- Class
- Beta blockers
- Body system
- Cardiovascular
- Brand names
- Lopressor, Toprol-XL
- Antidote or reversal
- Glucagon is used for beta-blocker overdose.
What is Metoprolol used for?
- Hypertension
- Angina
- Heart failure with reduced ejection fraction (metoprolol succinate)
- After a myocardial infarction
- Rate control in atrial fibrillation
Metoprolol tartrate is immediate release; metoprolol succinate is extended release. They are not interchangeable mg for mg.
How Metoprolol works
Cardioselective beta-1 blocker: lowers heart rate, contractility and blood pressure, and reduces the heart's oxygen demand.
Common side effects
- Fatigue
- Dizziness
- Bradycardia
- Hypotension
- Cold hands and feet
Report right away
- Heart rate below 50 to 60 or new heart block
- Shortness of breath, weight gain or edema (worsening heart failure)
- Wheezing
Nursing considerations for Metoprolol
- Check the apical pulse for a full minute and the blood pressure before each dose; hold and notify the prescriber when they are below the ordered parameters (often HR under 60 or systolic BP under 90).
- Monitor diabetic patients closely: beta blockers can mask the tachycardia and tremor of hypoglycemia.
- Do not crush metoprolol succinate extended-release tablets (they may be split along the score).
Patient teaching
- Do not stop the drug suddenly: it can cause rebound tachycardia, angina or a heart attack. The dose is tapered.
- Rise slowly to avoid dizziness.
- Take metoprolol tartrate with or right after a meal, at the same time each day.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Beta blockers practice questions
NCLEX-style questions on the class Metoprolol belongs to.
3 questions. Choose an answer to see the rationale.
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A patient's apical pulse is 52 before scheduled metoprolol. What should the nurse do first?
Show answer
Answer C: Hold the dose and notify the prescriber per the ordered parameters A heart rate below the ordered parameter (often 60) is a reason to hold a beta blocker and notify the prescriber. Never change a dose on your own.
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Which patient condition makes propranolol the most concerning choice?
Show answer
Answer B: Asthma Propranolol is nonselective and blocks beta-2 receptors in the lungs, which can cause bronchospasm in a patient with asthma.
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A patient with type 1 diabetes starts a beta blocker. Which teaching point is most important?
Show answer
Answer D: Tremor and fast heartbeat may not appear when blood sugar is low Beta blockade masks the adrenergic warning signs of hypoglycemia, such as tachycardia and tremor. Sweating usually persists.
Frequently asked questions
What is Metoprolol used for?
Hypertension; Angina; Heart failure with reduced ejection fraction (metoprolol succinate); After a myocardial infarction.
What drug class is Metoprolol?
Metoprolol belongs to the class beta blockers. Cardioselective beta-1 blocker: lowers heart rate, contractility and blood pressure, and reduces the heart's oxygen demand.
What are the nursing considerations for Metoprolol?
Check the apical pulse for a full minute and the blood pressure before each dose; hold and notify the prescriber when they are below the ordered parameters (often HR under 60 or systolic BP under 90). Monitor diabetic patients closely: beta blockers can mask the tachycardia and tremor of hypoglycemia.
What should patients report while taking Metoprolol?
heart rate below 50 to 60 or new heart block; shortness of breath, weight gain or edema (worsening heart failure); wheezing.
What is the antidote for Metoprolol?
Glucagon is used for beta-blocker overdose.