyme (ACE) inhibitors like ramipril and lisinopril
• angiotensin receptor blockers like candesartan
• calcium channel blockers like amlodipine
• diuretics (tablets that make you pee more) like furosemide

Beta blockers are not usually the first choice of treatment for high blood pressure.

The medicine your doctor prescribes depends on your age and ethnicity:

• if you're under 55 – you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker unless you're of African Caribbean or Black African origin
• if you're aged 55 or older – you'll usually be offered a calcium channel blocker
• if you're any age and of African Caribbean or Black African origin – you'll usually be offered a calcium channel blocker

You may have to try other medicines to lower your blood pressure if you get side effects. Many people need to take a combination of different tablets.

Tell your doctor you're taking metoprolol if you're going to be put to sleep (using general anaesthetic), or have any kind of major operation.

Your doctor may advise you to stop taking metoprolol 24 hours before surgery. This is because metoprolol can lower your blood pressure too much when it's combined with some anaesthetics.

You do not need to stop playing sports if you take metoprolol.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

If you compete in sports at a high level, bear in mind that metoprolol is not allowed to be taken in some sports.

Some people on metoprolol say their sex drive goes down or they cannot get an erection.

But this is not a common side effect and there is not enough evidence to say for sure that metoprolol causes it.

If you're having problems with your sex life, talk to your doctor.

Metoprolol will not affect your contraception.

But some types of hormonal methods of contraception, such as the combined pill, progestogen-only pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking or using a combined hormonal contraceptive.

Metoprolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose.

If this happens to you, do not drive a car, ride a bike, or use tools or machinery.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking metoprolol. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol can increase the risk of side effects with metoprolol. It can make you feel dizzy or light-headed.

During the first few days of taking metoprolol, or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

It's best to stop drinking alcohol if you find metoprolol makes you feel dizzy.

Apart from stopping alcohol if you feel dizzy, you can eat and drink normally while taking metoprolol.

You can boost the health of your heart by making some key lifestyle changes:

• Quit smoking – smoking increases your heart rate and blood pressure. Giving up smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
• Cut down on alcohol – drinking too much alcohol raises blood pressure over time. It makes heart failure worse, too. Try to keep to the recommended guidelines of no more than 14 units of alcohol a week.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day will help.
• Eat well – eating a healthy, balanced diet can help if you have high blood pressure or a heart problem. Aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products, and lean proteins. It's a good idea to follow these tips for a lower salt diet, too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year and the pneumococcal vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS. Coronavirus (COVID-19) vaccination is recommended for most people. Make sure you've had all the doses that you are eligible for. Talk to your doctor if you think you might be in one of the at risk groups.