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metoprolol

Side Effect Search

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Metoprolol may cause skin rash in 5% of people.

This drug may also cause the following symptoms that are related to skin rash:

Medical Source Information
Yellow highlights indicate symptoms related to skin rash.

Dermatologic side effects reported very rarely have included worsening of psoriasis. A case of generalized psoriasiform lesions has been reported. Urticaria has also been reported in postmarketing experience.

A 62-year-old man with ischemic heart disease developed a generalized, chronic, nummular, psoriasiform, erythematous rash that disappeared after metoprolol was withheld. Subsequent skin patch testing revealed sensitivity to metoprolol.

Hematologic side effects including agranulocytosis, nonthrombocytopenic purpura and thrombocytopenic purpura have been associated with beta-blocking agents in general.

Hypersensitivity side effects reported in 5% of patients have included pruritus and rash. Very rarely, worsening of psoriasis has also been reported.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects: slow or uneven heartbeats; feeling light-headed, fainting; feeling short of breath, even with mild exertion; swelling of your ankles or feet; nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); depression; or cold feeling in your hands and feet. Less serious side effects may include: vomiting; decreased sex drive, impotence, or difficulty having an orgasm; sleep problems (insomnia); tired feeling; or anxiety, nervousness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects to Watch
Watch closely for the following side effects and notify your physician immediately should any of these develop:

Abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (signs of problems with blood clot formation)
weight gain, congestive heart failure, worsening of congestive heart failure or shortness of breath

Lab and Diagnostic Tests
If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):

monitor for [coronary artery disease|heart disease that involves a blockage of the blood supply to the heart], [decreased oxygen to the heart due to blockage of the coronary arteries|blood vessels that supply the heart], liver problems or chest discomfort/angina
Monitor alkaline phosphatase and lactate dehydrogenase
Blood tests to assess normal clotting - in people who develop signs of bleeding such as abnormal bruising or signs of bleeding including bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash

References

Adverse reactions of the skin to metoprolol and other beta-adrenoreceptor-blocking agents. Neumann HA, van Joost T Dermatologica 1981;162:330-5.
Controlled release metoprolol formulations. A review of their pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and ischaemic heart disease. Plosker GL, Clissold SP Drugs 1992;43:382-414.
Product Information. Lopressor (metoprolol). Anonymous Novartis Pharmaceuticals, East Hanover, NJ. PROD;
Angioedema following the intravenous administration of metoprolol. Krikorian RK, Quick A, Tal A Chest 1994;106:1922-3.
Metoprolol-induced hepatitis: rechallenge and drug oxidation phenotyping. Larrey D, Henrion J, Heller F, et al Ann Intern Med 1988;108:67-8.
Product Information. Lopressor (metoprolol). Anonymous Novartis Pharmaceuticals, East Hanover, NJ. PROD;
Adverse reactions of the skin to metoprolol and other beta-adrenoreceptor-blocking agents. Neumann HA, van Joost T Dermatologica 1981;162:330-5.
Metoprolol: an updated review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy, in hypertension, ischaemic heart disease and related c. Benfield P, Clissold SP, Brogden RN Drugs 1986;31:376-429.
Controlled release metoprolol formulations. A review of their pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and ischaemic heart disease. Plosker GL, Clissold SP Drugs 1992;43:382-414.
Analysis of adverse effects among patients with essential hypertension receiving an ACE inhibitor or a beta-blocker. Rosenthal J, Bahrmann H, Benkert K, Baumgart P, Bonner G, Klein G, Neiss A, Schnelle K, Frohlich ED Cardiology 1996;87:409-14.
Metoprolol: an updated review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy, in hypertension, ischaemic heart disease and related c. Benfield P, Clissold SP, Brogden RN Drugs 1986;31:376-429.

Multum version: 154.0 (Jun 16, 2010)

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