Metoprolol Succinate ER Side Effects

Generic name: metoprolol

Medically reviewed by Drugs.com. Last updated on Feb 9, 2024.

Note: This document provides detailed information about Metoprolol Succinate ER Side Effects associated with metoprolol. Some dosage forms listed on this page may not apply specifically to the brand name Metoprolol Succinate ER.

Applies to metoprolol: oral capsule extended release, oral tablet, oral tablet extended release.

Other dosage forms:

• intravenous solution

Important Warnings This medicine can cause some serious health issues

Oral route (Tablet)

Ischemic Heart Disease Do not abruptly discontinue metoprolol tartrate tablets USP therapy in patients with coronary artery disease.

Severe exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following the abrupt discontinuation of therapy with beta-blockers.

When discontinuing chronically administered metoprolol tartrate tablets USP, particularly in patients with coronary artery disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored.

If angina markedly worsens or acute coronary insufficiency develops, metoprolol tartrate tablets USP administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken.

Patients should be warned against interruption or discontinuation of therapy without the physician’s advice.

Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue metoprolol tartrate tablets USP therapy abruptly even in patients treated only for hypertension.

Serious side effects

Along with its needed effects, metoprolol (the active ingredient contained in Metoprolol Succinate ER) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking metoprolol:

More common

• blurred vision
• chest pain or discomfort
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• slow or irregular heartbeat
• sweating
• unusual tiredness or weakness

Less common

• bloating or swelling of the face, arms, hands, lower legs, or feet
• chest tightness
• cough
• decreased urine output
• difficult or labored breathing
• difficulty with speaking
• dilated neck veins
• disturbed color perception
• double vision
• fast, pounding, or racing heartbeat or pulse
• halos around lights
• headache
• inability to move the arms, legs, or facial muscles
• inability to speak
• irregular breathing
• loss of vision
• night blindness
• noisy breathing
• overbright appearance of lights
• pain, tension, and weakness upon walking that subsides during periods of rest
• paleness or cold feeling in the fingertips and toes
• rapid weight gain
• seeing, hearing, or feeling things that are not there
• short-term memory loss
• slow speech
• swelling of the face, fingers, feet, or lower legs
• tingling of the hands or feet
• tingling or pain in the fingers or toes when exposed to cold temperatures
• trouble breathing
• tunnel vision
• unusual weight gain or loss

Rare

• bluish color of the skin of the fingers or toes
• chills
• clay-colored stools
• continuing loss of appetite
• continuing or severe abdominal or stomach pain
• continuing or severe nausea and vomiting
• dark urine
• difficulty with moving
• fever
• hoarseness
• increased frequency of urination
• itching skin
• light-colored stools
• lower back or side pain
• muscle pain or stiffness
• numbness of the fingers or toes
• pain, swelling, or redness in the joints
• rash
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• unpleasant breath odor
• unusual bleeding or bruising
• upper right abdominal or stomach pain
• vomiting of blood
• weakness
• yellow eyes and skin

Incidence not known

• black, tarry stools
• bleeding gums
• blood in the urine or stools
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• cool, sweaty skin
• pinpoint red spots on the skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking metoprolol:

Symptoms of overdose

• bluish color of the fingernails, lips, skin, palms, or nail beds
• change in consciousness
• loss of consciousness
• no blood pressure or pulse
• stopping of the heart
• very drowsy or sleepy

Other side effects

Some side effects of metoprolol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• belching
• bloated feeling
• decreased interest in sexual intercourse
• difficulty having a bowel movement
• discouragement
• dry mouth
• excess air or gas in stomach or bowels
• feeling of constant movement of self or surroundings
• feeling of fullness
• feeling of indigestion
• feeling sad or empty
• inability to have or keep an erection
• irritability
• loss in sexual ability, desire, drive, or performance
• loss of interest or pleasure
• nightmares
• pain in the chest below the breastbone
• passing gas
• redness or other discoloration of the skin
• runny or stuffy nose
• sensation of spinning
• sneezing
• tiredness
• trouble concentrating
• trouble sleeping

Rare

• bone pain
• continuing ringing or buzzing or other unexplained noise in the ears
• dry eyes
• hair loss or thinning of the hair
• hearing loss
• increased sensitivity of the skin to sunlight
• pain in the penis on erection
• severe sunburn

Incidence not known

• change in taste or bad, unusual, or unpleasant (after) taste
• fear or nervousness
• hives or welts

For Healthcare Professionals

Applies to metoprolol: compounding powder, injectable solution, oral capsule extended release, oral solution, oral tablet, oral tablet extended release.

General

The most common adverse reactions were tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, and rash.^[Ref]

Cardiovascular

• Very common (10% or more): Heart failure (up to 27.5%), hypotension (systolic blood pressure less than 90 mmHg) (up to 27.4%), bradycardia (heart rate less than 40 beats per minute) (up to 15.9%),
• Common (1% to 10%): Cold extremities, arterial insufficiency, palpitation, first degree heart block (P-R interval 0.26 seconds or greater), second or third degree heart block, postural disorders
• Uncommon (0.1% to 1%): Cardiogenic shock in patients with acute myocardial infarction
• Rare (0.01% to 0.1%): Disturbances of cardiac conduction, cardiac arrhythmia
• Very rare (less than 0.01%): Intermittent claudication increased
• Frequency not reported: Claudication^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, nausea, dry mouth, gastric pain, constipation, flatulence, heartburn, abdominal pain, vomiting
• Frequency not reported: Retroperitoneal fibrosis^[Ref]

Other

• Common (1% to 10%): Tiredness, peripheral edema, accident and/or injury, death, fatigue
• Uncommon (0.1% to 1%): Edema, precordial pain
• Frequency not reported: Lactic dehydrogenase elevated
• Postmarketing reports: Chest pain^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, vertigo, stroke, headache
• Uncommon (0.1% to 1%): Paresthesia, somnolence, impaired concentration
• Rare (0.01% to 0.1%): Alertness decreased
• Very rare (less than 0.01%): Amnesia/memory impairment, tinnitus, taste disturbance
• Frequency not reported: Short-term memory loss
• Postmarketing reports: Syncope^[Ref]

Respiratory

• Common (1% to 10%): Shortness of breath, wheezing, dyspnea
• Rare (less than 0.1%): Rhinitis^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, rash
• Uncommon (0.1% to 1%): Sweating increased
• Rare (0.01% to 0.1%): Loss of hair
• Very rare (less than 0.01%): Photosensitivity reactions, psoriasis aggravated, gangrene in patients with preexisting severe peripheral circulatory disorders, hyperhidrosis, alopecia^[Ref]

Psychiatric

• Common (1% to 10%): Depression
• Uncommon (0.1% to 1%): Insomnia, nightmare
• Rare (0.01% to 0.1%): Nervousness, anxiety
• Very rare (less than 0.01%): Confusion, hallucination, personality disorder, disturbances of libido
• Frequency not reported: Sleep disturbance^[Ref]

Musculoskeletal

• Uncommon (0.1% to 1%): Muscle cramps
• Very rare (less than 0.01%): Arthralgia, arthritis
• Frequency not reported: Musculoskeletal pain^[Ref]

Metabolic

• Uncommon (0.1% to 1%): Weight gain
• Frequency not reported: Unstable diabetes
• Postmarketing reports: Blood triglycerides increased, high density lipoprotein (HDL) decreased^[Ref]

Ocular

• Rare (less than 0.1%): Visual disturbance, dry and/or irritated eyes, conjunctivitis
• Frequency not reported: Blurred vision^[Ref]

Hepatic

• Rare (0.01% to 0.1%): Liver function test abnormalities
• Very rare (less than 0.01%): Hepatitis
• Frequency not reported: Transaminase elevated, alkaline phosphatase elevated
• Postmarketing reports: Jaundice, non-specific hepatic dysfunction^[Ref]

Genitourinary

• Rare (0.01% to 0.1%): Impotence/sexual dysfunction
• Very rare (less than 0.01%): Peyronie's disease^[Ref]

Immunologic

• Rare (less than 0.1%): Positive antinuclear antibodies^[Ref]

Hematologic

• Very rare (less than 0.01%): Thrombocytopenia
• Frequency not reported: Agranulocytosis^[Ref]

Frequently asked questions

• Metoprolol Succinate vs Tartrate: What's the difference between them?
• Which is safer: metoprolol succinate or tartrate?
• What is the best time of day to take blood pressure medication?
• Does metoprolol make you sleepy?
• Does metoprolol cause hair loss?
• How long does Metoprolol stay in your system after you stop taking it?
• How long does it take for metoprolol to work?

Further information

Metoprolol Succinate ER side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer