Metoprolol side effects

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Side effects

The following adverse events were observed and have been reported in patients using Metoprolol.

Hypertension and Angina

Central Nervous System

Cardiovascular

Respiratory

Gastrointestinal

Hypersensitive Reactions

Miscellaneous

Myocardial Infarction

Central Nervous System

Cardiovascular

Respiratory

Gastrointestinal

Dermatologic

Potential Adverse Reactions

Central Nervous System

Cardiovascular

Hematologic

Hypersensitive Reactions




Hypertension and Angina

Most adverse effects have been mild and transient.

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Central Nervous System

Tiredness and dizziness have occurred in about 10 of 100 patients. Depression has been reported in about 5 of 100 patients. Mental confusion and short-term memory loss have been reported. Headache, nightmares, and insomnia have also been reported.

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Cardiovascular

Shortness of breath and bradycardia have occurred in approximately 3 of 100 patients. Cold extremities; arterial insufficiency, usually of the Raynaud type; palpitations; congestive heart failure; peripheral edema; and hypotension have been reported in about 1 of 100 patients. Gangrene in patients with pre-existing severe peripheral circulatory disorders has also been reported very rarely.

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Respiratory

Wheezing (bronchospasm) and dyspnea have been reported in about 1 of 100 patients. Rhinitis has also been reported.

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Gastrointestinal

Diarrhea has occurred in about 5 of 100 patients. Nausea, dry mouth, gastric pain, constipation, flatulence, and heartburn have been reported in about 1 of 100 patients. Vomiting was a common occurrence. Postmarketing experience reveals very rare reports of hepatitis, jaundice and non-specific hepatic dysfunction. Isolated cases of transaminase, alkaline phosphatase, and lactic dehydrogenase elevations have also been reported.

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Hypersensitive Reactions

Pruritus or rash have occurred in about 5 of 100 patients. Very rarely, photosensitivity and worsening of psoriasis has been reported.

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Miscellaneous

Peyronie’s disease has been reported in fewer than 1 of 100,000 patients. Musculoskeletal pain, blurred vision, and tinnitus have also been reported.

There have been rare reports of reversible alopecia, agranulocytosis, and dry eyes.

Discontinuation of the drug should be considered if any such reaction is not otherwise explicable. There have been very rare reports of weight gain, arthritis, and retroperitoneal fibrosis (relationship to Metoprolol has not been definitely established).

The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with Metoprolol.

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Myocardial Infarction

Central Nervous System

Tiredness has been reported in about 1 of 100 patients. Vertigo, sleep disturbances, hallucinations, headache, dizziness, visual disturbances, confusion, and reduced libido have also been reported, but a drug relationship is not clear.

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Cardiovascular

The following adverse reactions were reported: Hypotension, Bradycardia, Second or third degree heart block, First degree heart block, Heart failure

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Respiratory

Dyspnea of pulmonary origin has been reported in fewer than 1 of 100 patients.

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Gastrointestinal

Nausea and abdominal pain have been reported in fewer than 1 of 100 patients.

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Dermatologic

Rash and worsened psoriasis have been reported, but a drug relationship is not clear.

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Miscellaneous

Unstable diabetes and claudication have been reported, but a drug relationship is not clear.

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Potential Adverse Reactions

A variety of adverse reactions not listed above have been reported with other beta-adrenergic blocking agents and should be considered potential adverse reactions to Metoprolol.

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Central Nervous System

Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics.

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Cardiovascular

Intensification of AV block.

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Hematologic

Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura.

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Hypersensitive Reactions

Fever combined with aching and sore throat, laryngospasm, and respiratory distress.

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Adapted from the FDA Package Insert.