What Pharmacists Say About When to Take Metoprolol (Plus 4 Other Tips)

There’s a good chance you’ve heard of metoprolol before. It’s one of the most common medications prescribed in the U.S., and it’s available in two different versions.

Metoprolol tartrate (Lopressor) is the immediate-release (IR) version, usually taken 2 to 4 times a day. Metoprolol succinate (Toprol XL) is the extended-release (ER) form. It’s designed to last longer, so it’s usually taken once a day.

If you’ve been prescribed metoprolol, your healthcare team likely gave you instructions to follow. And your pharmacist may have given you tips for taking it, too. But it never hurts to review the basics. Below, you’ll find five pharmacist-backed tips to help you get the best results from taking metoprolol.

Good to know: These tips can vary slightly depending on whether you’re taking metoprolol tartrate (metoprolol IR) or metoprolol succinate (metoprolol ER). Be sure to check your medication bottle so you know which type of metoprolol you have. It’s also a good idea to double check with your healthcare team to see if they have any specific instructions for how they’d like you to take metoprolol.

1. You can take metoprolol in the morning or at night, as long as you’re consistent

You can take metoprolol morning or night. In fact, it’s fine to take it any time of the day, as long as you take it around the same time each day.

Promotion disclosure

Metoprolol

Avg retail price

$9.00(Save Free%)

GoodRx discount

$9.00

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

Keep in mind that metoprolol IR is often taken more than once a day. For example, your healthcare professional may prescribe a twice-daily dosage. So, you’d likely take one at breakfast and one at dinner.

Metoprolol ER is usually taken once a day. So you can choose to take it with breakfast or with dinner. Just stay consistent with that schedule.

It’s a good idea to take your very first dose of metoprolol with your evening meal, in case it makes you dizzy. If it doesn’t make you dizzy, you can start taking your dose at your preferred time of day.

2. It’s recommended to take metoprolol with food

Both metoprolol IR and metoprolol ER should be taken with food. Manufacturers recommend taking them with, or just after, a meal. Taking your metoprolol doses with food may help lessen stomach-related side effects. Plus, it may help you remember to take your dose(s) consistently.

There is a special formulation of metoprolol ER — called Kapspargo Sprinkle — that has unique instructions. These sprinkle capsules can be swallowed whole. But they can also be opened, and the contents can be sprinkled over a small amount of soft food, such as applesauce or pudding. However, you should still take Kapspargo with or right after a meal — even if you’re sprinkling it over a soft food.

Kapspargo can be helpful for people who have trouble swallowing whole pills. If you open the capsule and sprinkle the contents over soft food, it should be consumed within 1 hour. Don’t store the food/medication mixture for later use.

3. You may need to separate metoprolol from certain medications

You can typically take metoprolol at the same time you take your other medications. One exception to this is if you need to take other medication on an empty stomach. In this case, you should take your other medication 1 hour before (or 2 hours after) eating. As discussed above, you should take metoprolol with or right after a meal.

Another exception would be if you take another medication that needs to be separated from all other medications. One example of this is levothyroxine (Levoxyl, Synthroid, Tirosint), a thyroid medication. It’s recommended to take levothyroxine at least 4 hours before other medications. This would include separating it from metoprolol.

You usually don’t need to separate metoprolol from other blood pressure medications, such as losartan (Cozaar). But taking more than one blood pressure medication can raise your risk for hypotension (blood pressure that’s too low). Some people take blood pressure medications at opposite times of the day to help prevent this side effect.

Keep in mind, there are some medications that you may need to avoid completely with metoprolol. For example, the antidepressant fluoxetine (Prozac), can cause too much metoprolol to stay in your body. It’s recommended to avoid this combination when possible.

Make sure your prescriber and pharmacist have an up-to-date list of your other medications and supplements. This can help them prevent or manage interactions.

4. Missing too many doses of metoprolol can cause potentially serious symptoms

Remembering to take your medication on time can be tricky, especially if you take more than one. Missing one or two doses of metoprolol is unlikely to cause serious harm. If you realize you forgot to take a dose, skip the missed one and take your next dose as usual. Never double up on doses to make up for a missed one.

Missing multiple doses can be more serious. You may experience withdrawal symptoms if you miss several doses in a row — or abruptly stop taking metoprolol for other reasons. Chest pain is possible, and in rare cases, a heart attack could even occur.

Discuss with your healthcare team if you’re having trouble remembering your doses. They may suggest a different heart medication that’s less likely to cause withdrawal symptoms. And if you need to stop metoprolol, they can instruct you on how to stop it safely, usually gradually over a few weeks.

5. There are ways to help manage or relieve side effects from metoprolol

Common metoprolol side effects, such as drowsiness and dizziness, usually improve as your body adjusts to it. But it’s important for your prescriber to know what you’re experiencing so they can adjust your metoprolol dosage if needed.

Consider taking it easy just after starting metoprolol. Then, slowly add in more activities as your body allows.

Other ways to help beat fatigue include:

• Going to bed at regular times, allowing for 7 to 9 hours of sleep per night

• Staying hydrated throughout the day

• Eating energy-boosting foods, such as leafy greens, whole grains, and seeds or nuts

• Taking movement breaks throughout the day

Be aware of less common side effects of metoprolol

Metoprolol can sometimes slow your heart rate down too much. Your blood pressure might also drop too low. This doesn’t happen to most people taking metoprolol, but it’s important to tell your prescriber if you notice these changes. You should ask your prescriber whether you should be checking your blood pressure or heart rate at home.

Metoprolol mainly works in the heart, so body-wide side effects generally occur less often. Other possible metoprolol side effects include:

• Skin rash: Rashes can be caused by many things, so it’s best to contact your prescriber for any new or unusual skin changes.

• Diarrhea: Your pharmacist can recommend an over-the-counter anti-diarrhea medication. Follow up with your prescriber for severe symptoms or diarrhea lasting more than 2 days.

• Sleep changes: Many people feel sleepy when they first start metoprolol. But other sleep changes are possible too, including insomnia and disturbing dreams.

• Sexual problems: Sexual side effects in men, such as erectile dysfunction, are possible with metoprolol. It’s unclear if beta blockers cause sexual side effects in women. Talk with your prescriber if your sex life seems negatively impacted after starting metoprolol. They may suggest a medication change or other treatment to help address your concerns.

Reach out to your healthcare team for any persistent side effects. For severe symptoms — including trouble breathing, chest pain, or body swelling — get medical care right away.

How to save money on metoprolol

There are plenty of ways to save on your metoprolol prescription. GoodRx can help you find discounted prices.

How to save on metoprolol tartrate

There are ways to save on metoprolol tartrate, which is available as both a brand-name and generic medication. GoodRx can help you save over 70% off the average retail price of the generic version. Generic metoprolol tartrate’s price at certain pharmacies is as low as $3.60 with a free GoodRx discount.

How to save on metoprolol succinate tablets

There are also ways to save on metoprolol succinate, which is also available as both a brand-name and generic medication. GoodRx can help you save over 60% off the average retail price of the generic version. Generic metoprolol succinate’s price at certain pharmacies is less than $46.77 with a free GoodRx discount.

Why trust our experts?

Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Our editorial standards

Meet our experts