These effects are not experienced by everyone and may improve over time.
If sleep disruption becomes severe or affects daily functioning, speak with your healthcare provider.
8. Depression or Mood Changes
Changes in mood have sometimes been reported by people taking beta blockers.
Possible symptoms may include:
low mood
loss of interest
unusual sadness
changes in motivation
However, depression is common and can have many causes, so it should not automatically be attributed to metoprolol.
Persistent or significant mood changes should be discussed with a healthcare professional.
9. Sexual Side Effects
Some people may experience sexual difficulties while taking metoprolol.
These can include:
reduced sexual desire
difficulty getting or maintaining an erection
changes in sexual performance
Heart disease, high blood pressure, stress, diabetes, and other medications can also contribute to these symptoms.
If sexual side effects are affecting quality of life, a doctor may be able to adjust treatment safely.
10. Changes in Blood Sugar Warning Signs
Metoprolol can make certain symptoms of low blood sugar less noticeable, especially a rapid heartbeat.
This can be particularly important for people with diabetes who use insulin or other glucose-lowering medications.
Other signs of low blood sugar, such as sweating, weakness, confusion, or shakiness, may still occur.
People with diabetes should follow their usual blood glucose monitoring plan and discuss any concerns with their healthcare team.
A Rare but Serious Concern: Worsening Heart Failure Symptoms
Metoprolol is often used to treat certain forms of heart failure, but symptoms can occasionally worsen, particularly during dose changes or if the medicine is not tolerated.
Contact a healthcare professional promptly if you develop:
rapidly increasing swelling
sudden weight gain
worsening shortness of breath
difficulty breathing while lying down
unusual weakness
These symptoms can have several causes and need proper assessment.
Do Not Stop Metoprolol Suddenly
One of the most important things to know about metoprolol is that it should generally not be stopped suddenly without medical guidance.
Abruptly stopping a beta blocker can cause the heart rate and blood pressure to rise and may worsen chest pain. In people with coronary heart disease, sudden withdrawal can potentially lead to serious heart complications.
If treatment needs to be discontinued, a healthcare professional may recommend gradually reducing the dose.
Which Side Effects Need Urgent Attention?
Seek urgent medical care if you develop symptoms such as:
severe difficulty breathing
fainting or loss of consciousness
severe or worsening chest pain
signs of a serious allergic reaction, such as swelling of the face, lips, tongue, or throat
severe weakness with a very slow heartbeat
rapidly worsening heart failure symptoms
What Should You Do If You Notice Side Effects?
Do not change the dose or stop metoprolol on your own.
Instead, note:
what symptoms you are experiencing
when they started
whether they occur after taking the medicine
your blood pressure or pulse, if you normally monitor them
any other medications or supplements you use
Your healthcare provider can then determine whether the symptoms are likely related to metoprolol, another medication, or an underlying health condition.
The Bottom Line
Metoprolol is widely used and can be very effective for several cardiovascular conditions. Many people take it without serious problems, but side effects such as fatigue, dizziness, slow heart rate, low blood pressure, cold hands and feet, and sleep changes can occur.
The most important rule is not to stop metoprolol suddenly without medical advice. If you develop severe symptoms, breathing difficulties, fainting, significant chest pain, or rapidly worsening heart problems, seek medical care promptly.
