Atenolol: Uses, Dosage, and Side Effects
US Brand Name
Lopressor, Toprol XL (Metoprolol)
Pharmacologic category
{Beta-blockers}. Other medications in this category include atenolol (Tenormin), {propranolol} (Inderal), {bisoprolol} (Zebeta), and {carvedilol} (Coreg).
Conditions treated and dosages
{Hypertension} (high blood pressure): 25-100 mg (immediate-release) twice daily or 25-200 mg (extended-release) once daily
{Angina} (chest pain): 50-200 mg (immediate-release) twice daily or 100-400 mg (extended-release) once daily
{Heart failure}: 12.5-25 mg (immediate-release) twice daily, titrated to a maximum of 200 mg daily, or 25-200 mg (extended-release) once daily
{Heart attack}: 25-50 mg (immediate-release) twice daily, starting 15 minutes after IV metoprolol administration
{Supraventricular tachycardia} (SVT): 5 mg IV every 5 minutes (up to 3 doses) or 25-100 mg (immediate-release) twice daily
{Ventricular tachycardia}: 100-200 mg (immediate-release) twice daily
{Atrial fibrillation} (rate control): 25-100 mg (immediate-release) twice daily or 25-200 mg (extended-release) once daily
{Atrial flutter} (rate control): 25-100 mg (immediate-release) twice daily or 25-200 mg (extended-release) once daily
Migraine prophylaxis (prevention): 50-200 mg (immediate-release) twice daily
Essential tremor: 50-100 mg (immediate-release) twice daily
Hyperthyroidism (adjunctive therapy): 25-100 mg (immediate-release) twice daily
Generalized Anxiety Disorder (off-label use): 25-100 mg (immediate-release) twice daily
Dosage Forms and strengths
Immediate-release tablet: 25 mg, 50 mg, 100 mg
Extended-release tablet (Toprol XL): 25 mg, 50 mg, 100 mg, 200 mg
Administration Instructions
Immediate-release tablets should be taken with or immediately following a meal.
Extended-release tablets should be taken with or without food, preferably in the morning.
Do not crush or chew extended-release tablets.
Adverse Reactions and Side Effects
Bradycardia (common): Slow heart rate
Hypotension (common): Low blood pressure
{Dizziness or lightheadedness} (common): Feeling lightheaded or unsteady
{Fatigue} (common)}: Tiredness or lack of energy
Depression (less common): Persistent feelings of sadness or hopelessness
{Shortness of breath} (less common): Difficulty breathing
Erectile dysfunction (less common): Difficulty maintaining an erection
Contraindications
Known hypersensitivity to metoprolol or its components
Sinus bradycardia
{Heart block} greater than first degree
Cardiogenic shock
Heart Failure Exacerbation
Hypotension: Systolic blood pressure <100 mmHg
Drug-to-Drug Interactions
{Clonidine} (Catapres): Increased risk of severe hypertension if stopped suddenly
{Digoxin} (Lanoxin): Increased risk of bradycardia
Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen [Advil, Motrin], naproxen [Aleve]): Reduced antihypertensive effect of metoprolol
CYP2D6 inhibitors (e.g., fluoxetine [Prozac], paroxetine [Paxil], bupropion [Wellbutrin]): Increased metoprolol concentrations and risk of adverse effects
Is it Safe in Pregnancy?
Metoprolol is considered a pregnancy category C medication, which means there is limited data on its safety during pregnancy. It should only be used during pregnancy if the potential benefits outweigh the potential risks. Consult a healthcare professional before using metoprolol during pregnancy.
Is it ok to Take if I’m Breastfeeding?
Metoprolol is excreted in breast milk in small amounts. The risk to the nursing infant is considered low, but the potential effects on the infant should be carefully monitored. Consult a healthcare professional before using metoprolol while breastfeeding.
Estimated Price
Estimated price of a 30-day supply without insurance and using GoodRx coupon: The cost of a 30-day supply of metoprolol can vary depending on the strength and dosage form. For a 30-day supply of 50 mg immediate-release tablets, the estimated cost is around $4-$9 using a GoodRx coupon. For a 30-day supply of 50 mg extended-release tablets (Toprol XL), the estimated cost is around $15-$30 using a GoodRx coupon. Prices may vary depending on the pharmacy and location.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.