Lopressor (metoprolol tartrate) is an immediate‑release beta‑1 selective beta‑blocker prescribed to lower high blood pressure (hypertension), relieve chest pain from angina pectoris, and reduce the risk of death after an acute myocardial infarction (heart attack). By slowing heart rate and decreasing the force of contraction, it reduces myocardial oxygen demand and helps stabilize cardiovascular function.
Beyond these core indications, clinicians commonly use Lopressor to control rapid heart rhythms (rate control in atrial fibrillation or other supraventricular tachyarrhythmias) and to manage symptomatic palpitations or performance‑related tachycardia. While beta‑blockers like metoprolol can help prevent migraines and manage certain tremors or anxiety‑related symptoms, those are considered off‑label uses and require individualized medical judgment. Note: heart failure management typically uses metoprolol succinate extended‑release (Toprol‑XL), not the immediate‑release Lopressor formulation.
Dosing is individualized based on condition, response, and tolerability. Follow your prescriber’s instructions exactly. Typical adult regimens for metoprolol tartrate (Lopressor) are:
Hypertension: Many start at 50 mg twice daily or 100 mg per day in divided doses. The usual maintenance range is 100–450 mg per day, divided into two to three doses. Adjustments are made every 1–2 weeks based on blood pressure and heart rate.
Angina: Commonly 100 mg per day in divided doses, titrated to 200–400 mg per day as needed and tolerated to reduce exertional chest pain and improve exercise tolerance.
Post‑MI: After initial hospital management (often including IV beta‑blockade), an oral maintenance dose such as 100 mg twice daily is typical, adjusted to heart rate, blood pressure, and symptoms under medical supervision.
Rate control in atrial fibrillation or other tachyarrhythmias: Dosing varies widely; start low and titrate carefully to achieve target resting heart rate without causing symptomatic bradycardia or hypotension.
How to take it: Take Lopressor with or immediately after meals to improve absorption and reduce side effects. Try to take doses at the same times each day. Swallow tablets whole or split only if scored; do not crush unless your pharmacist confirms it is appropriate. Monitor blood pressure and pulse regularly and report marked bradycardia (for example, resting heart rate consistently below the threshold your prescriber sets), dizziness, fainting, or chest pain. Do not stop Lopressor abruptly; taper as directed to avoid rebound hypertension, ischemia, or arrhythmias.
- Worsening heart conditions: Beta‑blockers can exacerbate severe bradycardia, AV block, or decompensated heart failure. Initiation and titration require clinician oversight.
- Respiratory disease: Although metoprolol is beta‑1 selective, high doses can still affect beta‑2 receptors and may aggravate bronchospasm in asthma or COPD. Use with caution; carry rescue inhalers if prescribed, and seek care if wheezing worsens.
- Diabetes: Lopressor may mask adrenergic symptoms of hypoglycemia (such as tremor and palpitations). Monitor glucose closely and recognize alternative signs like sweating or confusion.
- Thyroid and adrenal conditions: Beta‑blockade can mask hyperthyroidism symptoms and prolong recovery from thyrotoxic states. In pheochromocytoma, use only with adequate alpha‑blockade to prevent hypertensive crisis.
- Liver disease: Metoprolol is hepatically metabolized (CYP2D6). Lower starting doses and careful uptitration may be needed in hepatic impairment.
- Pregnancy and lactation: Use only if benefits outweigh risks. Beta‑blockers can cause fetal growth restriction and neonatal bradycardia or hypoglycemia; monitor newborns. Metoprolol appears in breast milk in low amounts; watch infants for excessive sleepiness or feeding difficulty.
- Surgery and anesthesia: Tell your surgical team you take a beta‑blocker. Do not stop abruptly before procedures unless your surgeon and cardiologist advise a plan.
- Driving and tasks: Dizziness or fatigue can occur, especially during dose changes. Use caution with activities requiring alertness.
Do not use Lopressor if you have:
- Overt cardiogenic shock or decompensated heart failure
- Severe sinus bradycardia
- Second‑ or third‑degree AV block or sick sinus syndrome without a pacemaker
- Known hypersensitivity to metoprolol or other beta‑blockers
- Untreated pheochromocytoma (must establish alpha‑blockade first)
Your clinician will assess risks and may choose alternative therapies if these conditions apply.
Common: Fatigue, dizziness, lightheadedness (especially when standing), slower heart rate, low blood pressure, cold hands or feet, nausea, diarrhea, or mild stomach upset. Some people report sleep changes, vivid dreams, or mild mood changes.
Less common: Shortness of breath or wheezing (bronchospasm), rash or itching, dry eyes, or reduced exercise tolerance. Sexual side effects may occur.
Serious, seek urgent care: Fainting, severe dizziness, confusion, bluish lips or fingertips, chest pain that worsens or feels different from usual angina, very slow heartbeat, new or worsening shortness of breath, swelling of legs/ankles (possible heart failure), or signs of severe allergic reaction (facial swelling, trouble breathing). People with diabetes should be alert to masked hypoglycemia—sweating, confusion, or sudden fatigue may be the only clues.
Most side effects improve as your body adjusts or with dose changes. Never change your dose without medical guidance.
Metoprolol is metabolized by CYP2D6. Strong CYP2D6 inhibitors can raise Lopressor levels and intensify effects: paroxetine, fluoxetine, bupropion, quinidine, propafenone, terbinafine, and some antipsychotics. Your clinician may start at a lower dose and monitor heart rate and blood pressure more closely when these are used together.
Other heart‑rate‑lowering or blood‑pressure‑lowering agents can add to beta‑blocker effects: non‑dihydropyridine calcium channel blockers (verapamil, diltiazem), digoxin, amiodarone, clonidine, and antiarrhythmics. Combining with verapamil or diltiazem requires caution due to AV block and bradycardia risk. If you take clonidine, do not stop it abruptly while on a beta‑blocker; your prescriber will outline a safe taper sequence.
Additional considerations: Other antihypertensives, alcohol, and general anesthetics may potentiate hypotension. NSAIDs (e.g., ibuprofen, naproxen) can blunt antihypertensive response. Rifampin and other enzyme inducers may lower metoprolol levels. Beta‑agonist bronchodilators (albuterol) may be less effective; monitor asthma symptoms. Epinephrine for anaphylaxis still works but blood pressure and heart rate responses may differ—carry your auto‑injector if prescribed and inform emergency staff about beta‑blocker use.
Food: Take Lopressor with food consistently; while grapefruit is not a major issue for metoprolol, consistent timing with meals helps maintain stable levels. Always share a complete medication and supplement list with your clinician and pharmacist.
If you miss a dose of Lopressor, take it as soon as you remember unless it is close to the time for your next dose. If it is almost time for the next dose, skip the missed dose and resume your regular schedule. Do not double up or take extra to “catch up,” as this can cause excessive bradycardia or low blood pressure. If you miss doses frequently, set reminders or speak with your clinician about a regimen that fits your routine.
Symptoms of metoprolol overdose include profound dizziness, fainting, very slow heart rate, severe low blood pressure, breathing difficulty or wheezing, confusion, seizures, and cold or clammy skin. Overdose is a medical emergency.
What to do: Call emergency services immediately (911 in the U.S.) or contact Poison Control at 1‑800‑222‑1222. Do not drive yourself to the hospital. If the person is unconscious, not breathing, or seizing, begin basic life support if trained. Hospital care may include airway support, IV fluids, medications to increase heart rate and blood pressure, glucagon, and other advanced therapies. Bring the medication bottle to the emergency team if possible.
Store Lopressor tablets at room temperature, ideally 20–25°C (68–77°F), in a dry place away from moisture, heat, and direct light. Keep tablets in the original, tightly closed container with the desiccant if provided. Do not store in the bathroom. Keep out of reach of children and pets. Properly discard expired or unused medication through take‑back programs; do not flush unless instructed.
In the United States, Lopressor (metoprolol tartrate) is a prescription‑only medication. Buying Lopressor without a prescription is not legal and can be dangerous, especially from websites that bypass medical evaluation. Legitimate pharmacies will require a valid prescription and should be accredited (for example, through state boards of pharmacy or programs such as LegitScript). Avoid “no‑Rx” online sellers; products from these sources may be counterfeit, sub‑potent, or unsafe.
If you do not currently have a prescription, there are safe and legal ways to access care quickly. The Urological Institute of Northeastern New York offers structured options—such as same‑day or telehealth evaluations—so patients can begin the process without an existing prescription and, when appropriate, receive a clinician‑issued prescription after assessment. Their care team can coordinate on‑site or partner pharmacy dispensing, medication counseling, and follow‑up blood pressure and heart rate checks. This approach maintains medical oversight while minimizing delays.
Bottom line: you cannot legally buy Lopressor without prescription in the U.S., but you can start with rapid clinical evaluation to obtain one appropriately. Seek care through reputable health systems, and use licensed pharmacies for safe, verified medication.
Lopressor is the brand name for metoprolol tartrate, an immediate‑release beta‑1 selective beta‑blocker. It helps lower heart rate and blood pressure, reduces chest pain (angina), improves outcomes after a heart attack, and is used for rate control in certain arrhythmias such as atrial fibrillation.
It blocks beta‑1 receptors in the heart, slowing the heart rate, decreasing the force of contraction, and reducing renin release from the kidneys. The result is lower blood pressure and reduced oxygen demand by the heart.
Heart rate and blood pressure typically begin to decrease within 1 hour of a dose, with peak effect around 1–2 hours. The effect of immediate‑release metoprolol tartrate usually lasts about 6–12 hours.
Take Lopressor with or immediately after a meal at the same times each day to keep levels steady. Swallow tablets with water; immediate‑release tablets may be split if scored. Do not stop suddenly—your prescriber should guide any taper.
Take it as soon as you remember unless it is close to the next dose. If it’s nearly time for your next dose, skip the missed dose and resume your regular schedule. Do not double up.
Common effects include fatigue, dizziness or lightheadedness, slow heart rate, low blood pressure, cold hands and feet, mild nausea, and sleep disturbances or vivid dreams. These often lessen as your body adjusts.
Call your clinician urgently for fainting, severe dizziness, very slow pulse, shortness of breath or wheezing, swelling in legs or sudden weight gain (possible heart failure worsening), or chest pain that is new or worse. Rarely, depression or mood changes can occur.
People with severe bradycardia, cardiogenic shock, second- or third‑degree heart block without a pacemaker, or decompensated heart failure should not use it. Use caution in asthma/COPD, diabetes (it can mask low blood sugar symptoms), peripheral vascular disease, and in those with severe liver disease.
Alcohol can enhance blood‑pressure‑lowering effects and increase dizziness or fainting risk. If you drink, limit intake and see how you feel; avoid activities requiring alertness until you know your response.
Beta‑blockers are sometimes used in pregnancy when benefits outweigh risks; metoprolol is commonly chosen but may be associated with fetal growth restriction, so monitoring is needed. Metoprolol enters breast milk in small amounts and is generally considered compatible with breastfeeding, but discuss with your clinician.
Yes. Combining with other heart‑rate‑lowering drugs (verapamil, diltiazem, digoxin, amiodarone) can increase the risk of slow heart rate or heart block. SSRIs like paroxetine and fluoxetine, bupropion, and certain HIV medicines can raise metoprolol levels. NSAIDs may blunt blood‑pressure control. Be cautious with clonidine (withdraw slowly) and PDE5 inhibitors due to additive hypotension.
Although metoprolol is beta‑1 selective, higher doses can still affect beta‑2 receptors in the lungs and may trigger bronchospasm. People with asthma or COPD should use it only under close medical supervision.
It can mask symptoms of low blood sugar like tremor and palpitations, making hypoglycemia harder to recognize; sweating may still occur. It can also modestly raise blood sugar in some people. Monitor glucose closely and discuss targets with your clinician.
No. Lopressor is metoprolol tartrate (immediate‑release), usually taken multiple times daily. Toprol‑XL is metoprolol succinate (extended‑release), designed for once‑daily dosing and has different approved uses.
Check blood pressure and resting heart rate regularly, and track symptoms like dizziness, fatigue, chest pain, or shortness of breath. If you have heart failure, watch for swelling or rapid weight gain. People with diabetes should monitor glucose more closely.
Store at room temperature, away from moisture and out of reach of children. Overdose can cause severe bradycardia, low blood pressure, fainting, or shock; seek emergency care immediately.
Do not stop abruptly. Sudden discontinuation can trigger rebound angina, elevated blood pressure, or even a heart attack. Your clinician will provide a tapering plan if it’s time to stop.
Metoprolol is sometimes used off‑label for performance anxiety and migraine prevention, though propranolol often has more evidence for these uses. Discuss risks and benefits with your clinician.
Dosing is individualized based on your condition, heart rate, blood pressure, and response. It is often started low and titrated. Never adjust your dose without medical advice.
A heart‑healthy diet, regular physical activity as advised, limiting alcohol, quitting smoking, stress reduction, and good sleep complement the blood‑pressure‑lowering effect of metoprolol tartrate.
Lopressor (metoprolol tartrate) is immediate‑release and typically dosed 2–3 times daily; Toprol‑XL is extended‑release and dosed once daily. Toprol‑XL has strong evidence and specific approval for chronic heart failure, whereas Lopressor is preferred when flexible, short‑acting dosing is needed. They are not milligram‑for‑milligram interchangeable; any switch should be guided by a clinician.
Both are beta‑1 selective beta‑blockers for blood pressure and angina. Atenolol lasts longer (often once daily) and is renally cleared, requiring dose adjustments in kidney disease; Lopressor is hepatically metabolized. Metoprolol crosses the blood‑brain barrier more, so it may be slightly more likely to cause vivid dreams but may work better for rate control and post‑MI care.
Bisoprolol is more cardioselective and usually once daily, with strong heart‑failure outcome data (CIBIS‑II). Lopressor is immediate‑release and more flexible for titration or multiple daily doses. For heart failure, bisoprolol or metoprolol succinate is favored; for short‑term rate control, Lopressor is often used.
Carvedilol blocks beta‑1, beta‑2, and alpha‑1 receptors, providing added vasodilation and robust heart‑failure mortality benefits. It may cause more dizziness from blood‑pressure drops and is less ideal in asthma. Lopressor is beta‑1 selective and may be better tolerated for rate control in reactive airway disease.
Propranolol is nonselective and more lipophilic, making it useful for migraines, essential tremor, and performance anxiety. Lopressor is beta‑1 selective and preferred in coronary disease and post‑MI due to cardiac targeting. In asthma or COPD, Lopressor is generally safer than propranolol.
Nebivolol is highly beta‑1 selective and has nitric‑oxide–mediated vasodilation, which may improve tolerability and sexual function in some. It is once daily and often more expensive. Lopressor is well‑established, generic, and flexible in dosing but requires multiple daily doses.
Labetalol blocks alpha‑1 and beta receptors and is frequently used for hypertension in pregnancy and hypertensive emergencies. Lopressor is used after MI, for angina, and for rate control. For chronic hypertension in pregnancy, labetalol is often preferred.
Nadolol is a nonselective beta‑blocker with a very long half‑life, enabling once‑daily dosing and use in conditions like portal hypertension/variceal prophylaxis. Lopressor is cardioselective and shorter‑acting, favored for cardiac rate control and post‑MI therapy. Nadolol requires renal dosing adjustments.
No. Sotalol is both a nonselective beta‑blocker and a class III antiarrhythmic that prolongs the QT interval, requiring ECG and renal monitoring. Lopressor is a pure beta‑1 blocker for blood pressure, angina, and rate control. They treat different problems and are not substitutes.
Metoprolol succinate (Toprol‑XL) has strong evidence and approval for chronic heart failure with reduced ejection fraction. Lopressor (tartrate) is not the preferred metoprolol formulation for heart failure maintenance therapy. For heart failure, metoprolol succinate, carvedilol, or bisoprolol is typically chosen.
Esmolol is an intravenous, ultra‑short‑acting beta‑1 blocker used in critical care for rapid, minute‑to‑minute heart rate or blood pressure control. Lopressor is oral and used for ongoing outpatient management. They serve different clinical settings.
Timolol is nonselective and commonly used in eye drops for glaucoma; oral use is less common today. Lopressor is beta‑1 selective and used systemically for cardiac indications. For patients with asthma, Lopressor is usually safer than timolol.
Acebutolol and pindolol have ISA, meaning they partially stimulate beta receptors while blocking them, which may cause less resting bradycardia but can be less effective post‑MI. Lopressor has no ISA, making it preferred after a heart attack and for consistent rate control.
Beta‑blockers differ in selectivity, dosing frequency, metabolism, and evidence for specific conditions. Switching should be supervised, with careful dose conversion and monitoring of blood pressure, heart rate, and symptoms to avoid withdrawal or decompensation.
