Can Metoprolol Cause Diarrhea? A Look at Side Effects and Management

October 10, 2025 •

4 min read

According to FDA labeling, diarrhea occurs in about 5% of patients taking metoprolol, classifying it as a relatively common gastrointestinal side effect. While typically mild and temporary, it can be a concerning symptom for many people taking this beta-blocker.

Quick Summary

Diarrhea is a recognized side effect of metoprolol, affecting a small percentage of users. Symptoms are usually mild and improve as the body adjusts, though severe or persistent cases warrant medical consultation. Effective management involves dietary adjustments, staying hydrated, and consulting a doctor about potential over-the-counter treatments.

Key Points

Diarrhea is a known side effect: FDA-approved drug labels list diarrhea as a common adverse effect, occurring in about 5% of patients.
The effect is usually mild and temporary: For most people, metoprolol-induced diarrhea is mild and should improve as your body adjusts to the medication.
Mechanism is not fully understood: While the exact cause is unclear, it is not attributed to changes in gut motility, but may relate to the drug's effect on gastrointestinal receptors.
Manage with dietary changes and hydration: For mild symptoms, increasing fluid intake, avoiding irritating foods, and sticking to a low-fiber diet can be helpful.
Consult a doctor for persistent or severe symptoms: If diarrhea is severe, lasts for more than a few days, or is accompanied by other worrying symptoms, contact your healthcare provider immediately.
Never stop metoprolol abruptly: Stopping your medication suddenly can lead to serious cardiovascular problems, so any changes must be made under medical supervision.
Medication adjustments might be necessary: If symptoms don't resolve, a doctor might consider reducing the dose, switching to a different formulation, or trying an alternative medication.

Understanding Metoprolol

Metoprolol is a beta-blocker prescribed to manage several heart-related conditions, including high blood pressure (hypertension), angina (chest pain), and heart failure. It works by blocking the effects of certain natural substances, like epinephrine, on the heart and blood vessels. This causes the heart to beat more slowly and with less force, which lowers blood pressure and reduces the heart's workload.

While metoprolol is highly effective for its intended purposes, like all medications, it carries a risk of side effects. Many side effects are cardiovascular, but it can also impact other systems in the body, including the gastrointestinal tract.

The Connection Between Metoprolol and Diarrhea

Reports from the FDA and various clinical studies confirm that diarrhea is a possible side effect of metoprolol. The incidence is estimated to be around 5% of patients, meaning it affects a small but notable portion of users.

How Does Metoprolol Cause Diarrhea?

The precise mechanism by which metoprolol and other beta-blockers cause diarrhea is not fully understood, but it is not believed to be due to changes in gut motility. Some research suggests that beta-blockers may influence the receptors within the gastrointestinal tract, leading to various symptoms. One study also explored a potential link between beta-blockers and effects on intestinal muscles, which perform contractions to move food through the gut. Whatever the cause, this side effect is typically temporary as the body adapts to the new medication.

Factors Influencing Metoprolol-Induced Diarrhea

Dosage: Higher doses of metoprolol may increase the risk of experiencing gastrointestinal side effects.
Medication form: The immediate-release (IR) form, taken multiple times daily, might lead to more frequent side effects like diarrhea compared to the extended-release (ER) version.
Individual Sensitivity: A person's unique physiology and other underlying conditions can influence their reaction to the medication.
Concurrent Medications: Taking other drugs, such as antibiotics or magnesium-containing antacids, can also contribute to diarrhea.

Managing Diarrhea from Metoprolol

If you experience mild diarrhea while taking metoprolol, several strategies can help manage the symptoms. It is crucial to remember that you should never stop taking your medication abruptly without consulting your doctor, as this can lead to serious cardiovascular complications.

Dietary Adjustments

To help control symptoms, healthcare providers often recommend dietary changes. Sticking to the BRAT diet (bananas, rice, applesauce, toast) is a common suggestion, as these foods are low in fiber and easy to digest. Other recommendations include:

Increasing Fluid Intake: Staying hydrated is critical to replace lost fluids and electrolytes. Water, clear broths, and electrolyte drinks are excellent choices.
Eating Small, Frequent Meals: This can be less taxing on the digestive system than large meals.
Avoiding Irritants: Limiting foods that can aggravate the digestive tract, such as spicy, greasy, or fatty foods, and reducing alcohol and caffeine consumption can help reduce symptoms.

Over-the-Counter Medications

For moderate cases, over-the-counter antidiarrheals like loperamide (Imodium A-D) or bismuth subsalicylate (Pepto-Bismol) can be effective. However, it is essential to consult with a healthcare professional before taking these to ensure they are safe for you and won't interact with other medications.

When to Consult Your Doctor

While mild diarrhea may resolve on its own as your body adjusts, certain situations warrant a call to your healthcare provider. You should contact your doctor if the diarrhea is severe, persists for more than a few days, or is accompanied by other serious symptoms. Your doctor can then evaluate the cause, potentially adjust your dosage, or switch you to an alternative medication.

Potential Drug Adjustments for Persistent Diarrhea

If lifestyle changes are not enough to control persistent metoprolol-induced diarrhea, your doctor may consider several options. They will first need to rule out other causes of diarrhea, such as infections or other underlying gastrointestinal issues.


Option	Description	Considerations
Dose Reduction	Lowering the daily dose of metoprolol may reduce the severity of side effects, including diarrhea.	This is only possible if a lower dose is still effective for the patient's primary condition.
Switching Medications	Changing from an immediate-release to an extended-release formulation might help, as the drug is released more slowly.	Your doctor will determine the most suitable formulation based on your health needs.
Alternative Beta-Blocker	Your doctor may switch you to a different beta-blocker that may not cause the same gastrointestinal side effects.	This requires careful consideration of the alternative medication's side effect profile and its effectiveness for your condition.
Adding a Supplemental Medication	In some cases, a doctor might recommend adding an anti-diarrheal medication to manage the symptoms.	This is typically a short-term solution and should only be done under medical supervision.

Conclusion

Diarrhea is a recognized, albeit usually mild and temporary, side effect of metoprolol. For most individuals, it resolves as the body becomes accustomed to the medication. Following simple dietary guidelines and ensuring adequate hydration are often sufficient for managing mild symptoms. In cases where diarrhea persists or becomes severe, it is vital to consult a healthcare provider. They can help rule out other causes, explore potential adjustments to your treatment plan, and ensure the continued effectiveness and safety of your heart medication. Remember, maintaining open communication with your healthcare team is key to successfully managing any medication-related side effects.

Frequently Asked Questions

Diarrhea is a recognized side effect, occurring in approximately 5% of patients taking metoprolol, according to information from FDA drug labeling.

For most people, the diarrhea is mild and transient, meaning it typically resolves on its own as your body adjusts to the medication within a few days or weeks.

While over-the-counter antidiarrheals such as loperamide (Imodium) may help manage symptoms, you should always consult with your healthcare provider or pharmacist before taking them to ensure there are no contraindications or interactions with your metoprolol.

Both formulations can cause diarrhea, but the immediate-release version, with its higher initial concentration, may be more likely to cause gastrointestinal issues like diarrhea and tiredness.

Drinking plenty of fluids, avoiding spicy and greasy foods, and eating smaller, more frequent meals can help. Some healthcare professionals recommend eating bland foods like those in the BRAT diet (bananas, rice, applesauce, toast).

If you experience severe or persistent diarrhea, or if it causes significant distress or weight loss, you should contact your doctor. They may need to adjust your dose, switch medications, or investigate other potential causes.

No, it is not safe to stop taking metoprolol abruptly. This can lead to a withdrawal effect and potentially serious heart problems. Always consult your doctor before making any changes to your medication regimen.