Drugs Q & A

Should I take Metoprolol in the Morning or at Night?

Metoprolol belongs to the class of medications called beta-blockers. Metoprolol is used to treat high blood pressure and prevent the symptoms of certain types of angina (chest pain). It is also used to help reduce the risk of death right after a heart attack. It works by reducing the demands put on the heart.

Metoprolol is also taken by people who have had a heart attack to reduce the risk of having another one. Metoprolol is often used in combination with other high blood pressure medications such as diuretics (water pills) when the use of one medication by itself is not enough to control blood pressure.

How should I use metoprolol?

The usual maintenance dose of metoprolol ranges from 100 mg daily to 200 mg daily, however the dose may be increased to 400 mg daily if necessary to obtain symptom control. Immediate-release tablets are taken in 2 divided doses while slow-release tablets are taken once a day.

The medication should be taken with or soon after a meal. Try to take the doses of metoprolol at the same time each day. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Should I take Metoprolol in the Morning or at Night?

Metoprolol slows down your heart rate and makes it easier for your heart to pump blood around your body. Your very first dose of metoprolol may make you feel dizzy, so take it at bedtime. If you don’t feel dizzy after that, you can take it in the morning.

Studies have shown that taking metoprolol at night is associated with a worsening of sleep characteristics, as a result its best to take the drug in the morning so as to avoid sleep disruptions.

Short-term consequences of sleep disruption include increased stress responsivity; somatic problems; reduced quality of life (QoL); emotional distress; mood disorders and other mental health problems; cognition, memory, and performance deficits; and behavior problems in otherwise healthy individuals.

What are the side effects of metoprolol?

Metoprolol oral tablet can cause certain side effects.

More common side effects

The more common side effects that can occur with metoprolol include:

•          tiredness

•          dizziness

•          diarrhea

•          constipation

•          breathing problems such as shortness of breath, cough, and wheezing

•          bradycardia (heart rate that’s slower than normal)

•          reduced interest in sex

•          rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

•          Low blood pressure (hypotension). Symptoms can include:

o          severe dizziness

o          lightheadedness

o          fainting

•          Cold hands and feet. Symptoms can include

o          hands and feet that are cold and may be painful

•          Very slow heart rate (severe bradycardia)

•          Extreme fatigue. Symptoms can include:

o          feeling more tired than usual

o          tiredness that gets progressively worse each day

•          Serious depression. Symptoms can include:

o          continuous feelings of sadness or anxiety

o          feelings of hopelessness or worthlessness

o          lack of interest in hobbies you once enjoyed

o          eating too much or too little

o          trouble concentrating

You can find useful information on: What To Do If You Accidentally Took Double Dose of Metoprolol?


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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