How does metoprolol work?
Metoprolol is a type of medicine called a beta blocker.
Like other beta blockers, metoprolol works by changing the way your body responds to some nerve impulses, especially in the heart.
It slows down your heart rate and makes it easier for your heart to pump blood around your body.
How long does it take to work?
Metoprolol starts to work the same day, but it can take up to 1 week to work fully.
You may not feel any different when you take metoprolol, but this does not mean it's not working.
It's important to keep taking your medicine.
Are there any long-term side effects?
Metoprolol is generally safe to take for a long time. In fact, it works best when taken for a long time.
How does it compare with other beta blockers?
Metoprolol works as well as other beta blockers for reducing high blood pressure, but is less likely to cause some side effects. That's because metoprolol works mainly on the heart. Other beta blockers, such as propranolol, work on the heart but affect other parts of the body as well.
Beta blockers are not usually the first choice of treatment for high blood pressure.
There are lots of other medicines to lower blood pressure and treat chest pain that work in a different way from beta blockers.
They include:
- ACE inhibitors like ramipril and lisinopril
- angiotensin receptor blockers (ARBs) like candesartan
- calcium channel blockers like amlodipine
- diuretics (tablets that remove extra fluid from your body) like indapamide
There are lots of different medicines for high blood pressure. The medicine recommended for you depends on things like how high your blood pressure is, your age and your ethnicity.
You may have to try other medicines to lower your blood pressure if you get side effects. Many people need to take a combination of different tablets.
Will I need to stop metoprolol before surgery?
Tell your doctor you're taking metoprolol if you're going to have a general anaesthetic to put you to sleep, or you're having any kind of major operation.
Your doctor may advise you to stop taking metoprolol 24 hours before surgery. This is because metoprolol can lower your blood pressure too much when it's combined with some anaesthetics.
Will it affect my sex life?
Some people on metoprolol say their sex drive goes down or they cannot get an erection.
But this is not a common side effect and there is not enough evidence to say for sure that metoprolol causes it.
If you're having problems with your sex life, talk to your doctor.
Will it affect my contraception?
Metoprolol will not affect your contraception.
But some types of hormonal methods of contraception, such as the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.
Talk to your doctor if you're taking or using a combined hormonal contraceptive.
If metoprolol makes you sick (vomit) or have severe, watery diarrhoea or diarrhoea that lasts for more than 24 hours, your contraceptive pill may not protect you from pregnancy. Check the pill packet to find out what to do.
Find out more:
Can I drive or ride a bike?
Metoprolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose.
If this happens to you, do not drive a car, ride a bike, or use tools or machinery.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking metoprolol. GOV.UK has more information on the law on drugs and driving.
Can I drink alcohol while taking metoprolol?
You can drink alcohol while taking metoprolol but be careful as drinking alcohol can increase the effects of metoprolol so that it lowers your blood pressure too much. This can make you feel dizzy or light-headed.
During the first few days of taking metoprolol, or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.
It's best to stop drinking alcohol if you find metoprolol makes you feel dizzy.
Is there any food or drink I need to avoid?
Apart from stopping alcohol if you feel dizzy, you can eat and drink normally while taking metoprolol.
Can lifestyle changes help the health of my heart or high blood pressure??
You can boost the health of your heart by making some key lifestyle changes.
These will also help if you have high blood pressure.
Smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure. Try to avoid secondhand smoke.
Drinking too much alcohol raises blood pressure over time. Try to keep to the recommended guidelines of no more than 14 units of alcohol a week.
Regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day will help.
Aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products, and lean proteins. It's a good idea to limit the salt in your diet too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
When you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up.
To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
If you have high blood pressure, it's recommended that you have the flu vaccine every year and the pneumococcal vaccine, COVID-19 vaccine and RSV vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS.