Metoprolol ER is used to lower high blood pressure, reduce chest pain, and treat heart failure. It is also used after a heart attack to improve survival.

Metoprolol ER is sometimes used off-label for migraine prevention and to treat tremors and irregular heartbeats.

Metoprolol ER is a beta-blocker that blocks beta receptors. Normally, beta receptors are stimulated by epinephrine and norepinephrine. These are stress hormones that increase heart rate, increase the heart's workload, and constrict blood vessel walls.

By blocking these receptors, metoprolol ER lowers heart rate and blood pressure and reduces stress on the heart.

The most common side effects associated with metoprolol ER are low blood pressure and low heart rate. It can also cause the following symptoms:

• Depression
• Diarrhea
• Dizziness
• Drowsiness
• Fatigue
• Insomnia
• Itching
• Memory impairment
• Nightmares
• Rash
• Vivid dreams

Metoprolol ER is only available by prescription from a licensed provider.

Looking for a refill or a new prescription for metoprolol ER? Schedule an appointment with a Sesame provider and get a same-day prescription for metoprolol, if appropriate.

The best time to take metoprolol ER will depend on individual factors. It can be taken either in the morning or evening but should be taken at the same time every day. To reduce side effects, it should be taken after a meal.

In some people, metoprolol ER causes insomnia, nightmares, and trouble sleeping. If this happens, it may be better to take metoprolol ER in the morning to avoid these side effects. For others, metoprolol ER causes drowsiness, fatigue, and dizziness. If you experience these side effects, it may be beneficial to take metoprolol ER in the evening.

Metoprolol ER is not safe or appropriate for everyone. Those with allergies to metoprolol should not use it. People with low blood pressure, low heart rate, sick sinus syndrome (heart rhythm disorder), acute heart failure, and cardiogenic shock should not use metoprolol ER. In certain cases, your provider will recommend a different antihypertensive medication.

Metoprolol ER should be used cautiously in people with certain conditions. Your provider should closely monitor you to make sure metoprolol does not make other conditions worse.

These conditions include:

• Asthma
• COPD
• Diabetes
• Hyperthyroidism
• Liver disease
• Myasthenia gravis
• Peripheral vascular disease
• Pheochromocytoma
• Psoriasis

Speak with your provider if you are pregnant, planning on becoming pregnant, or breastfeeding.

Metoprolol ER should be used cautiously in people with severe allergies. Metoprolol ER can reduce the effect of epinephrine, which is used for emergency anaphylaxis.

Metoprolol ER interacts with many other medications. Always tell your healthcare provider and pharmacist about all prescription and OTC medications, vitamins, and supplements you take.

Metoprolol ER may interact with the following medications:

• Antiarrhythmics
• Bupropion
• Clonidine
• Digoxin
• Diltiazem
• Fluoxetine
• Guanfacine
• MAO inhibitors
• Paroxetine
• Rifampin
• Terbinafine
• Tizanidine
• Verapamil

This is not a complete list of all interactions with metoprolol ER.