Does Metoprolol Cause High Potassium?

In our latest question and answer, the pharmacist discusses whether or not metoprolol can cause high potassium levels (i.e.hyperkalemia).

Dec 30, 2017

Dan asked

Hello. I'm taking Metoprolol 50mg and wondering if I'm okay with eating turkey and potatoes. I read that metoprolol can increase potassium levels?

Answer

Metoprolol, a beta blocker, isn't generally considered to be a contributing factor for hyperkalemia (i.e. high blood potassium levels). In addition, hyperkalemia is not a listed adverse reaction in the prescribing information for either Lopressor (immediate release metoprolol) or Toprol (extended release metoprolol).

Having said that, there have been rare case reports (such as this one) where metoprolol is thought to be a contributing factor in a hyperkalemia situation. However, most case reports state that hyperkalemia is not generally expected to happen in clinical practice.

Metoprolol is classified as a cardio-selective beta blocker, meaning that it is more selective for a specific beta receptor (beta 1) than other beta receptors in the body. Non-selective beta blockers, such as propranolol, are sometimes associated with hyperkalemia and many non-selective ones do have hyperkalemia listed as a possible side effect.

There are some studies that theorize how all beta blockers (not just non-selective ones) could increase potassium, but again, any link isn't conclusive.

Lastly, there are no known "food" interactions with metoprolol and the foods you mentioned (turkey, potatoes) should be okay to consume along with the medication. 

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