When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use if you had an allergic reaction to metoprolol or similar medicines. Do not use this medicine if you have certain blood circulation or heart problems. Ask your doctor about these problems.

How to Use This Medicine:
Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Take this medicine with a meal or right after a meal. Take this medicine the same way every day, at the same time.
• Swallow the tablet whole with a glass of water. You may break the extended-release tablet in half, but do not chew or crush it.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how metoprolol works. Tell your doctor if you are taking any of the following:
  
  • Digoxin, dipyridamole, hydralazine, hydroxychloroquine, methyldopa, quinidine
  • Medicine to treat depression (such as bupropion, clomipramine, desipramine, fluoxetine, fluvoxamine, paroxetine, sertraline), medicine to treat mental illness (such as chlorpromazine, fluphenazine, haloperidol, thioridazine), medicine for heart rhythm problems (such as propafenone), HIV/AIDS medicine (such as ritonavir), medicine to treat a fungus infection (such as terbinafine), a monoamine oxidase inhibitor (MAOI), an ergot medicine for headaches, a calcium channel blocker (such as amlodipine, diltiazem, verapamil), or an alpha blocker (such as clonidine, prazosin, reserpine, guanethidine)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have blood vessel, heart, or circulation problems (such as heart failure, rhythm problems, or slow heartbeat). Tell your doctor if you have kidney disease, liver disease, diabetes, lung disease (such as asthma), an overactive thyroid, or a history of allergies.
• This medicine may cause worse symptoms of heart failure while the dose is being adjusted.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• This medicine could lower your blood pressure too much, especially when you first use it or if you are dehydrated. Stand or sit up slowly if you feel lightheaded or dizzy.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Lightheadedness, dizziness, or fainting
• Slow heartbeat
• Swelling in your hands, ankles, or feet, trouble breathing, tiredness
• Worsening chest pain

If you notice these less serious side effects, talk with your doctor:

• Diarrhea
• Mild dizziness or tiredness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088