Metoprolol medicine side effects: What's your experience?

New to this site! My elderly Father, aged 89, is currently taking 50mg Metoprolol (sustained release) and Xarelto 20mg. Those are his only meds. His History: includes 6 bypasses in 2001, successful. Virtually nothing cardiac related until his severe aortic stenosis was found in early 2021. He also has A-flutter. Aortic valve replaced June 2021, goes home, complete heart block, back via helicopter and gets pacer 2 days after being discharged. My question: This guy has never fallen until September of 2021. He's now fallen 4x! He reports he's incredibly fatigued, leg weakness, and real lack of balance. We are all panicked b/c of the blood thinner, etc, etc. Says it feels as if his legs don't work, knees buckle, etc. Is this the metoprolol? He wore a Ziopatch last month and had some runs of SVT - all shorter than 20 seconds, highest HR was 160. Now cardiologist wants to raise Metoprolol to 75mg and my sister and I (both nurses) are uncomfortable with that. All my Dad wants to do is be balanced and stable enough to get into his awesome Swiss tractor and mow the field. He's normally a very active guy. He's had some dependent edema lately too - rectified with some PRN Lasix/Potassium. Otherwise healthy....mind as sharp as ever! Would love some thoughts! <3

I was prescribed 25 mgs. Of Metoprolol Succinate Er tablets for paroxysmal A-fib twice a day, then raised to two at night and one in the a.m. even though all my readings were good. I experienced extreme fatigue and brain fog to the point of having to give up volunteer work with the AARP Tax Program. After talking to my PCP, she lowered the dosage back to the two tablets. Six months later we lowered it by a half tablet and I lowered it by another one half a few months after that. Ergo, I now take one-half in the a.m. and one-half in the p.m. the brain fog lifted and the fatigue improved greatly. I am 82 yrs. old and weigh about 140. I think doctors often fail to consider a person’s size and age when prescribing. Good luck to you. Consider looking for a doctor who will listen to you.

Friend: I have been taking Metoprolol for 20+ years with none of the side effects you described.... at least that I allow my mind to focus upon. For what it is worth; give thanks in advance for eventual good outcome, be at peace, resolve to live as normal as you possibly can. Make sure you have a highly trained cardiologist and describe your feelings in a specific and organized way.
Believe your test results and measurements. More likely your symptoms are a function of your condition and not necessarily the med. Press on. There are alot of people on your side!

Thank you so Much for your respond, and i Will see another spesialist. Wish you all the best!

Thank you so much for your respond!

Hi @mzock01 and welcome to Mayo Clinic Connect. You'll see I moved your post to a discussion about Metoprolol so you can meet other members who may be having similar issues as your father.
I can tell you from personal experience that I have had a higher level of fatigue since they increased my dose, but I am in my late 30's.
Did his doctor offer any other options for a different medication?

Hello and thank you for moving the post. 🙂 I actually just spoke to his cardiologist's office today and his RN was going to check to see if we can change something. We are frustrated, because we have been talking to the doctor's about his lack of balance, unsteadiness for months and months and it just seems as if they never point to the Metoprolol. His only other med is Xarelto. They keep mentioning his age, which is annoying b/c he's not your typical 89 year old. 🙂 He keeps saying his legs feel weak - do you have that side effect too?

@mzock01 I haven't had leg weakness per say. I would classify mine as overall weakness and I just attributed that to the general fatigue that it causes, but that is interesting and I may keep track of that to see if it changes over time.

I’ve had multiple issues with it. The first was my bp shot up to over 200/100 with the first pill I swallowed. Multiple trips to the pharmacist, the manufacturer and my doctor left everyone puzzled. Finally the manufacturer said I’m one of the rare cases where I’m highly allergic to it. Get this now, not the medicine but the coating that holds the pill together. We tried multiple manufacturer and got worse reactions. The medicine does help my palpitations but I cannot use more than 25mgs daily, if I use more, my bp skyrockets. So don’t give up on the medicine, talk to your pharmacist and see what they say.

After all the problems I had with one 50mg of Metoprolol in the morning, I was glad I went directly to my pharmacist. I explained to my doctor that I was allergic to it and my bp skyrocketed to over 200/100 but he kept insisting I wasn’t. He even wanted me to take 200mgs daily. As with my other comment, I highly recommend anyone having bad side effects like I did, to go to your pharmacist instead of your doctor and ask them questions before heading to the personal doctor like I was doing and still do. It’s only my suggestion but it saved my life if I had taken the 200mgs instead of the first 50mgs. That much Metoprolol probably would have caused my heart to go into tachycardia then A-fib and then the fatal heart attack. My cardiologist told me to increase my dosage as needed, from 25, to 50, to 75, to 100 max. But that high had pushed my bp up, major fatigue and watery blisters and other issues. Where medications are concerned, your pharmacist is your best friend.