Metoprolol succinate ER

generic for Toprol XL

Metoprolol succinate ER Side Effects

See also Warning section.

Drowsiness, dizziness, tiredness, diarrhea, and slow heartbeat may occur. Decreased sexual ability has been reported rarely. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

With some brands of this medication, an empty tablet shell may appear in your stool. This is harmless.

This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: very slow heartbeat, severe dizziness, fainting, blue fingers/toes, trouble breathing, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as confusion, mood swings, depression).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
  • idiopathic thrombocytopenic purpura
  • agranulocytosis
  • neutropenic disorder
  • acute confusion
  • abnormal sexual function
  • nightmares
  • depression
  • blurred vision
  • dry eye
  • ocular irritation
  • tinnitus
  • progressive angina pectoris
  • heart block
  • bradycardia
  • cardiac arrhythmia
  • chronic heart failure
  • peripheral vasoconstriction
  • thrombotic thrombocytopenic purpura
  • hypotension
  • rhinitis
  • bronchospastic pulmonary disease
  • xerostomia
  • constipation
  • hepatitis
  • Peyronie's disease
  • skin photosensitivity
  • psoriasiform eruption
  • pruritus of skin
  • alopecia
  • arthritis
  • arthralgia
  • drowsy
  • hallucinations
  • dizziness
  • insomnia
  • fatigue
  • dysgeusia
  • skin rash
  • peripheral edema
  • weight gain
  • headache disorder
  • palpitations
  • dyspnea
  • chest pain
  • nausea
  • vomiting
  • heartburn
  • flatulence
  • diarrhea
  • abdominal pain with cramps
  • paresthesia
  • gangrene
  • drug-exacerbated psoriasis
  • worsening of chronic heart failure
  • symptoms of anxiety
  • mesenteric artery thrombosis

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

A product that may interact with this drug is: fingolimod.

Other medications can affect the removal of metoprolol from your body, which may affect how metoprolol works. Examples include lumefantrine, propafenone, quinidine, SSRI antidepressants (such as fluoxetine, paroxetine), St. John's wort, among others.

Some products have ingredients that could raise your heart rate or blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).