How to use
Metoprolol is usually taken in tablet form, once a day at the same time with a glass of water. Metoprolol should be taken with food. You may cut Metoprolol tablets in half, but only if instructed to do so by your physician. Avoid crushing the tablet, as this may cause too much medication to be released into your body at once.

Overdose
If you suspect an overdose, seek immediate medical attention and contact your local poison control center. Symptoms of an overdose may include:

• Slow or uneven heartbeats
• Shortness of breath
• Bluish-colored fingernails
• Dizziness, weakness or fainting

Missed dose
If you miss a dose, take the missed pill as soon as you remember it. If the next dose is less than 4 hours away, skip the missed dose and return to your normal schedule.

Notes
Metoprolol is only effective as a hypertension treatment if taken alongside a healthy diet and regular exercise regimen. Please consult with your physician before undertaking any strenuous activity, as it may aggravate your cardiac condition.
Do not share this medication with others, as they may have a problem that is not effectively treated by this drug.

Storage

Store this medication at room temperature between 59 and 86 degrees F (15-30 degrees C), away from light and moisture. KEEP THIS AND ALL MEDICATIONS OUT OF REACH OF CHILDREN.

Important note
The above information is intended to supplement, not substitute for, the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

* Illustrations are for graphic purposes only and the ordered medication may differ in appearance.

Precautions

You should not use this medication if you are allergic to Metoprolol or if you have a serious heart problem such as heart block, sick sinus syndrome or slow heart rate.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use Metoprolol:

• Pheochromocytoma
• Problems with circulation (such as Raynaud's syndrome)
• Congestive heart failure
• Asthma, bronchitis, emphysema
• Diabetes
• Low blood pressure
• Depression
• Liver or kidney disease
• A thyroid disorder
• Myasthenia gravis

Metoprolol is classed by the FDA as pregnancy category C. It is not known whether Metoprolol is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Metoprolol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Drug interactions

Inform your doctor of any medication that you take regularly, especially the following:

• Clonidine (Catapres)
• Ritonavir (Norvir)
• Anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox)
• Digoxin (digitalis, Lanoxin)
• Medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others
• An MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam)
• A heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem)
• Cold medicines, stimulant medicines, or diet pills
• Terbinafine (Lamisil)
• Medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair)
• A diuretic (water pill) such as amiloride (Midamor, Moduretic), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex) and others
• A diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage)

This list is not complete and other drugs may interact with Metoprolol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction:

• Hives
• Difficulty breathing
• Swelling of the face, lips, tongue, or throat

Call your doctor at once if you have any of these serious side effects:

• Slow or uneven heartbeats
• Feeling light-headed, fainting
• Feeling short of breath, even with mild exertion
• Swelling of your ankles or feet
• Nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
• Depression
• Cold feeling in your hands and feet.

Less serious Metoprolol side effects may include:

• Vomiting
• Decreased sex drive, impotence, or difficulty having an orgasm
• Sleep problems (insomnia)
• Tired feeling
• Anxiety, nervousness

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effects.