Metoprolol, known by the trade names Lopressor and Toprol in the U.S. and Apo-Metoprolol in Canada, is a commonly prescribed antihypertensive mediation in the treatment of high blood pressure, the early stages of myocardial infarction (heart attack), and angina. The PDR Nurse's Drug Handbook most notably states the highest risk for side effects with metoprolol medications are cardiovascular in nature. Numerous side effects also occur between metoprolol and other medications. Patients should read pharmacy-provided package inserts and discuss any concerns with their pharmacists or doctors.
Cardiovascular Side Effects
Patients taking metoprolol are advised to take their blood pressure and heart rate every morning before rising. Health care providers will teach a patient the safe-range readings for the systolic, diastolic and heart rate in order to safety take the medication. A slow heart rate (bradycardia) and low blood pressure (hypotension) are the most common side effects of this medication. Heart failure and AV block are the most serious side effects and any chest pain or the feeling that the heart is beating abnormally should be reported to a health care provider immediately; the patient should seek urgent medical care.
Rebound hypertension is a side effect of antihypertensive medication that occurs when patients stop taking their medications for personal reasons. Rebound hypertension is a dangerous condition in which the blood pressure becomes very high and unresponsive to the patient's normal dose of medication. This condition requires hospitalization and most often IV drug medication to correct. If a patient wishes to discontinue the metoprolol regimen, it is important that he discuss this with his physician to avoid dangerous and life-threatening side effects.
Central Nervous System Side Effects
Fatigue and dizziness are the most common nervous side effects with metoprolol. Until a patient knows how her body will react to metoprolol, she should take care to rise slowly from bed or a sitting position to avoid dizziness or a syncopal episode (fainting). Patients experiencing fatigue and lethargy may have to schedule rest periods and understand that the medication is attempting to "calm the body down" and reduce stress on the heart and arteries.
Patients new to metoprolol therapy should not drive or perform complex mental tasks until the effects of the drug on their bodies and levels of functioning are known.
Respiratory Side Effects
Dyspnea, or shortness of breath, is the most common respiratory side effect of metoprolol. If a patient feels suddenly unable catch his breath, he should remain calm as any panic will only make breathing more challenging. If pain accompanies his attempts to inhale or exhale, the patient should seek immediate medical attention.
Integumentary Side Effects
Some patients have reported a rash while on metoprolol. This may be managed with a corticosteroid over-the-counter medication if the rash is mild. Painful and serious cases of rash should be reported to a physician for proper treatment.
References
- "PDR Nurse's Drug Handbook 2010;" Thomson Reuters and Alexander Ivy; 2009
- "Mosby's 2010 Nursing Drug Reference;" Linda Skidmore-Roth; 2009
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