propranolol vs metoprolol comparison illustration

Propranolol vs Metoprolol: Choosing the Right Beta Blocker for You

While propranolol and metoprolol are both beta blockers with similar properties and mechanisms of actions, they they are different compounds and have distinct similarities and differences that should be understood before taking either of them.

What are Beta Blockers?

Beta blockers are drugs that work to lower a person’s blood pressure.  They do so by blocking the adrenaline (or epinephrine) from binding to beta receptors in your body, causing your heart to beat slower, thereby lowering blood pressure.  What is interesting about beta blockers is that some can affect the heart, while others work more on the blood vessels.  This is one of the reasons why there is more than one out there, and it is why you must talk to your doctor thoroughly about this decision and allow them to make the final, educated call on what you should be taking. 

What is Propranolol?

Propranolol is a form of beta blocker that has been around for quite a long time now.  First developed in the 1960s and brought to market, the drug was originally intended to be used for treating chest pain and lowering blood pressure.  However, it soon became obvious that there were other positive uses for the drug as well.  Doctors and researchers soon became aware of it being able to help with migraines, hand tremors, and even event driven performance anxiety in some instances.  Because of it, it is one of the most versatile drugs out there.  On top of that, it’s relatively inexpensive as well, making it very appealing to a large group of people (one of the most commonly prescribed drugs in 2017).

What is Metoprolol?

Metoprolol is yet another beta blocker, and it, too, has been around the block for a while now as well.  It was introduced to the market in 1978 by the Novartis brand, and since then it has been developed by various companies within the drug realm.  While Metoprolol can be utilized for purposes other than the main ones, it is usually prescribed to take on angina (chest pain), and hypertension.  It can also be used to lessen the chances of heart failure as well. 

Alternate Uses

We touched on how versatile Propranolol can be a bit earlier, but we should dive into it a little bit more here by looking at them head-to-head.  If you have symptoms apart from chest pain or high blood pressure, then you’re more likely to be put on Propranolol than you are to be put on Metoprolol.  We have been able to find where people have been put on Metoprolol before, but the history of it is just not as defined as with Propranolol. 

Those years might not seem like a big difference, but Propranolol had over a decade gap to Metoprolol, and that helped them get out in front and understand it better.  Recently, there have even been studies that show encouraging results for PTSD patients taking Propranolol.  So, there could be even more uses for the drug that emerge in the coming years. 

Both drugs can be prescribed for heart-related problems or for higher than normal blood pressure.  Both have been used on migraines and for hand tremors, but more than likely Propranolol will be used for each.  When it comes to anxiety, it would almost always end up being Propranolol, and the same goes for PTSD, though the research is still fairly new on that. 

As for why Propranolol is considered to be better at attacking anxiety, the reason has to do with how well it crosses the ‘blood-brain barrier.’  Both drugs do cross it, so you can see Metoprolol used.  However, Propranolol has shown to be more effective at doing so.  Therefore, that is the drug that most doctors will prescribe to you if you have that specific condition. 

Side Effects

With Propranolol and Metoprolol, the same basic side effects are going to be present when taking them.  As they are both beta blockers, there is not a whole lot of difference between the two, making them react in the same sort of manner as the other would.  As such, you can generally view the side effects for one and assume they exist for the other. 

When taking either of these beta blockers, you might experience things such as cramps, diarrhea, constipation, insomnia, nausea, feeling lightheaded, memory loss, lower blood pressure (that one is the point), shortness of breath, feeling cold, and fatigue, among others. 

Having said all of that, there are some differences to note.  When you are on Metoprolol, you will notice that you have less tolerance for exercise than when you are on Propranolol.  Indigestion also seems to be a common issue that Propranolol does not have. 

Meanwhile, Propranolol can cause you to have a slower heart rate than Metoprolol can.  This may not seem like a very big deal to most people, but it could have a profound impact on your body.  So, it is vital to understand how and why both are different as you go to discuss what is best with your doctor. 

Addiction and Dependence Issues

A question that many people will tend to wonder about with any drug they may be researching is about how well (or poorly) it does in terms of addiction and dependence.  With both Propranolol and Metoprolol, as well as other beta blockers as well, you don’t have very much to worry about unlike benzos and others classes of drugs frequently prescribed.  Both drugs are not narcotic and are not considered to be ‘controlled substances.’  There is very little chance that abuse could take place, though it could be used in the wrong manner, just as any drug could be. 

Risk of Addiction and Dependance

Because both Metoprolol and Propranolol are so closely related to one another, we can treat them the same way when we speak about how to come off of them.  While they do have different half-lifes (Metoprolol is about 4 hours and Propranolol is almost 6.5), they still are going to need to be addressed in the same manner.  Anyone that is coming off of them should only do so if instructed by their doctor. 

The reason why is because it can increase the chances of a heart attack should you come off of them suddenly.  If you are on either of them for a purpose that is not related to the heart or lowering your blood pressure, this is probably not going to be as big of an issue.  Still yet, it would be wise to consult with your doctor on how and when to come off of them.  You may need to be tapered off, so make sure to ask and discuss this in detail. 

Missed Doses and Overdoses

Once again, we see a lot of commonality here, so we don’t need to go into minute details as far as missed doses and overdoses go.  With each, you do need to be careful to follow the doctor’s exact instructions.  But sometimes we forget or make mistakes, and if they occur, here’s what to do.  With both Metoprolol and Propranolol, you should get contact poison control or seek medical attention immediately if you have overdosed.  This can cause your heart rate, blood sugar, or blood pressure to plummet, so it’s best to make 100% sure you’re going to be safe.  If you miss a dose, then it is suggested that you just skip it if you are on Metoprolol.  Take it the next time around. 

For the short-acting version Propranolol, it’s a bit different, in that they want you to take it if you are not within four hours of the next dose.  If you are within those four hours, then skip it.  If you are taking the extended release, then change the four above to eight, and you will know what to do.  With either drug, you should never look to ‘make up’ for a missed dose by taking extras.

Don’t Take Them If…

All beta blockers are going to make certain people susceptible to increased risks, so regardless of which you choose, Propranolol or Metoprolol, you have some things to be on the lookout for. 

The main things are that if you are someone with diabetes or someone that has breathing problems, then you need to discuss those thoroughly with your doctor.  In most cases, you will not be a good candidate for beta blockers.  Beta blockers can inhibit your ability to know (or ‘feel’) that your sugar is too low, and they can also slow your breathing down more than it already is.  There are others on the list that the two share together, like anyone with liver disease should refrain from taking it, but those are the main two to watch out for.  A complete medical history being available to your doctor should be enough to ensure that they help you by making the correct decision. 


When it comes to the type of drugs that Propranolol and Metoprolol are, they do have some differences to be aware of.  Propranolol comes in a few forms, while Metoprolol has just one.  Propranolol has the regular (or slow-acting) version of the medicine and they also have an extended release capsule ass well.  There is even a form of gel that is used for some infants that have certain conditions, while it can also be administered via IV in life-threatening situations. 

Metoprolol is very similar to Propranolol as it has the extended release capsule and the quicker version as well.  With each of them, you should refrain from chewing or crushing the extended release tablets, as those can work quicker if you do so, negating the purpose of them to begin with.  With the normal version, it is not frowned upon to do so. 

Propranolol vs Metoprolol Dosage

As a rule of thumb, you should always make sure to take any drug prescribed to you in the exact manner in which your doctor has told you to take it.  Having said that, both Propranolol and Metoprolol are very closely related in terms of dosage.  You won’t see a much larger dose of Metoprolol given than you would Propranolol.  One of the main differences that you will see, though, is how different the dose is for specific treatments. 

If you are taking either of these beta blockers for heart or blood pressure problems, you’re likely to get a consistently larger dose (80mg a day+) than you would if you were taking it for anxiety, hand tremors, or even migraine headaches ( usually only 10mg or 20mg as needed).  Again, it does vary, as some that are on them for hand tremors might take a higher dose, but in general, it will not be anywhere near as large of a dose as the two main problems the drugs were designed to treat.  The good news with that is that side effects are much less likely to weigh you down if you take a smaller dose. 

Conclusion: Which Beta Blocker is the Best For You?

Picking which beta blocker is best for you can be a tricky choice to make.  Thankfully, you don’t have to make it all alone.  You have medical professionals that can help you reach your goal, whatever that might be.  Most likely, if you are looking to deal with a problem that is not related to your heart or having high blood pressure, then you’ll end up going with Propranolol. 

It just has a longer history with treating other ailments, so your doctor is likely to turn to it.  It’s also probably going to be cheaper for you as well (prices can be tough given all the various insurance plans out there) due to the fact that it does have a generic version.  Ultimately, the two are pretty hard to split, and it will likely come down to what purpose the drug is going to be used for and the availability, as well as how comfortable your doctor is with prescribing that specific drug. 

If you are interested in seeing if propranolol is a good option for you, can help connect you with physicians who can prescribe and have the medication shipped to you if they feel it is appropriate for your situation.

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