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What happens if you take metoprolol on an empty stomach?

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Metoprolol without foodMetoprolol with foodAlternativesSummary
Doctors might recommend taking certain forms of metoprolol with food because taking it on an empty stomach might lead to more severe side effects.
Medically reviewed by Alyssa Walton, PharmD
Written by Mathieu Rees
Updated on

Metoprolol is a generic medication that belongs to a group of drugs called beta-blockers. These medications can help treat several heart conditions, like angina, heart failure, and high blood pressure.

You can take metoprolol on an empty stomach or with food, depending on the drug’s form. If doctors recommend taking metoprolol with food, it may be because this will improve your body’s absorption of the medication or reduce the risk of serious side effects.

Metoprolol on an empty stomach

An adult eating breakfast in front of a laptop to avoid taking metoprolol on an empty stomach.
Photography by Mixetto/Getty Images

According to the National Institutes of Health (NIH), two main forms of oral metoprolol exist:

  • Immediate-release oral formulation: Doctors recommend taking this form either with food or shortly after eating. This form is commonly known as metoprolol tartrate, under the brand name Lopressor.
  • Extended-release oral formulation: You can take this form on an empty stomach, with food, or after eating. This form of metoprolol is known as metoprolol succinate, under the brand name Toprol.  

You may be wondering what happens if you take immediate-release metoprolol on an empty stomach. Although no recent studies focus on the specifics of why you should take it with food, a doctor might have some more general reasons for recommending that you take medications with a meal.

One reason is that taking medications with a meal can affect how the drug is absorbed in your body. Sometimes, taking medication on an empty stomach means your body doesn’t absorb it well enough and it may become less effective.

Plus, if a medication causes certain side effects — particularly stomach-related ones like nausea, vomiting, or diarrhea — taking it with a meal can help settle your stomach and reduce these side effects.

No reliable scientific evidence states that taking metoprolol on an empty stomach worsens these types of side effects or makes them more likely to happen. Yet all forms of metoprolol can cause some effects.

These include:

  • tiredness
  • reduced ability to exercise
  • depression
  • low blood pressure
  • cold hands and feet
  • decreased sex drive
  • dizziness
  • diarrhea
  • tinnitus
  • glucose intolerance
  • low blood glucose levels
  • heart block (when someone’s heartbeat is unusually slow)
  • bronchospasm (a tightening of the muscles that line the lung’s airways)

Abruptly stopping metoprolol can cause serious withdrawal effects, like angina or heart attack.

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Taking metoprolol with food

Little scientific research examines what happens when someone takes metoprolol with specific foods or drinks. Yet there is evidence that certain foods and supplements can interact with drugs of the same type as metoprolol. These drugs are beta-blockers.

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According to a 2022 review of the scientific literature, grapefruit juice can reduce the effectiveness of some beta-blockers. This is because grapefruit juice contains substances called flavonoids, which can reduce the absorption of certain drugs. Other flavonoid-containing fruit juices include:

  • orange
  • apple
  • kiwi
  • papaya

Some foods and drinks, including alcohol, can actually increase the effects of certain beta-blockers. At the same time, these drugs can also increase the effects of alcohol. To complicate matters further, certain alcoholic beers and wines contain flavonoids, which may reduce beta-blocker activity.

Saint John’s wort is a natural remedy that contains hyperphorin, which can also increase the activity of some beta-blockers. By contrast, green tea can reduce the absorption of the beta-blocker nadolol (Corgard)

According to a 2016 study, people who take beta blockers have a 13% risk of developing hyperkalemia. This is when someone’s blood potassium levels are too high. Taking potassium supplements while also taking beta-blockers could increase this risk. The same might be true of high potassium foods.

According to the Centers for Disease Control and Prevention (CDC), the following foods are good sources of potassium:

  • bananas
  • oranges
  • melons
  • cooked spinach
  • cooked broccoli
  • potatoes
  • sweet potatoes

Metoprolol alternatives

Beta-blockers work by reducing the effect of certain hormones, like adrenaline. These hormones can increase or change a person’s heart rate. Since this can be dangerous for people with certain heart conditions, beta-blockers can help treat several heart conditions.

If you have a heart condition but cannot take metoprolol, alternatives are available. The Food and Drug Administration (FDA) lists the following generic beta blockers

You can speak with a doctor about which beta-blocker would work best for you.

Summary

Metoprolol is a beta-blocker that helps treat heart conditions. It comes in two main oral forms. You should take immediate-release metoprolol either with food or shortly after a meal. Taking it on an empty stomach may affect the drug’s absorption, or you might experience more side effects.

Because metoprolol is a beta-blocker, some foods and drinks may interact with it. These include grapefruit juice, alcohol, and tea. The same is true of high potassium foods and potassium supplements.

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