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Metoprolol Succinate ER

Metoprolol succinate ER (extended-release) is a beta-adrenergic blocker primarily used to treat conditions such as hypertension (high blood pressure), heart failure, and angina (chest pain). It works by blocking the effects of adrenaline on beta receptors, which helps to lower heart rate, reduce blood pressure, and improve heart function.

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Frequently Asked Questions

How quickly does metoprolol succinate ER work?
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Patients may begin to notice effects on blood pressure within a few hours, with optimal control typically established after several days.

Can I take metoprolol succinate ER with food?
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Yes, it can be taken with or without food; however, consistency in how you take it is advisable.

What should I do if I miss a dose?
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If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up doses.

Are there any dietary restrictions while using metoprolol succinate ER?
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There are no specific dietary restrictions, but a balanced diet is advisable to help manage overall health.

Is metoprolol succinate ER safe during pregnancy or breastfeeding?
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Consult your healthcare provider if you are pregnant or breastfeeding to discuss the risks and benefits of using metoprolol.

Comprehensive Drug Guide

How Does Metoprolol Succinate ER Work?

Metoprolol selectively blocks beta-1 adrenergic receptors in the heart, leading to a decrease in heart rate and contractility. This action reduces cardiac output and lowers blood pressure, which is beneficial for patients with hypertension, angina, and heart failure.



Common Dosages

  • Extended-Release Tablets: 25 mg, 50 mg, 100 mg, and 200 mg.

Typical Dosing

  • The usual starting dose for hypertension is 25 mg to 100 mg once daily, depending on the severity of the condition and individual response. The dose may be adjusted based on clinical response, with a maximum dose of 400 mg per day for heart failure.


Typical Dosing

FDA Approved Indications

  • Hypertension: to lower blood pressure.
  • Heart Failure: as part of a comprehensive heart failure management strategy.
  • Angina: to reduce the frequency of angina attacks.


Who Shouldn't Take Metoprolol Succinate ER?

  • Known hypersensitivity to metoprolol or any component of the formulation.
  • Severe bradycardia (slow heart rate).
  • Advanced atrioventricular block (unless a pacemaker is present).
  • Decompensated heart failure or cardiogenic shock.


Advice From The Pharmacist

  • Take metoprolol exactly as prescribed, and do not stop taking it suddenly without consulting your healthcare provider, as this may lead to worsening symptoms.
  • Monitor your blood pressure and heart rate regularly while on this medication.
  • Avoid alcohol and certain over-the-counter medications that may affect blood pressure.


Side Effects of Metoprolol Succinate ER

Common Side Effects

  • Fatigue
  • Dizziness
  • Depression
  • Cold extremities
  • Slow heart rate


Uncommon/Severe Side Effects

  • Severe hypotension (low blood pressure)
  • Heart block
  • Respiratory issues (in asthmatic patients)


Risks and Warnings of Metoprolol Succinate ER

  • Bradycardia: Monitor heart rate; dosage adjustments may be necessary if bradycardia occurs.
  • Withdrawal Symptoms: Abrupt discontinuation can lead to rebound hypertension or angina; tapering is recommended.
  • Respiratory Effects: Use with caution in patients with asthma or other respiratory conditions.


Interactions with Metoprolol Succinate ER

Common Drug Interactions

  • CNS Depressants: Use caution when combining with other CNS depressants, as they may increase sedation.
  • Other Antihypertensives: Monitor blood pressure closely if used in combination with other antihypertensive agents.


Alternatives to Metoprolol Succinate ER

  • Other Beta-Blockers: Such as atenolol or carvedilol for similar indications.
  • Calcium Channel Blockers: Such as amlodipine or diltiazem for hypertension and angina management.