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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for side effects of Metoprolol

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 7127 Questions

Posted on Fri, 26 Aug 2016 in Hypertension and Heart Disease
Question: I started metoprolol - ER 25MG 3 weeks ago as a replacement for lisinopril. I have progressively worsening side effects with labored breathing especially when lying down. I can't get an appointment with my doctor until Monday at least but need to stop taking this. Would I be safe to miss 2 doses ?
Answered by Dr. Ilir Sharka 26 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that metoprolol is a betablocker, while lisinopril is an ACE inhibitor.

Unlike lisinopril, metoprolol can cause decrease in the hear rate, besides a slight decrease in blood pressure.

Stopping taking metoprolol cold turkey could lead to withdrawal adverse effects such as rebound tachycardia.

For this reason, I would recommend you to gradually reduce the dose to half of a tablet for a couple of days and then stop it. This is to avoid possible rebound tachycardia.

Regarding your blood pressure, if your blood pressure is above 140/80 mmHg, I would recommend starting a calcium channel blocker (amlodipine, nicardipine, etc.) or an ARB (losartan, valsartan, etc.) to have a better control of your blood pressure.

Some lifestyle modifications would also be helpful to manage better your blood pressure naturally:

- avoid salt and caffeine intake
- perform a lot of physical activity (walking, aerobics, etc.)
- try to lose some pounds if you are overweight.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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