a bottle of Metoprolol tablets

Metoprolol is a beta blocker heart medicine. It is perennially on the doctors’ top 10 hit parade of most prescribed medicines. Over the last decade, roughly 70 million prescriptions were dispensed each year. This medication is prescribed for chest pain (angina pectoris) heart failure, and after a patient has had a heart attack. We suspect, though, that the majority of dispensed prescriptions are for metoprolol for high blood pressure. How good is it and what are the risks? This reader is concerned about blood sugar:

Can Metoprolol for High Blood Pressure Raise Blood Glucose?

Q. I have been taking metoprolol for my high blood pressure for the past five years. Since then, my blood sugar has ranged between 108 and 111. I never had blood sugar levels that high before taking metoprolol.

My doctor is concerned. I believe that this beta blocker is raising my blood sugar. Are there any studies concerning such drugs and high blood sugar levels?

A. Beta blockers can raise blood sugar (Drug Intelligence & Clinical Pharmacy, April 1985). This is not a side effect that is generally recognized by health professionals as a problem. The official prescribing information mentions “unstable diabetes” almost as an afterthought and includes the disclaimer that “a drug relationship is not clear.”

Other researchers acknowledge that older blockers like metoprolol: “…are generally considered to worsen metabolic control in patients with diabetes…” (Cardiovascular Diabetology, May 25, 2010).

The exception seems to be carvedilol (Coreg). It may improve blood sugar management.

Metoprolol for High Blood Pressure and HbA1c:

A review of the medical literature (British Journal of Clinical Pharmacology, April 22, 2015) notes that beta blockers like metoprolol and propranolol:

“…increase blood glucose concentrations by inhibiting the release of insulin from pancreatic beta-cells…”

The authors conclude that beta blockers increase fasting blood glucose and can raise HbA1c (a measure of blood sugar control over a couple of months.

We’re not sure why this potential complication of beta Blockers has slipped under the radar. Some other adverse reactions may also be missed:

Other Metoprolol Side Effects:

  • Fatigue, tiredness, dizziness
  • Depression, mental confusion, memory loss
  • Insomnia, nightmares
  • Slow heart rate (bradycardia)
  • Asthma, wheezing, shortness of breath
  • Cold hands and feet
  • Low blood pressure (hypotension)
  • Digestive upset, diarrhea, nausea, flatulence
  • Rash, itching
  • Blood disorders

Metoprolol for High Blood Pressure?

Many health professionals no longer consider beta blockers like atenolol, metoprolol and propranolol the first choice for treating high blood pressure. Dr. Franz Messerli is one of the country’s leading experts in the field of preventive cardiology. He has written a lot about beta blockers like metoprolol for high blood pressure.

In one paper Dr. Messerli and his colleagues noted that beta blockers have not been found to be better than placebo when it comes to preventing sickness or death (Journal of the American College of Cardiology, Sept. 22, 2009). They point out that when used in the treatment of hypertension:

“…BB [beta blocker] therapy resulted in a 22% increased risk for new-onset diabetes mellitus, a known powerful risk factor for CV [cardiovascular] disease.”

Never Stop Metoprolol for high blood pressure suddenly

If a beta blocker needs to be stopped, it should be done gradually under careful medical supervision. Sudden discontinuation could cause chest pain or a heart attack. There are situations when metoprolol is absolutely essential, such as hypertrohic cardiomyopathy. In such cases, metoprolol should not be stopped.

If a doctor has prescribed metoprolol for high blood pressure, however, ask about the research supporting this use. Make sure the physician is aware of Dr. Messerli’s editorial comment in the Journal of the American College of Cardiology.

Your doctor should be able to prescribe a medicine that won’t increase your risk for diabetes.

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  1. Julie
    Ohio
    Reply

    I have been on metoprolol since Nov. I’m also gaining weight, can’t sleep,am mean and aggitated all the time and depressed. This was my second heart attack. My stent was blocked. After a year of telling docs and cardiologist and ER docs when my blood pressure was Skye high, and being told I was having panic attacks, I went in feet first with another heart attack. It says not to go off it suddenly. Well I haven’t had my script for 5 days. It’s says never go off suddenly. What can happen? I actually feel better.

  2. Marilyn
    Indiana
    Reply

    There have been several comments about possibly going on “something else” but no one says that they did and what they went on successfully. I’m just getting started on metoprolol 50mg morning & evening and now am frightened to stop it and concerned about it raising my blood sugar and making my cholesterol numbers worse. Any comments?

  3. Betty
    Reply

    Just finished a Google search on: beta blockers effects on cholesterol levels. Very informative! Several articles going back to the early 1980’s showed they raise LDL and lower HDL – dangerously so! At least one even said that although they helped reduce the risk factor of elevated BP, which helped prevent heart attacks and strokes, on the other hand they greatly increased the risk factors of triglycerides, and messed up HDL and LDL – which by leading to coronary artery clogging outweighs the BP benefits. But your docs probably don’t know this, so will blame your eating and exercise habits, and add a statin to your Rx list! Sad:-(

  4. Becky
    Ohio
    Reply

    This is a seriously dangerous drug. I am in a lawsuit for the sudden death of my husband over this drug. He had pericarditis, a mild case, and went into the hospital for two days. They gave him 200mg of this deadly drug, and he was dead in 12 days. He never had high blood pressure. He was talking one minute in our bedroom and dead the next. Better study what beta/ blockers do to your body.

  5. Angie B.
    St. Louis, MO
    Reply

    I had a different problem with this medicine. It made me extremely irritable. I would get so angry at the smallest things. Everything made me want to scream.

    I told my doctor and she didn’t believe me. I thought maybe I was just going through something, but when it didn’t lessen I told my doctor I wanted off it. Within 2 days I was back to my regular self. I could see myself getting into very serious trouble if I had stayed on it. If you are experiencing terrible irritability and taking this medicine, tell your doctor you want off it.

  6. Larry K.
    Virginia
    Reply

    My prediabetics didn’t exist until I started taking Losartin and Metoprolol. So every Dr visit, she runs around like the world is coming to an end if I don’t lose more weight. I’m still just prediabetic 5 years later. You do the math, I’m sure it the drugs.

  7. biglou.iak
    NE Oklahoma
    Reply

    I have been on losartan (100 mg) for high blood pressure, then had a RBBB so now also on metoprolol (25 mg) twice a day. I have also up’ed my 20 mg to 40 mg of simvastatin. My once prediabetic A1c was around 5 to 5.8 is now at 6.5. I blame it on winter gain of carbohydrates and “cookie time” (the holidays). So now I think it just could be the simvastatin and metoprolol together boosting my A1c. I am trying another 3 months of diet and exercise to get it down or my family doctor wants me on metformin, which has a side effect of diarrhea. Not anxious to sign up for that.

  8. Susan
    Tyler, TX
    Reply

    My dad is almost 89 years old and on metoprolol. He has almost every side effect you listed. However, he really does have Type 2 diabetes that is fairly well controlled with metformin and diet. He needs to be on a beta blocker due to his cardiac history, but is there a better beta blocker with fewer problems than metoprolol?

  9. Betty
    Yorktown, VA
    Reply

    Beta blockers can also disrupt your cholesterol levels, raising LDL and lowering HDL. My levels were always perfectly healthy. One year after being on the beta blocker the were both at dangerous levels: LDL too high and HDL too low.

  10. Lida
    Reply

    It is a sad fact that you cannot always rely on your doctor to know all the facts about a drug they have prescribed. That being said, can you offer an alternative beta blocker with fewer side effects?

  11. Ginger
    Wilmington NC
    Reply

    Well, that explains a lot! My blood glucose readings have been staying around 105 for years – just enough for my family physician to get that look. Since diabetes runs in my family she is concerned. And no wonder I’m always hungry and can’t lose weight if it is affecting my insulin. I’m going to see if my cardiologist can put me on something else.

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