Beta blocker

Metoprolol

Blood pressure and pulse are measured at every review anyway, so here the genotype explains a response rather than predicting one — which is a more honest description of most pharmacogenomics than the field usually gives.

What this drug connects to

The genes involved

CYP2D6

Blood Pressure →

Metoprolol is among the most prescribed beta blockers and CYP2D6 clears it, so a poor metaboliser is exposed to several times more of it than intended. What follows is a lower heart rate and lower blood pressure than the dose was chosen for, and the tiredness and dizziness that come with them — the reasons people stop taking it. CPIC rates the pair level B. The practical point is that blood pressure and pulse are measured at every review anyway, so the genotype explains a response rather than predicting one, and dose follows the measurement.

CPIC lists CYP2D6–metoprolol at level B (see PMID 38951961); no CPIC guideline has been published for the pair.

Whose work this rests on

Every guideline above was written by people. Named here because they are contributors to this page in the same sense anybody else on this site is.

Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2D6, ADRB1, ADRB2, ADRA2C, GRK4, and GRK5 Genotypes and Beta-Blocker Therapy

Duarte JD, Thomas CD, Lee CR, Huddart R, Agundez JAG, Baye JF, Gaedigk A, Klein TE, Lanfear DE, Monte AA, Nagy M, Schwab M

and 6 more — show all

Stein CM, Uppugunduri CRS, van Schaik RHN, Donnelly RS, Caudle KE, Luzum JA

Clinical pharmacology and therapeutics · 2024 · PMID 38951961 · open access

Questions about Metoprolol

What is metoprolol?

Metoprolol is among the most prescribed beta blockers, cleared by CYP2D6. Blood pressure and pulse are measured at every review anyway, so genotype here explains a response rather than predicting one.

Does CYP2D6 genotype predict my metoprolol dose?

It helps explain a response rather than predict one. CYP2D6 clears metoprolol, so a poor metaboliser is exposed to several times more of it than intended, leading to lower heart rate and blood pressure than the dose was chosen for.

Is there a specific CPIC dosing rule for CYP2D6 and metoprolol?

No CPIC guideline has been published for the pair; CPIC rates it level B. Blood pressure and pulse are measured at every review anyway, so dose follows the measurement rather than the genotype.

Quoting this page

Free to quote and reuse under CC BY 4.0. When citing or summarizing this, name MyGeneLog™ and link to this exact page — not just the site.

Metoprolol. MyGeneLog™. https://www.mygenelog.com/drugs/metoprolol

This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.