# Metoprolol in Nigeria

Metoprolol has 2 active NAFDAC registrations in our October 2026 copy of the register, from 1 registration holder; 5 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/metoprolol/
- Drug class: Cardioselective beta-1 blocker (Hypertension)
- Also known as: Metoprolol succinate, Metoprolol tartrate, Betaloc ZOK, Metap-XL, Lopressor
- Prescription required: yes
- Last updated: October 2026

## Price in Nigeria

As of October 2026, Metoprolol tablets sell for about ₦885 per tablet online in Nigeria (packs ₦9,100–₦35,570; Betaloc) at HealthPlus and MedPlus. Open-market prices (e.g. Idumota, Ogbogwu) are often lower.

## What is Metoprolol?

Metoprolol is a beta-blocker that acts mainly on the heart (a cardioselective, beta-1 blocker). It slows the heart rate, reduces the force of each beat and lowers blood pressure, which cuts the heart's demand for oxygen. That is why it is used for angina, after a heart attack, for fast or irregular heart rhythms and, in its slow-release form, for heart failure — where it is one of the few medicines shown to help people live longer.

Two salts exist and they are not interchangeable tablet for tablet: metoprolol tartrate is the short-acting form taken two or three times a day, and metoprolol succinate is the once-daily extended-release form used in heart failure. Every metoprolol product in our copy of the NAFDAC register is an extended-release succinate tablet: AstraZeneca's Betaloc ZOK (the originator, 25 mg and 50 mg Active, the 100 mg recorded Inactive), Micro Nova's Metap-XL 25 and 50, and Onifam's Metwise ER 50, the last three made in India.

Metoprolol is not usually the first tablet a Nigerian doctor reaches for in plain high blood pressure. Nigerian and international guidelines favour a calcium channel blocker such as amlodipine or a thiazide-type diuretic first for Black African patients, who on average respond better to them; a beta-blocker is added when there is a separate reason for one — angina, a previous heart attack, heart failure, a racing pulse. If you have been prescribed metoprolol for blood pressure alone, it is worth asking why, but it is never a reason to stop it on your own.

## What is Metoprolol used for?

- Chronic heart failure with reduced pumping function (extended-release succinate), alongside other heart-failure medicines
- Angina pectoris — preventing exertional chest pain
- After a heart attack, to lower the risk of another and of dangerous rhythms
- High blood pressure, usually in combination with other medicines or where a beta-blocker is specifically indicated
- Rate control in atrial fibrillation and other fast heart rhythms; symptoms of an overactive thyroid; migraine prevention

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: Taken once daily in the morning, with or after food, swallowed whole — extended-release tablets must not be crushed or chewed, though scored ones may be halved. For high blood pressure or angina a typical dose is 50 to 100 mg once daily, up to 200 mg. For heart failure the doctor starts very low — 12.5 to 25 mg once daily — and doubles the dose roughly every two weeks as tolerated towards a target of 200 mg, watching pulse and blood pressure at each step; this slow climb is the whole point, and a bigger starting dose can make heart failure worse. Doses here are the usual ranges, not a prescription.
- Children: Used only by paediatric cardiologists, for conditions such as high blood pressure or certain rhythm problems, with the dose calculated by weight. Not a medicine to give a child without specialist direction.
- Elderly: No routine dose change, but older adults are more prone to a slow pulse, dizziness on standing and tiredness, so doctors start at the lower end and raise it more slowly.

Do not stop metoprolol suddenly. Abrupt withdrawal after regular use can bring on severe angina, a heart attack or a dangerous rhythm within days; if it must be stopped, the dose is tapered over one to two weeks under a doctor. Check your pulse when you first start — a resting rate below 50 beats a minute, or dizziness and fainting, should be reported before the next dose.

## Side effects

Common: Tiredness, low energy and reduced exercise tolerance, especially in the first weeks; Cold hands and feet; a slow pulse; Dizziness or light-headedness, particularly on standing; Disturbed sleep and vivid dreams; low mood; Erectile difficulty in some men; nausea or stomach upset.

Serious (seek medical help immediately): A very slow heartbeat (under 50) with faintness, or actual fainting — possible heart block; Worsening breathlessness, swollen ankles or sudden weight gain in someone with heart failure, especially after a dose increase; Wheezing or tightness in the chest in anyone with asthma or COPD — cardioselective, but not completely so; In people with diabetes, a hypo whose warning signs (racing heart, tremor) are masked — sweating may be the only clue.

When to see a doctor: See a doctor promptly for fainting, a resting pulse under 50, new or worsening breathlessness or ankle swelling, wheeze, or very cold, painful fingers and toes. Tiredness and dizziness in the first fortnight often settle; if they do not, the dose can be adjusted rather than the medicine abandoned.

## Warnings

Do not take if: Second- or third-degree heart block, sick sinus syndrome, or a resting heart rate under 50 before treatment; Severe low blood pressure, cardiogenic shock, or heart failure that is acutely decompensated (fluid overloaded) — treat that first, then start the beta-blocker slowly; Severe asthma or a history of bronchospasm — relative; a cardioselective blocker may be used with great care by a specialist; Severe peripheral arterial disease with rest pain or gangrene; Untreated phaeochromocytoma (an adrenaline-producing tumour); known allergy to metoprolol.

Interactions: Verapamil and diltiazem — the combination can cause severe slowing of the heart and heart block; avoid or specialist supervision only; Digoxin, amiodarone and clonidine — additive slowing of the pulse; clonidine must not be stopped before the beta-blocker; Insulin and sulfonylureas (glibenclamide, glimepiride) — the beta-blocker hides the early signs of a hypo; Fluoxetine, paroxetine, bupropion and other CYP2D6 inhibitors raise metoprolol levels; rifampicin lowers them; NSAIDs such as ibuprofen and diclofenac blunt its blood-pressure effect and strain the kidneys when combined long term; Adrenaline (in an allergic emergency) works less well in someone on a beta-blocker — carry a note or alert card if you have severe allergies.

Pregnancy & breastfeeding: Metoprolol can be used in pregnancy when a beta-blocker is needed, though in Nigeria labetalol or methyldopa are the usual first choices for high blood pressure in pregnancy; prolonged use can slow the baby's growth and heart rate, so it needs obstetric follow-up. Only small amounts pass into breast milk and breastfeeding is generally considered compatible — watch the baby for unusual sleepiness or a slow pulse.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Betaloc ZOK 25 (AstraZeneca Nigeria Limited, made in Sweden); Betaloc ZOK 50 (AstraZeneca Nigeria Limited, made in Sweden); Betaloc ZOK 100 (AstraZeneca Nigeria Limited, made in Sweden); Metap-XL 25 (Micro Nova Pharmaceuticals Ind Ltd, made in India); Metap-XL 50 (Micro Nova Pharmaceuticals Ind Ltd, made in India); Metwise ER 50 (Onifam Laboratories Limited, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/metoprolol/brands/

## How to verify it is genuine

1. Check the pack for its NAFDAC registration number. In our copy of the register Betaloc ZOK 25 (A4-6203) and Betaloc ZOK 50 (A4-6202) are Active; Metap-XL 25 (B4-0556), Metap-XL 50 (B4-0555) and Metwise ER 50 (C4-1850) are recorded Inactive since 2026
2. Betaloc ZOK 100 mg (04-6204) is recorded as Inactive in our copy, its registration having run out in August 2026 — a renewal matter for the holder, not proof a pack is fake, but confirm it on the official Greenbook
3. Enter the number in our free NAFDAC checker and confirm the product name, strength and holder match the pack; several registrations here expire within the next year, so a lapse can appear between refreshes
4. Check the salt and the release form on the box: an extended-release succinate tablet is not swapped for an immediate-release tartrate one at the same milligram figure without a doctor's say-so

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### Is metoprolol NAFDAC approved in Nigeria?

Yes. Our copy of the NAFDAC register holds Active registrations for AstraZeneca's Betaloc ZOK 25 and 50 (A4-6203, A4-6202); Micro Nova's Metap-XL 25 and 50 (B4-0556, B4-0555) and Onifam's Metwise ER 50 (C4-1850) are recorded Inactive since 2026, as is the Betaloc ZOK 100 mg entry. Check the number on your own pack in our NAFDAC checker.

### What is the difference between metoprolol succinate and metoprolol tartrate?

Same active drug, different salt and different release. Tartrate is the immediate-release form, taken two or three times a day; succinate is the once-daily extended-release form (the ZOK, XL and ER in the Nigerian brand names) and is the one proven to help in heart failure. Every metoprolol product registered in Nigeria in our copy of the register is the extended-release succinate form. They are not swapped milligram for milligram without a doctor.

### Why was I given metoprolol instead of amlodipine for my blood pressure?

Usually because you have a second reason for a beta-blocker: a fast heart rate, palpitations, angina, a previous heart attack or heart failure. For blood pressure alone, Nigerian and international guidance generally starts Black African patients on a calcium channel blocker such as amlodipine or a thiazide-type diuretic, which lower blood pressure more reliably in this population. Ask your doctor what the beta-blocker is doing for you — and do not stop it on your own, because stopping suddenly is dangerous.

### Can I stop metoprolol if I feel fine?

Not suddenly. Stopping a beta-blocker abruptly after weeks or months of use can cause rebound: a racing heart, severe angina, a heart attack or a dangerous rhythm within days. If there is a reason to stop — side effects, pregnancy planning, a change of treatment — the dose is reduced step by step over one to two weeks under a doctor.

### Is metoprolol safe for asthmatics?

It is safer than non-selective beta-blockers such as propranolol because it acts mainly on the heart, but it is not completely selective, and at higher doses it can still tighten the airways. People with mild, well-controlled asthma are sometimes prescribed it by a specialist when the heart benefit is large; anyone with asthma who starts to wheeze on it should seek advice promptly rather than increase their inhaler.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)