August 1, 2014
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Drug Factsheets

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Apo-Metoprolol

(metoprolol)

DIN (Drug Identification Number)

00751170 APO-METOPROLOL (TYPE L) 100MG TABLET
00749354 APO-METOPROLOL (TYPE L) 50MG TABLET
00618640 APO-METOPROLOL 100MG TABLET
02246010 APO-METOPROLOL 25MG TABLET
00618632 APO-METOPROLOL 50MG TABLET

What side effects are possible with Apo-Metoprolol?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain or discomfort
  • changes in sexual desire or ability
  • constipation
  • diarrhea
  • dizziness or lightheadedness
  • drowsiness (slight)
  • dry mouth
  • headache
  • increased sensitivity to sunlight
  • increased sweating
  • tiredness or weakness
  • vivid dreams
  • weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • back or joint pain
  • breathing difficulty or wheezing
  • chest pain
  • cold hands and feet
  • confusion
  • hallucinations (hearing or seeing things that aren't there)
  • red, scaling, or crusted skin
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, difficulty breathing, tiredness with activity, swelling of feet, ankles, or lower legs)
  • signs of kidney problems (e.g., increased need to urinate, decreased urine production, skin itching, nausea, vomiting, rash)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • slow heartbeat (especially less than 40 beats per minute)
  • tingling sensation in the extremities

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • fingers or toes cold to touch, painful or discoloured
  • symptoms of a serious allergic reaction (such as swelling of the face or throat, hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.





Are there any other precautions or warnings for Apo-Metoprolol?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Breathing conditions: Patients with asthma and certain other breathing problems should, in general, not take a beta-blocker such as metoprolol. If you have these types of conditions and your doctor prescribed metoprolol for you, it may be at a lower dose, and your doctor will monitor you regularly while you are taking this medication.

Diabetes: The signs of low blood sugar may not be as noticeable when taking metoprolol. This medication may make it more difficult for people with diabetes to control their blood sugar. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor will monitor you while you are taking this medication and may need to adjust the doses of antidiabetes medications.

Dizziness or fainting: Dizziness or fainting are side effects of metoprolol and may occur after first starting this medication. Avoid driving and other potentially hazardous tasks until you have determined how this medication affects you.

Heart disease: Beta-blockers, such as metoprolol, can worsen existing heart failure. It is important to take metoprolol exactly as prescribed by your doctor to decrease the chance of this happening. If you have a history of heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hyperthyroidism (high level of thyroid hormones): If you have hyperthyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Stopping the medication suddenly could worsen this condition.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Severe allergies: If you have allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe), discuss with your doctor about what to do if you have an allergic reaction. Metoprolol may make it more difficult to treat severe allergic reactions with epinephrine.

Stopping the medication: People with heart disease who stop taking this medication abruptly may experience severe effects, such as chest pain, irregular heartbeat, or heart attack. If you have heart disease, do not stop taking this medication without checking with your doctor first. When this medication needs to be stopped, it should be done gradually under supervision of your doctor.

Surgery: If you are scheduled for surgery, inform all health care professionals involved in your care that you are taking metoprolol.

Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking metoprolol, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Normal adult doses of metoprolol may cause a drop in blood pressure that is larger than anticipated. Lower doses may be necessary for seniors.

What other drugs could interact with Apo-Metoprolol?

There may be an interaction between metoprolol and any of the following:

  • acetylcholine
  • alcohol
  • alpha-1 blockers (e.g., doxazosin, prazosin, tamsulosin)
  • amphetamines (e.g., dextroamphetamine)
  • anesthetic agents
  • angiotensin converting enzyme inhibitors (ACEIs; e.g., captopril, ramipril)
  • angiotensin II receptor blockers (ARBs; e.g., irbesartan, losartan)
  • antiarrhythmic medications (e.g., amiodorone, quinidine, propafenone)
  • antidiabetes medications (e.g., glyburide, metformin, insulin)
  • antifungals (e.g., terbinafine)
  • antihistamines (e.g., diphenhydramine)
  • antimalarials (e.g., hydroxychloroquine, quinine)
  • antipsychotics (e.g., chlorpromazine, thioridazine)
  • aripiprazole
  • barbiturates
  • beta-agonists (asthma medications; e.g., salbutamol, salmeterol, formoterol)
  • beta-blockers (e.g., atenolol, metoprolol, propranolol)
  • bupropion
  • calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, amlodipine)
  • celecoxib
  • clonidine
  • darunavir
  • digoxin
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
  • donepezil
  • epinephrine
  • epoprostenol
  • ergot derivatives (e.g., bromocriptine, ergotamine, methylergonovine)
  • fentanyl
  • floctafenine
  • galantamine
  • ginger
  • ginseng
  • imatinib
  • insulin
  • isoniazid
  • lidocaine
  • methacholine
  • methyldopa
  • methylphenidate
  • midodrine
  • monoamine oxidase (MAO) inhibitors (e.g., tranylcypromine, phenelzine)
  • nonsteroidal anti-inflammatories (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • norepinephrine
  • peginterferon alfa-2b
  • pentoxifylline
  • phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
  • pilocarpine
  • quinidine
  • rifampin
  • ritonavir
  • rituximab
  • rivastigmine
  • selective serotonin reuptake inhibitors (e.g., fluoxetine, paroxetine, sertraline)
  • theophylline
  • ticlopidine
  • yohimbine

If you are taking any medications containing this drug, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.

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