Metoprolol: Side Effects and How To Reduce Them

Metoprolol (Lopressor) is an antihypertensive drug that belongs to a group of medications called beta-blockers. 

It is used to treat hypertension (high blood pressure) and conditions that cause arrhythmias (irregular heartbeat). 

Metoprolol is also used for the prevention of heart attacks and strokes.

Metoprolol drug can cause a few side effects, some of which tend to be more severe in elderly patients.

This article discusses Metoprolol side effects that you should watch out for and what you can do to avoid or minimize them.

What Are The Side Effects Of Metoprolol?

Headaches

Frequent headache is a common Metoprolol side effect that usually occurs for a few days when the patient starts using this drug. 

This symptom usually goes away within a few days without any active intervention.

Feeling weak, tired, or dizzy

These Metoprolol adverse effects are likely to occur due to the decline in blood pressure as a result of the anti-hypertensive effect of Metoprolol. 

Getting up slowly from sitting or lying down positions can help lessen these symptoms. Also, lying down for a while can relieve lightheadedness or dizziness. 

However, if these symptoms persist, you can visit your doctor to know if your dose of Metoprolol needs to be reduced.

Cold hands and feet

Patients using Metoprolol medication are likely to experience the coldness of the hands and feet. 

These side effects could be attributed to the decrease in blood pressure achieved by using metoprolol.

The sensation of coldness often goes away within a few days of using the drug as the body gets used to its effects.

If these symptoms are causing discomfort or are interfering with your routine activities, you can consider wearing gloves and socks to keep your hands and legs warm. 

You should also minimize your exposure to cold weather when possible.

However, if the symptoms still persist, you must inform your doctor. 

Digestive discomfort

Stomach upsets, nausea, vomiting, and pain in the abdomen can occur for a few days when you first start using Metoprolol. 

Limiting your intake of high-fat foods can often relieve these side effects. It is also important to avoid drinking alcohol to minimize these side effects.

Serious allergic reaction

A serious allergic reaction (anaphylaxis) to Metoprolol is reported in rare cases. 

Some common symptoms of an allergic reaction include:

• Swelling of the lips, mouth, and throat
• Itching
• Skin rashes
• Difficulty breathing 

In addition, your throat might feel tight, causing difficulty swallowing.

You must inform your doctor immediately if you notice these signs. 

Asthma

Patients with asthma might notice worsening of their symptoms, such as shortness of breath and tightening or wheezing of the chest, if they start using Metoprolol. 

These symptoms are often accompanied by swollen legs or ankles, irregular heartbeats, or a cough that becomes worse when you exercise.

Kidney or liver problems

Metoprolol can interfere with the functions of the kidneys and liver, and you may develop side effects such as yellowish discoloration of the nails, skin, and whites of the eyes, reduced appetite, and reduced urine secretion.

Frequent monitoring of your liver and kidney functions through blood tests and ultrasonography is recommended for the early detection of the decline in the functions of these vital organs.

Thrombocytopenia

Thrombocytopenia (reduced platelet count) can occur in some rare cases following the use of Metoprolol. 

The decrease in platelet count can cause symptoms such as unusual bruising or bleeding. 

If not detected and treated properly, thrombocytopenia can cause serious complications. Hence, it is important to talk to your doctor if you notice the signs of low platelet count. 

How Long Do Metoprolol’s Side Effects Last?

The mild side effects of Metoprolol, such as headaches, usually go away within 7 to 10 days of taking the medication. 

Some side effects, such as liver and kidney problems and thrombocytopenia, may last longer. You should talk to your doctor if the side effects persist for over a week.

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Are There Any Long-Term Side Effects of Metoprolol?

Metoprolol is not known to cause any long-term side effects. It is generally safe to use for a long time. In fact, the effectiveness is higher when it is used for long periods of time.

The mild side effects of this drug usually resolve with continued treatment as the body gets used to it.

Some serious side effects of Metoprolol, such as liver and kidney problems and thrombocytopenia, might persist for longer. 

If you develop any side effects that point to these conditions, you can contact your doctor to know whether you need to stop using Metoprolol and use alternative medication to manage your condition.

What Are Metoprolol’s Side Effects in the Elderly?

Elderly patients are particularly vulnerable to the side effects of beta-blockers like Metoprolol. Here are some side effects of Metoprolol reported in older adults:

Kidney and liver problems

As age increases, the efficiency of the kidneys and liver to clear drugs such as Metoprolol from the body is reduced. 

As a result, a higher level of Metoprolol remains in the system for a longer period of time.

Hence, elderly patients are more likely to develop kidney and liver dysfunctions while using Metoprolol. 

Regular monitoring of kidney and liver functions is recommended in these cases to ensure timely detection and treatment.

Drug interaction

Elderly patients are more likely to have other conditions such as heart problems, diabetes, and high cholesterol. 

As a result, they need to use other drugs, which might interact with Metoprolol causing drug interactions.

Liver, kidney, or heart problems

Side effects associated with the central nervous system (CNS) are common in elderly patients using beta-blockers such as Metoprolol. 

The risk of these side effects is attributed to the lipophilic properties of the medication. The term lipophilic means having the ability to dissolve in or combine with fat.

The common CNS symptoms noted in elderly patients using this drug include bizarre and vivid dreams, delirium, psychosis, sleep disturbances, and visual hallucinations. 

Hence, elderly people require close monitoring for any neurological symptoms when they start using Metoprolol.

Increased risk of falls

Older patients have an increased risk of falls and injuries from Metoprolol due to the effect of this medication on the functions of the nervous system.

Side Effects of Stopping Metoprolol

Stopping the use of Metoprolol abruptly can result in serious consequences. This drug has a black box warning from the Food and Drug Administration (FDA) that alerts doctors and patients about the risks involved in stopping Metoprolol suddenly. 

Some side effects of stopping Metoprolol include worsening of the existing symptoms such as chest pain, arrhythmias, and high blood pressure. It can also increase your risk of a heart attack.

Hence, you should never stop using Metoprolol without consulting your doctor. Your doctor might advise you to lower the dose of Metoprolol gradually over a period of time before you stop using it completely.

Conclusion

Metoprolol is an effective anti-hypertensive drug commonly prescribed for the management of high blood pressure and heart conditions. It can cause a few side effects, some of which are more severe in elderly patients.

If you are using metoprolol, watch out for these side effects and seek the advice of your doctor to know if you need to lower the dose or stop using it gradually.

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