One important point: there isn’t a scientifically fixed list of exactly “the 10 most common” side effects for every person taking metoprolol. Side effects vary depending on whether you’re taking metoprolol tartrate or metoprolol succinate, the dose, and the condition being treated. Here is a practical guide to the effects people may experience.
1. Dizziness or lightheadedness
This is one of the better-recognized side effects. Because metoprolol lowers heart rate and blood pressure, you may feel dizzy, particularly when standing up quickly or during the first days after starting or increasing the dose.
What may help: Rise slowly from sitting or lying down, stay adequately hydrated unless your doctor has restricted your fluids, and sit or lie down if you become lightheaded.
If dizziness is severe, persistent, or accompanied by fainting, contact your healthcare professional.
2. Tiredness or fatigue
Feeling unusually tired, weak, or lacking energy can occur because metoprolol reduces the heart’s rate and workload. Clinical information for metoprolol tartrate reports tiredness relatively frequently.
For some people, this improves as the body adjusts to the medication.
Important: Don’t automatically assume severe fatigue is harmless. If it is interfering with normal activities or is getting progressively worse, tell your prescriber.
3. Diarrhea
Diarrhea is listed among the possible side effects of metoprolol.
Mild diarrhea may settle with time. However, persistent diarrhea can cause dehydration, which may worsen dizziness or low blood pressure.
Contact your healthcare professional if it is severe, prolonged, or accompanied by significant weakness or dehydration.
4. Dry mouth
Some people taking metoprolol experience a dry mouth.
Drinking water regularly, using sugar-free gum or lozenges, and maintaining good oral hygiene may make it more comfortable.
If dry mouth persists, discuss it with your pharmacist or doctor, particularly if you’re developing mouth sores or dental problems.
5. Skin rash or itching
A rash or itching can occur with metoprolol.
A mild rash should still be reported if it persists or worsens because it can sometimes be difficult to distinguish an ordinary medication reaction from an allergic reaction.
Emergency warning: Difficulty breathing, facial/throat swelling, or a rapidly developing severe reaction requires emergency medical attention.
6. Slow heartbeat
Metoprolol is deliberately designed to slow the heart rate, so a lower pulse can be an expected effect. However, an excessively slow heart rate can become a problem. Bradycardia has been reported with metoprolol.
Warning symptoms include:
- Severe dizziness
- Weakness
- Feeling faint
- Fainting
- Unusual shortness of breath
If these occur, contact a healthcare professional promptly.
7. Low blood pressure
Because metoprolol lowers blood pressure, some people can develop hypotension, particularly after starting treatment or changing the dose.
Symptoms can include dizziness, weakness, blurred vision, or feeling faint.
Your doctor may monitor your blood pressure and pulse and adjust the dose if necessary.
8. Cold hands and feet
Beta-blockers can sometimes reduce circulation to the extremities, resulting in unusually cold hands or feet. The FDA prescribing information for metoprolol tartrate lists cold extremities among reported cardiovascular effects.
Keeping your hands and feet warm may help. Persistent or painful changes in circulation should be discussed with your doctor.
9. Sleep disturbances or vivid dreams
Sleep-related effects—including insomnia and nightmares—have been reported with metoprolol.
If sleep problems begin after starting metoprolol, don’t change the timing of your dose on your own. Ask your prescriber whether adjusting the schedule would be appropriate for your particular formulation.
10. Depression or mood changes
Depression has been reported in people taking metoprolol.
A change in mood doesn’t necessarily mean metoprolol is the cause, but new or worsening depression should be discussed with your healthcare professional
