Like all medicines, metoprolol can cause side effects, but many people have no side effects, or only minor ones.
Side effects often improve as your body gets used to the medicine.
Common side effects of metoprolol
These common side effects of metoprolol happen in more than 1 in 100 people. There are things you can do to help cope with them:
Headaches
Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Take paracetamol or ask your pharmacist to recommend a painkiller.
Talk to your doctor if the headaches are severe or do not go away.
Feeling tired, dizzy or weak
If metoprolol makes you feel dizzy or weak, stop what you're doing, and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you're feeling tired or dizzy. Do not drink alcohol, as it may make your symptoms worse.
Cold hands or feet
Put your hands or feet under warm running water, massage them, and wiggle your fingers and toes. Try not to smoke or have drinks with caffeine in – these can make your blood vessels narrower and restrict your blood flow. Smoking also makes your skin colder. Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.
Feeling sick (nausea)
Stick to simple meals and do not eat rich or spicy food. It might help to take your tablets after you've eaten.
Stomach pain
Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.
If you're in a lot of pain, speak to your pharmacist or doctor.
Being sick (vomiting)
Take small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
If you take the combined pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Diarrhoea
Drink plenty of water or squash to prevent dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
If you take the combined pill and you have severe, watery diarrhoea, or diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Talk to your doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
It's rare, but some people have serious side effects when taking metoprolol.
Call a doctor or call 111 now if:
- you are short of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
- you have a fast heart rate, trembling and feel agitated – these are signs of too much thyroid hormone in the blood
- you get unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)
If you get chest pain and you've already been diagnosed with angina, follow the instructions you've been given for treating your angina:
- Stop what you're doing and rest.
- Use any medicine you've been prescribed – this is usually glyceryl trinitrate (GTN).
- Take another dose after 5 minutes if the first dose does not help.
- If you still have symptoms 5 minutes after taking the 2nd dose, call 999 for an ambulance.
Immediate action required: Call 999 now if:
- you get chest pain that does not stop after a few minutes, is a new pain, or your angina pain is worse – chest pain is a possible sign of a heart attack and needs to be checked out as soon as possible
- you are short of breath, wheezing and your chest feels tight – these could be signs of lung problems
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Serious allergic reaction
In rare cases, metoprolol may cause a serious allergic reaction (anaphylaxis)
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Other side effects
These are not all the side effects of metoprolol. For a full list, see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.