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Very common (10% or more): Heart failure (up to 27.5%), hypotension (systolic blood pressure less than 90 mm Hg) (up to 27.4%), bradycardia (heart rate less than 40 beats per minute) (up to 15.9%), Common (1% to 10%): Cold extremities, arterial insufficiency, palpitation, first degree heart block (P-R interval 0.26 seconds or greater), second or third degree heart block, postural disorders Uncommon (0.1% to 1%): Cardiogenic shock in patients with acute myocardial infarction Rare (0.01% to 0.1%): Disturbances of cardiac conduction, cardiac arrhythmia Very rare (less than 0.01%): Intermittent claudication increased Frequency not reported: Claudication Common (1% to 10%): Tiredness, peripheral edema, accident and/or injury, death, fatigue Uncommon (0.1% to 1%): Edema, precordial pain Frequency not reported: Lactic dehydrogenase elevated Postmarketing reports: Chest pain Common (1% to 10%): Dizziness, vertigo, stroke, headache Uncommon (0.1% to 1%): Paresthesia, somnolence, impaired concentration Rare (0.01% to 0.1%): Alertness decreased Very rare (less than 0.01%): Amnesia/memory impairment, tinnitus, taste disturbance Frequency not reported: Short-term memory loss Postmarketing reports: Syncope Common (1% to 10%): Pruritus, rash Uncommon (0.1% to 1%): Sweating increased Rare (0.01% to 0.1%): Loss of hair Very rare (less than 0.01%): Photosensitivity reactions, psoriasis aggravated, gangrene in patients with preexisting severe peripheral circulatory disorders, hyperhidrosis, alopecia Common (1% to 10%): Depression Uncommon (0.1% to 1%): Insomnia, nightmare Rare (0.01% to 0.1%): Nervousness, anxiety Very rare (less than 0.01%): Confusion, hallucination, personality disorder, disturbances of libido Frequency not reported: Sleep disturbance Rare (0.01% to 0.1%): Liver function test abnormalities Very rare (less than 0.01%): Hepatitis Frequency not reported: Transaminase elevated, alkaline phosphatase elevated Postmarketing reports: Jaundice, non-specific hepatic dysfunction1. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.

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