Most sources, and prescribing information inserts for all beta-blockers recommended tapering gradually over a 1-2 week period to reduce the risk of adverse effects. Sudden discontinuation of beta-blockers is particularly dangerous if treating coronary artery disease. Potential Side Effects From Abrupt Discontinuation Metoprolol ER (metoprolol succinate) has less side effects associated with it (versus metoprolol tartrate) because it is longer acting. The recommendation to gradually discontinue metoprolol is generally true for all beta-blocker medications, although some are associated with more side effects after abruptly stopping than others. When discontinuing chronically administered Lopressor, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1-2 weeks and the patient should be carefully monitored.' Lopressor Package Insert Per the prescribing information for Lopressor (metoprolol tartrate): 'Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred. Stopping metoprolol abruptly, or 'cold-turkey' can exacerbate chest pains and could potentially increase the risk of heart attack and other symptoms. Metoprolol, a beta-adrenergic antagonist (also known as a 'beta-blocker'), is generally recommended to be tapered (step-wise dose decreases) if you have been taking it chronically.
