Metoprolol medicine side effects: What's your experience?

I was prescribed Metoprolol (25 mg morning and evening) by an arrhythmia specialist at the Cleveland Clinic for AFIB and tachycardia.

Thing is, my tachycardia (which lasted non-stop for three weeks, confirmed by a week of Biotel Event Monitor) had stopped weeks before my appointment.

I took the Metoprolol once shortly before I went to the gym (my cardiologist said I could keep going, as my tachycardia was mostly sinus tachycardia).

It was a nightmare! I was gasping for breath when I tried to use the stair-stepper even at the least resistance (quite different from my usual HIIT exercise), even when I was merely standing. I was dizzy and faint, my normal pulse having dropped to 50, and my ordinary blood pressure (~ 110/65) dropping to 96/47.

I never took it again.

My local cardiologist said I could take it PRN (i.e., if my tachycardia returned), and if necessary at half the dose. The Cleveland Clinic MD said that was OK if my local cardio said it was OK.

So far, I have never resumed it at any dose. My pulse remains normal, only racing when I am at my most strenuous intensity on gym equipment during HIIT, dropping again afterwards the way it always used to. I have a horror of Metoprolol!

OTOH I haven't thrown the bottle out, in case that never-explained tachycardia (100-135 bpm night and day) returns.

@katydid77 I am 83, weigh 140, and my Toprol was recently increased from 25mg to 25 twice a day due to a rise in blood pressure. My fatigue, brain fog, tingling of face and extremities increased. Also now having balance issues. I’m suspicious that Toprol is the culprit.

I am so sorry you are experiencing these things. Metoprolol is a good medicine for helping to control BP by slowing the heart rate. However, every time I visited with my Cardiologist he would tell me my blood work was great, my weight was ideal and I was doing well over all. Then he would increase the Metoprolol. This happened four visits until I was taking two 25mg. tablets at night and one in the morning. I finally got a visit with primary care physician who really listened to my complaints. I told him I was functioning but had to force myself to do so. I was so tired I dreaded each day. He lowered my dosage by one 25mg tablet. Later, another primary care Dr. lowered it again. After 6 more months, I lowered it yet again. I was then prescribed a low dose of Hydrochlorothiazide (diuretic) and my BP leveled out. I was still experiencing periodic a-fib. After an ablation, I stopped the Metoprolol altogether. Good luck with finding a Doctor who has the time and the interest to listen to you the patient. Protocol should be considered a guideline not what works for every patient.

@realitytest I hated Metoprolol because it is known to interrupt sleep and to elevate blood sugar.
I took 25 mg. morning and evening to slow my heart rate- not for high BP.
I have switched to slow release Verapamil, a calcium channel blocker taken once a day in the am. There has been a noticeable improvement in sleep. Also, more energy. No more afternoon naps!

I have been taking metoprolol 25, twice a day for 2 years. Prescribed for tachycardia, blood pressure was no problem. The first 6 months were difficult, with much dizziness. Once I started eating a meal when taking them it seemed to even out. However the feeling 'tamped down' sort of like having a blanket thrown over my emotions. Also the lack of energy has been hard to get used to with the feeling of leaden legs. I still walk a mile to mile and a half a day, but not at the pace I would like. The cardiologist said my next option is flecacidde which I have said no too after reading it's side effects. However during this 2 year period I have only had one bad 45 minute episode. So I guess it does its job for the heart.

I was prescribed Metoporal last August when I was in AFib after 2 surgeries. I was taking it 2 times a day with a 50 mg dose. It made me very tired and I felt like I was in a fog all the time. The cardiologist reduced the dose to 50 once a day. This worked much better up until this past August when when BP dropped to 62/42. I fainted and ended up in the hospital for days and was taken off the Metoporal. I was on it for a fast heart beat not BP. I was released and given a 2 week holter monitor to wear. Had 5 episodes during the 2 weeks both with symptoms and without. Doctor put me on Flecainide and Eliquis. Had me on 50 mg twice a day along with Eliquis. Day 4 they had me increase to 75 mg twice a day. All was good if I didn't mind needing a daily nap and having daily palpitations. I DON'T nap. Never have. Palpitations had basically stopped until the increase dose was given. I would have a major drop in BP about an hour after taking it and almost fainted 3 times. Cardiologist agreed to reduce the dose back down to the 50 mg twice a day. This finally happened a week ago and I am feeling better. Still makes me tired, but at least I haven't had any palpitations or fainting. I started taking the Flecainide on Sept. 5th so not too long ago. I am scheduled for an ablation on November 25th. As my Primary Care said to me when I was balking at taking Flecainide, the Cardiologist wouldn't have prescribed it if he didn't feel the benefits outweighed the side effects. As to which medication is best for you, you'll have to discuss with your doctor and his reason for prescribing it. Good luck.

After my very first fib episode I was prescribed 25mg of metoprolol, which made me feel somewhat tired, but nothing I couldn't push through. After a few more Afib episodes over 6-8 months (during which I would take an additional 25mg of metoprolol in an attempt to slow things down), the dose was increased to 50mg, then to 75mg, which made me feel fatigued and zombie-like much of the time..., plus my resting HR often dropped below 50bpm. And just to make my situation more complex, my Afib condition occurred while I was also experiencing lingering covid symptoms (months). The best way I could describe metoprolol side effects is that it felt like I was going through life fighting a headwind. Not pleasant.

There's a bit more my metoprolol story...I had a PF ablation, was prescribed a CPAP device for sleep apnea, and reduced my metoprolol to 25mg a day, which I tolerate pretty well. Since then no Afib episodes (touch wood), and feeling less fatigued. Doc says that if my resting HR dips below 50 a lot, I should stop the metoprolol altogether.

I never figured out how much of my unwell-ness was metoprolol side effects, long covid, sleep apnea, or Afib...or something else?

@nevets Totally agree - often (maybe always?) its difficult to determine which of several issues is the cause of how we feel!

My EP prescribes metoprolol only when I have symptomatic palpitations , usually PACS. I had an adulation in January and have infrequent AFIB , but it’s still there. My EP isn’t concerned about it at all. I am wondering why some of you take metoprolol daily.

@the I was told by my doctor that it both controls high blood pressure and helps regulate heart rhythm.
It can be prescribed for either problem by itself or to help control both.