Metoprolol ER

Drug Information

Medically reviewed by Jessica Swirble, PharmD
Last updated on April 21, 2025

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Quick facts

• Brand Name: Lopressor, Toprol XL
• Generic Name: Metoprolol ER
• Uses: Treating high blood pressure (hypertension), angina, and heart failure; preventing heart attacks
• Drug Class: Beta-blocker
• Availability: Prescription only
• Generic Status: Yes
• Controlled Substance: No

What is metoprolol ER?

Metoprolol ER is a beta-blocker used to treat various cardiovascular conditions. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. This reduces the heart rate and makes the heart more efficient at pumping blood, which helps to lower blood pressure.

What conditions does metoprolol ER treat?

Metoprolol ER is primarily used to treat conditions such as:

• High blood pressure (hypertension): Metoprolol ER lowers blood pressure and reduces the risk of cardiovascular events such as strokes and heart attacks.
• Angina (chest pain): Used to decrease the frequency and severity of angina attacks.
• Heart failure: Metoprolol ER manages symptoms and improves heart function when prescribed along with therapy options.

It is also prescribed to prevent heart attacks in patients who have already suffered from one.

How does metoprolol ER work?

Metoprolol ER works by blocking the action of certain natural chemicals in your body, such as epinephrine and norepinephrine, on the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart.

How do I take metoprolol ER?

Metoprolol ER can be taken in different forms, depending on the specific needs:

• Extended-release oral tablets

The dosage and duration of treatment depend on the condition being treated, its severity, and your response to the medication.

Follow your healthcare provider's instructions regarding dosage and schedule. Do not exceed the prescribed dose or duration of treatment without consulting your provider.

How long until I feel better?

The effectiveness of metoprolol ER and the time it takes to notice improvement can vary among individuals. Blood pressure reduction can generally be observed within a few hours of taking the medication, but it may take several weeks to achieve optimal blood pressure control.

Continue taking metoprolol ER as prescribed even if you start feeling better. Do not abruptly stop the medication, as it may lead to adverse cardiovascular events.

Are there any other uses for metoprolol ER?

While metoprolol ER is primarily used for managing cardiovascular conditions, healthcare providers may sometimes prescribe it off-label for conditions such as:

• Tremors
• Migraine prevention

Discuss any alternative uses of metoprolol ER with your healthcare provider.

Dosage forms of metoprolol ER

Metoprolol ER is available in the following dosage forms:

• Oral tablets: 25mg, 50mg, 100mg, 200mg

Generic versions of metoprolol ER are available, providing cost-effective treatment options.

Metoprolol ER is a prescription medication. You will need a valid prescription from a licensed healthcare provider to obtain this medication.

Side Effects and Precautions for Metoprolol Extended-Release

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What are the side effects of metoprolol ER?

The use of metoprolol ER can lead to various side effects in some individuals.

Common mild side effects of metoprolol ER use include:

• Fatigue or tiredness
• Dizziness or lightheadedness
• Nausea or upset stomach
• Vomiting
• Diarrhea or constipation
• Slow heart rate (bradycardia)
• Cold hands and feet
• Shortness of breath
• Trouble sleeping (insomnia)

More severe side effects of metoprolol ER use can include:

• Very slow heartbeat
• Very low blood pressure
• Change in heart rhythm
• Severe allergic reactions (such as rash, itching, swelling of the face, tongue, or throat, trouble breathing)
• Chest pain or tightness
• Swelling of the ankles or feet (edema)
• Fainting or severe dizziness
• Blue color to your fingers or toes
• Severe headache
• Unusual sweating
• New or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain)

If you experience any severe or concerning side effects while taking Metoprolol ER, contact your healthcare provider right away.

What should I tell my healthcare provider before using metoprolol ER?

Tell your healthcare provider about any existing medical conditions, allergies, or other medications you are taking before starting treatment with metoprolol ER. This includes prescription drugs, over-the-counter medications, and dietary supplements, as they may interact with metoprolol ER.

Tell your provider if you are taking these medications or supplements:

• Other blood pressure medications
• Medications that slow the heart rate
• Medications that affect heart rhythm
• Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen and aspirin)
• Antidepressants or anti-anxiety medications
• Any drugs or supplements that may affect heart rate or blood pressure

You should also mention medical conditions such as:

• Asthma or other breathing disorders
• Diabetes (Metoprolol ER may mask signs of low blood sugar)
• Thyroid disorders
• Kidney or liver disease
• A history of severe allergic reactions

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider before using metoprolol ER to assess potential risks and benefits.

Are there any other special instructions I should follow?

Take metoprolol ER exactly as prescribed by your healthcare provider. Do not exceed the recommended dose or duration of treatment.

Metoprolol ER should be taken with a meal or just after eating to improve absorption and reduce the risk of stomach upset. Follow your healthcare provider's instructions for optimal effectiveness.

Avoid alcohol and activities that require alertness until you understand how Metoprolol ER affects you, as it can cause dizziness and fatigue.

Store metoprolol ER at room temperature, away from moisture and heat. Keep it out of reach of children.

What should I do in case of an overdose?

In case of a metoprolol ER overdose, seek medical attention immediately. Symptoms of overdose may include severe dizziness, fainting, difficulty breathing, or an unusually slow or irregular heartbeat. If you suspect an overdose, contact the poison control helpline at 1-800-222-1222 or call emergency services.

Proper Use & Dosage Information for Metoprolol Extended-Release

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What is the typical starting dose for Metoprolol ER?

Metoprolol ER is available in the following forms:

• Oral tablets: 25 mg, 50 mg, 100 mg, 200 mg

The typical starting dose of metoprolol ER varies depending on the condition being treated, the severity of symptoms, and individual patient factors. It is important to follow your healthcare provider's instructions regarding dosage and administration.

For hypertension:

• Oral tablets (extended-release): 25-100 mg, once daily.

For angina:

• Oral tablets (extended-release): 100 mg, once daily

The dosage may be gradually increased based on the response and tolerance to the medication. Your healthcare provider will determine the most appropriate dose based on your medical history, current medications, and response to the medication.

Metoprolol ER should be taken exactly as prescribed by your healthcare provider. Do not exceed the recommended dose or duration of treatment without consulting your provider.

If you have any questions about your dosage or need adjustments, contact your healthcare provider for guidance. If you want to talk to a provider right away, consider scheduling an online doctor appointment through a platform like Sesame.

What should I do if I miss a dose of metoprolol ER?

If you miss a dose of metoprolol ER, take it as soon as you remember unless it is close to the time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

Maintain a consistent dosing schedule to ensure the effectiveness of Metoprolol ER in managing your condition.

What should I do if I'm feeling better while taking metoprolol ER?

Continue taking metoprolol ER as prescribed by your healthcare provider, even if you start feeling better. Do not stop the medication abruptly without consulting your provider, as it may lead to a recurrence of symptoms or other complications.

Complete the full course of treatment as directed to minimize the risk of relapse.

If you have any concerns or questions about your medication, discuss them with your healthcare provider for personalized guidance and recommendations.

How should I store metoprolol ER?

Store metoprolol ER according to the instructions provided by your healthcare provider or pharmacist. Keep it at room temperature, away from moisture, heat, and light. Ensure the container is tightly closed and out of reach of children.

Do not use expired medication or medications that appear damaged or discolored. If you have any questions about storage, consult your healthcare provider or pharmacist for guidance.