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Does metoprolol lower resting heart rate?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on Oct 29, 2024.

Official answer

by Drugs.com

Yes, metoprolol can lower resting heart rate. It is a beta-blocking medication that is used to lower blood pressure, as well as relieve chest pain from angina pectoris. It is also used for the treatment of heart failure and heart attack. Metoprolol comes in both immediate-release and long-acting formulations.

How does metoprolol lower heart rate?

Metoprolol is a beta-blocker medication that works by blocking the effects of adrenaline (epinephrine) and noradrenaline (norepinephrine) on the heart. These hormones, also known as catecholamines, normally increase heart rate and force of contraction. By blocking their effects, metoprolol helps to slow down the heart rate.

How much does metoprolol lower heart rate?

The effect of metoprolol on heart rate depends on the dose, underlying health conditions, and individual response to the medication. The effects on heart rate are similar between the different formulations of metoprolol.

In a study of around 31,000 adults, the immediate-release form of metoprolol (50 mg twice a day) lowered heart rate by 19.1%. Additionally, people taking the long-acting form (100 mg once a day) had a 13.4% reduction from their starting heart rate.

In another study of about 4,000 adults living with heart failure, the extended-release form of metoprolol reduced heart rate by about 8-14 beats per minute (BPM). Average doses ranged from 146 mg to 167 mg per day in the five different groups researchers studied.

Researchers found that resting heart rate was 14 BPM lower in a group of people taking a beta-blocker compared to those that were not in a study looking at the effect of beta blockers on the heart and respiratory system. And in a separate study of people who took 200 mg of extended-release metoprolol per day after a heart attack showed it decreased heart rate by about 15 BPM.

In children ages 6 to 16 years old, metoprolol typically reduces heart rate by around 5 to 7 BPM. However, the response can vary and some children might have an even larger drop in heart rate.

Related questions

How soon does metoprolol lower heart rate?

How quickly metoprolol works depends on the formulation you are taking. Metoprolol lowers heart rate within one hour after taking a dose by mouth. When injected into the veins, metoprolol lowers heart rate within 20 minutes.

This is not all the information you need to know about metoprolol for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

Gullestad, L., et. al. 2005. What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker?: Experiences from the Metoprolol Controlled Release/Extended Release Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). In: Journal of the American College of Cardiology. DOI: https://doi.org/10.1016/j.jacc.2004.10.032

Lopressor [package insert]. Updated September 2023. Validus Pharmaceuticals LLC. Accessed 10/28/2024 at https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=0283bc9d-6998-493a-824a-d4c85f704111&type=display

Morris, J., et. al. 2024. Metoprolol. In: StatPearls [Internet]. Accessed 10/28/2024 at https://www.ncbi.nlm.nih.gov/books/NBK532923/

Priel, E., et. al. 2021. The Impact of beta blockade on the cardio-respiratory system and symptoms during exercise. In: Current Research in Physiology. DOI: https://doi.org/10.1016/j.crphys.2021.10.002

Shin, J., et. al. 2014. Risk of Emergent Bradycardia Associated with Initiation of Immediate- or Slow-Release Metoprolol. In: Pharmacotherapy. DOI: https://doi.org/10.1002/phar.1319

Toprol XL [package insert]. Updated April 2023. Aralez Pharmaceuticals US Inc. Accessed 10/28/2024 at https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=991fe00b-498b-400e-9e5b-921cb07d9b2c&type=display

Tuininga, Y. S., et. al. 1995. Evaluation of Importance of Central Effects of Atenolol and Metoprolol Measured by Heart Rate Variability During Mental Performance Tasks, Physical Exercise, and Daily Life in Stable Postinfarct Patients. In: Circulation. DOI: https://doi.org/10.1161/01.CIR.92.12.3415

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Does metoprolol cause hair loss?

Hair loss was not a commonly-reported side effect during clinical trials of metoprolol. However, rare reports of reversible hair loss have been reported by patients taking it. After stopping the medication, hair grows back again. Continue reading

How long does Metoprolol stay in your system after you stop taking it?

The half life of Metoprolol is between 3 and 7 hours. This is the time it takes for the drug levels in your plasma to reduce by half.

For a drug to be totally eliminated from your system it takes around 5.5 times the half life. As an estimate then, after taking a dose of Metoprolol it should be out of your system within 16.5 to 38.5 hours. Continue reading

How long does it take for metoprolol to work?

How long it takes metoprolol to work depends on what form is given and what condition is being treated. Effects on heart rate can be seen within one hour after taking metoprolol tartrate tablets and within 20 minutes after the intravenous form is given. The onset of action of metoprolol succinate is similar to metoprolol tartrate. Continue reading

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