What can I take instead of metoprolol?

October 5, 2025 •

5 min read

In 2020, over 117 million prescriptions for beta-blockers were filled for more than 26 million Americans [1.8.1]. If you are among them and wondering, 'What can I take instead of metoprolol?', several other effective medication classes are available for managing heart conditions.

Quick Summary

A detailed look at alternative medications to metoprolol, including other beta-blockers, ACE inhibitors, ARBs, and calcium channel blockers for managing various cardiovascular conditions. This information is for educational purposes only.

Key Points

Doctor Consultation is Crucial: Never stop or switch from metoprolol without medical supervision due to risks of serious heart-related side effects [1.4.2, 1.11.1].
Other Beta-Blockers Exist: Alternatives like carvedilol, bisoprolol, or nebivolol may be suitable and are chosen based on specific health conditions like heart failure or lung issues [1.2.2, 1.3.4].
Different Drug Classes are Options: ACE inhibitors, ARBs, and calcium channel blockers are effective alternatives that work through different mechanisms to lower blood pressure [1.2.3].
ACEs and ARBs: Lisinopril (ACE inhibitor) and losartan (ARB) are common first-line treatments for hypertension and heart failure, with ARBs often used if ACEs cause a cough [1.2.3, 1.6.2].
Calcium Channel Blockers and Diuretics: Medications like amlodipine (CCB) and hydrochlorothiazide (diuretic) are also primary choices for managing high blood pressure [1.5.3, 1.9.2].
Lifestyle is Key: A heart-healthy diet (like DASH), regular exercise, weight management, and quitting smoking are essential for managing blood pressure [1.10.3, 1.10.4].
Side Effects Drive Change: The primary reason to switch from metoprolol is often due to side effects like fatigue, dizziness, or its impact on other health conditions [1.7.2, 1.7.3].

Metoprolol is a widely prescribed beta-blocker used to treat high blood pressure (hypertension), chest pain (angina), heart failure, and to improve survival after a heart attack [1.2.3, 1.7.2]. It works by blocking the effects of the hormone epinephrine (adrenaline), which causes the heart to beat more slowly and with less force, thereby lowering blood pressure [1.5.5, 1.6.1].

However, metoprolol isn't suitable for everyone. Reasons for seeking an alternative may include bothersome side effects, lack of effectiveness, or specific co-existing health conditions [1.2.2]. Common side effects can include dizziness, fatigue, diarrhea, depression, and shortness of breath [1.7.2, 1.7.3].

Important Disclaimer: This article is for informational purposes only and does not constitute medical advice. You should never stop taking metoprolol or switch to an alternative without consulting your healthcare provider. Abruptly stopping metoprolol can lead to serious health risks, including worsening chest pain, increased blood pressure, and a higher risk of heart attack [1.4.2, 1.11.1].

Alternative Beta-Blockers

For many, an alternative beta-blocker may be the first option if metoprolol is not well-tolerated. The choice depends on the specific reason for the change and the patient's overall health profile [1.2.2].

Cardioselective (Beta-1) Blockers

These primarily affect the heart, making them a potentially better choice for individuals with lung conditions like asthma or COPD [1.2.4, 1.7.3].

Atenolol (Tenormin): Similar to metoprolol, it's a cardioselective beta-1 blocker used for hypertension and angina [1.2.4].
Bisoprolol (Zebeta): Recommended by the American Heart Association (AHA) for treating heart failure, bisoprolol has been shown to be effective in reducing mortality and hospitalization in these patients [1.2.3]. It is also effective for controlling high blood pressure [1.2.3].
Nebivolol (Bystolic): This is a third-generation beta-blocker that also helps to relax blood vessels [1.3.5]. Some studies suggest nebivolol may have a lower rate of cardiovascular events compared to metoprolol succinate [1.3.1].

Non-Cardioselective and Mixed Alpha/Beta-Blockers

These medications affect beta-1 (heart) and beta-2 (lungs, blood vessels) receptors, and some also block alpha receptors, which provides additional blood pressure-lowering effects [1.2.4].

Carvedilol (Coreg): Carvedilol blocks beta-1, beta-2, and alpha-1 receptors [1.2.4]. This dual action makes it very effective for heart failure and hypertension [1.2.3]. It is often a preferred choice for people with heart failure and may be a better option for those with diabetes as it is less likely to raise blood sugar levels compared to metoprolol [1.3.4].
Labetalol (Trandate): This medication also has mixed alpha- and beta-blocking properties and is very effective at lowering blood pressure [1.2.4].
Propranolol (Inderal): One of the first beta-blockers, it is nonselective and used for a wide range of conditions beyond hypertension, including tremors and migraines [1.2.4, 1.8.3].

Different Classes of Medications

If beta-blockers as a class are not suitable, a doctor might prescribe a medication from a completely different drug class [1.2.2].

Angiotensin-Converting Enzyme (ACE) Inhibitors

ACE inhibitors prevent the body from producing angiotensin II, a substance that narrows blood vessels. This relaxation of veins and arteries lowers blood pressure and makes it easier for the heart to pump blood [1.6.1]. They are a first-line treatment for hypertension and are also used for heart failure [1.2.3, 1.5.3].

Examples: Lisinopril, Enalapril, Ramipril [1.2.5].
Common Side Effect: A persistent dry cough is a well-known side effect for some people taking ACE inhibitors [1.2.3].

Angiotensin II Receptor Blockers (ARBs)

ARBs work similarly to ACE inhibitors but block the action of angiotensin II rather than its production [1.2.3]. This also leads to blood vessel relaxation and reduced blood pressure. They are often prescribed when ACE inhibitors are not tolerated due to side effects like coughing [1.6.2].

Examples: Losartan, Valsartan, Irbesartan [1.2.5].
Benefits: ARBs are considered a first-line treatment for hypertension and are also effective in treating heart failure and improving survival after a heart attack [1.2.3].

Calcium Channel Blockers (CCBs)

CCBs lower blood pressure by preventing calcium from entering the cells of the heart and arteries. This allows blood vessels to relax and widen [1.5.5]. CCBs are a first-line option for high blood pressure [1.5.3].

Examples: Amlodipine (Norvasc), Diltiazem (Cardizem), Verapamil [1.2.5].
Considerations: While effective for hypertension and angina, certain types of CCBs may aggravate heart failure and should be used with caution in those patients [1.5.1, 1.5.3].

Diuretics (Water Pills)

Diuretics work by helping the kidneys remove excess sodium and water from the body. This reduces the total volume of blood that the heart has to pump, which lowers blood pressure [1.9.2, 1.9.3].

Types: Thiazide (e.g., Hydrochlorothiazide), loop (e.g., Furosemide), and potassium-sparing (e.g., Spironolactone) diuretics [1.2.5, 1.9.3].
Usage: They are often one of the first medications tried for high blood pressure and are frequently used in combination with other drugs [1.9.2].

Comparison of Metoprolol Alternatives


Medication Class	How it Works	Common Examples	Best For	Potential Considerations
Beta-Blockers	Slows heart rate and reduces the force of contraction [1.6.1].	Carvedilol, Bisoprolol, Atenolol [1.2.4]	Heart failure, post-heart attack, angina [1.3.2, 1.5.1].	Can cause fatigue, dizziness. May not be ideal for people with asthma (cardioselective types are better) [1.7.3].
ACE Inhibitors	Relaxes blood vessels by blocking the formation of angiotensin II [1.6.1].	Lisinopril, Ramipril [1.2.5]	Hypertension, heart failure, post-heart attack, kidney disease in diabetics [1.2.3, 1.6.1].	Can cause a persistent dry cough [1.2.3].
ARBs	Relaxes blood vessels by blocking the action of angiotensin II [1.2.3].	Losartan, Valsartan [1.2.5]	Hypertension, heart failure. Often used when ACE inhibitors are not tolerated [1.6.2].	Generally have fewer side effects than ACE inhibitors [1.6.2].
Calcium Channel Blockers	Relaxes blood vessels by blocking calcium entry into muscle cells [1.5.5].	Amlodipine, Diltiazem [1.2.5]	Hypertension, especially in older adults and Black patients; angina [1.5.2, 1.5.3].	Can worsen some types of heart failure; may cause swelling in the lower legs [1.5.3, 1.7.1].
Diuretics	Removes excess salt and water from the body to reduce blood volume [1.9.2].	Hydrochlorothiazide, Furosemide [1.2.5]	Hypertension, edema (fluid retention) [1.9.1, 1.9.2].	Frequent urination. Can affect potassium levels (requires monitoring) [1.9.2, 1.9.4].

Lifestyle and Natural Approaches

While not a direct replacement for medication in diagnosed cardiovascular conditions, lifestyle modifications are crucial for managing blood pressure and overall heart health. They can complement prescribed treatments and, in some cases of mild hypertension, may be sufficient under a doctor's supervision [1.10.3].

Diet: Following the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, and whole grains, and low in sodium and saturated fat, can lower blood pressure [1.10.2, 1.10.3].
Exercise: Regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week, strengthens the heart and improves blood flow [1.10.2, 1.10.4].
Weight Management: Losing excess weight reduces strain on the heart and can significantly lower blood pressure [1.10.3].
Limit Alcohol and Quit Smoking: Limiting alcohol consumption and quitting smoking are two of the most effective lifestyle changes for improving heart health and lowering blood pressure [1.10.3, 1.10.4].
Stress Reduction: Chronic stress can contribute to high blood pressure. Techniques like mindfulness, yoga, and deep breathing can be beneficial [1.10.3].

Some supplements like Coenzyme Q10, magnesium, and L-carnitine have been studied for their potential benefits in heart health, but you should always consult your doctor before starting any supplement, as they can interact with medications [1.2.3, 1.10.2].

Conclusion

If you're considering a change from metoprolol, numerous alternatives are available, from other beta-blockers to entirely different classes of drugs like ACE inhibitors, ARBs, and calcium channel blockers [1.2.3]. The best choice is highly individual and depends on your specific health needs, tolerance for side effects, and the condition being treated [1.2.2]. The decision must be made in close partnership with a healthcare professional who can assess your situation and safely manage the transition. Never attempt to switch or stop your medication on your own [1.4.2].

For more information, you can consult resources from the American Heart Association.

Frequently Asked Questions

There isn't one single 'most common' alternative, as the choice is highly individualized. However, other beta-blockers like carvedilol, bisoprolol, and atenolol are frequently considered, as are ACE inhibitors like lisinopril and ARBs like losartan [1.2.3, 1.8.3].

For heart failure, carvedilol and long-acting metoprolol succinate are considered similarly effective [1.3.4]. Carvedilol might be preferred for patients with diabetes, while metoprolol, being more heart-selective, is often a better choice for those with asthma [1.3.4].

No. You should never stop taking metoprolol abruptly. Doing so can cause a sharp increase in heart rate and blood pressure, and increase the risk of a heart attack or worsening chest pain. A doctor must oversee a gradual tapering of the dose [1.4.2, 1.11.1].

Excellent non-beta-blocker alternatives include ACE inhibitors (e.g., lisinopril), ARBs (e.g., losartan), calcium channel blockers (e.g., amlodipine), and diuretics (e.g., hydrochlorothiazide). These are all considered first-line treatments for hypertension [1.5.3, 1.2.3].

People may switch from metoprolol due to side effects such as fatigue, dizziness, depression, or shortness of breath [1.7.2]. Other reasons include the medication not being effective enough or the presence of other health conditions, like asthma or severe peripheral artery disease [1.7.2, 1.7.4].

While lifestyle changes like the DASH diet, regular exercise, weight loss, and stress reduction can significantly lower blood pressure, they are not direct replacements for a prescription medication like metoprolol for diagnosed conditions. They are a critical part of a comprehensive treatment plan [1.10.3].

Switching from metoprolol should be done carefully under a doctor's guidance. This typically involves gradually reducing the metoprolol dose over one to two weeks to avoid withdrawal symptoms, while potentially starting the new medication [1.4.3, 1.4.4].