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Writer's pictureLauren Fang

Med of the Week: Metoprolol


Metoprolol feature with a picture of white pills

Metoprolol is the most commonly prescribed beta-blocker in the U.S. Here’s what you need to know about Metoprolol’s effects on dentistry before your next patient comes in:


Generic Name: Metoprolol

Brand Name(s): Lopressor, Toprol, Toprol XL

Pronunciation: meh TOE pro lol


About this drug:

  • Metoprolol is a selective beta1-adrenergic receptor blocker used to treat high blood pressure. This may reduce the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.

  • Metoprolol is also used for the long-term treatment of angina.

  • Metoprolol can also be used off-label for prevention/prophylaxis of migraine headache.


Dentistry-related tidbits:

  • Exercise caution when administering local anesthesia to a patient taking Metoprolol. Common local anesthetics (e.g. Articaine, Bupivacaine, Lidocaine, Mepivacaine, and Ropivacaine) can cause hypotension and bradycardia when combined with Metoprolol.

  • Also, ensure that the patient’s hypertension is controlled before giving Epinephrine.

  • Metoprolol may cause severe lightheadedness, tiredness, dizziness, hypotension, and syncope, especially in elderly patients.

  • Remind diabetic patients to check blood sugar levels regularly. Metoprolol may mask the signs and symptoms of hypoglycemia.

  • The combination of Carbamazepine and Metoprolol can cause PR interval prolongation, AV block, and bradycardia.

  • Metoprolol has numerous drug interactions with meds commonly prescribed by dentists (e.g. NSAIDs, steroids, narcotics, and more). Make sure to check for potential interactions before prescribing using a tool like Rx Check.


Fun facts:

  • According to ClinCalc, Metoprolol was the 6th most common medication in the U.S. in 2020, ranking at 66.4M prescriptions for 15M patients.

  • Metoprolol is a “selective” beta-blocker, meaning it’s less likely to affect breathing and insulin response than other nonselective beta-blockers.

  • There is an FDA Warning that abruptly stopping Metoprolol can cause chest pain or heart attack.


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