Metoprolol

(Date: November 2020. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Metoprolol is used to treat high blood pressure (hypertension) and some heart problems.

What are the benefits of taking metoprolol in pregnancy?

Metoprolol reduces the risk from high blood pressure and some heart problems. This is important as these conditions can get worse during pregnancy and may lead to complications.

Some women will be taking metoprolol before pregnancy; if so, it should be continued but reviewed at the earliest opportunity by your midwife, GP, cardiologist, or obstetrician.

Are there any risks of taking metoprolol in pregnancy?

A small number of pregnant women specifically taking metoprolol have been studied, with no concerns raised that its use causes birth defects or preterm birth. Metoprolol belongs to a family of medicines called beta blockers. Studies have also not shown that beta blockers cause birth defects, stillbirth or preterm birth. Women taking beta blockers may be more likely to have a small baby. However, a small baby can be due to underlying health conditions that beta blockers are commonly used to treat, like high blood pressure. It is therefore difficult to know if a beta blocker has also contributed to the baby being small.

Occasionally, beta blockers used in late pregnancy can affect the baby for a short while after birth (for example, causing low blood sugar). The baby may require an extra day or two in hospital following birth to look out for any problems. If these occur, they can be easily treated and usually settle quickly.

Are there any alternatives to taking metoprolol?

Possibly. Other medicines can be used to treat high blood pressure and heart problems. You should let your midwife, GP and/or obstetrician know that you are taking metoprolol so that it can be reviewed as soon as possible. If you have any questions about a medicine that you are offered in pregnancy you should discuss them with your doctor or midwife.

What if I prefer not to take medicines in pregnancy?

It is very important to take any medicines prescribed for high blood pressure or heart problems. High blood pressure in pregnancy can lead to a condition called pre-eclampsia, which can be serious. Heart problems can also be dangerous to both mother and baby and must be as well-controlled as possible.

Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Please do not stop metoprolol without speaking to your midwife, GP, cardiologist or obstetrician.

Will my baby need extra monitoring?

You will be offered a detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. If you continue metoprolol then you may be offered additional scans at around 32 and 36 weeks to check that your baby is growing normally.

Are there any risks to my baby if the father has taken metoprolol?

We would not expect any increased risk to your baby if the father takes metoprolol.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system offers all pregnant women, and women who have been pregnant in the past, the opportunity to create their own digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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