In some people, however, blood pressure can fall lower than intended.
Possible symptoms include:
Dizziness
Blurred vision
Feeling faint
Weakness
Confusion
Nausea
Unsteadiness
Low blood pressure becomes especially important when symptoms are severe or interfere with normal activities.
Why Low Blood Pressure May Be More Likely
The effect can become more noticeable when metoprolol is combined with other medicines that also lower blood pressure.
Dehydration, vomiting, diarrhea, fever, poor food and fluid intake, or excessive alcohol use can also contribute in some people.
If repeated blood pressure readings are unusually low for you and you feel unwell, contact your healthcare professional rather than adjusting medication independently.
Orthostatic Hypotension
Some people experience a drop in blood pressure when standing, known as orthostatic or postural hypotension.
Symptoms may include a brief wave of dizziness or blurred vision after getting up.
Rising slowly from bed or a chair may help.
Persistent episodes or fainting deserve medical assessment.
5. Cold Hands and Feet
Some people taking beta blockers notice that their fingers or toes feel colder than before.
This can happen because beta-blocker effects may alter blood flow in peripheral blood vessels.
For many people this is uncomfortable but not dangerous.
However, contact a healthcare professional if coldness is accompanied by:
Severe pain
Marked color changes
Numbness that persists
Wounds that heal poorly
A significant worsening of a known circulation problem
Metoprolol and Raynaud’s Symptoms
People with Raynaud’s phenomenon or significant peripheral vascular disease should mention this condition to their prescriber.
A healthcare professional can decide whether the benefits of treatment outweigh any potential worsening of peripheral symptoms.
6. Shortness of Breath or Wheezing
Metoprolol is considered relatively selective for beta-1 receptors in the heart, particularly at lower doses.
However, this selectivity is not absolute.
At higher doses, or in susceptible individuals, beta blockade can also influence beta receptors involved in airway function.
This can be important for people with asthma or other obstructive lung conditions.
Symptoms that deserve attention include:
New wheezing
Chest tightness
Increasing shortness of breath
Difficulty breathing
A noticeable reduction in the effectiveness of usual breathing treatments
Severe breathing difficulty requires urgent medical attention.
Does Asthma Mean Metoprolol Can Never Be Used?
Not necessarily.
The decision depends on the reason for treatment, severity of the lung disease, dose, and alternative options.
In some situations a clinician may still use a beta-1-selective blocker carefully.
This decision should be individualized rather than based on a blanket rule.
Do Not Assume Every Episode of Breathlessness Is a Side Effect