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Toprol XL extended-release tablets

Pronunciation

Generic Name: metoprolol succinate (MET-oh-PROE-lol SUX-i-nate)
Brand Name: Toprol XL

Do not suddenly stop taking Toprol XL extended-release tablets. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop Toprol XL extended-release tablets. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take Toprol XL extended-release tablets for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Toprol XL extended-release tablets again.

Tell your doctor or dentist that you take Toprol XL extended-release tablets before you receive any medical or dental care, emergency care, or surgery.

Tell your doctor if you have a history of diabetes or if you take medicine to lower your blood sugar (eg, glyburide, insulin). Toprol XL extended-release tablets may hide signs of low blood sugar, such as fast heartbeat. Be sure to watch for other signs of low blood sugar (eg, anxiety, chills, dizziness, drowsiness, fainting, headache, tremor, unusual sweating, vision changes, weakness). Tell your doctor right away if these effects occur.

Toprol XL extended-release tablets should not usually be used by patients who have a history of certain lung or breathing problems (eg, asthma) or who have a certain type of adrenal gland tumor (pheochromocytoma). It may worsen these conditions. Tell your doctor if you have a history of breathing problems or adrenal gland tumors. If you have these conditions and must take Toprol XL extended-release tablets, your doctor may need to adjust your dose or prescribe additional medicine to reduce the risk of side effects. Check with your doctor for more information.

Tell your doctor if you have a history of overactive thyroid. Toprol XL extended-release tablets may hide symptoms of overactive thyroid (eg, fast heartbeat). Do not suddenly stop taking Toprol XL extended-release tablets; suddenly stopping Toprol XL extended-release tablets could worsen your condition. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. Check with your doctor for more information.


Toprol XL extended-release tablets is used for:

Treating high blood pressure, alone or with other medicines; long-term treatment of chest pain; and treating certain types of heart failure. It may also be used for other conditions as determined by your doctor.

Toprol XL extended-release tablets is a beta-adrenergic blocking agent (beta-blocker). It works by reducing the amount of work the heart has to do (reduces chest pain) and the amount of blood the heart pumps out (lowers high blood pressure). It is also used to stabilize the heart rhythm in conditions in which the heart is beating too fast or in an irregular rhythm.

Do NOT use Toprol XL extended-release tablets if:

  • you are allergic to any ingredient in Toprol XL extended-release tablets or to another beta-blocker (eg, propranolol)
  • you have a very slow heart rate (eg, bradycardia), certain types of irregular heartbeat (eg, atrioventricular [AV] block, sick sinus syndrome), moderate to severe heart failure, very low systolic blood pressure (less than 100 mm Hg), or severe blood circulation problems
  • you are taking mibefradil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Toprol XL extended-release tablets:

Some medical conditions may interact with Toprol XL extended-release tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have an adrenal gland tumor (pheochromocytoma), an overactive thyroid, or are scheduled to have surgery
  • if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; blood circulation problems; or liver problems
  • if you have diabetes mellitus, chronic obstructive pulmonary disease (COPD), bronchitis, breathing problems, or a history of asthma

Some MEDICINES MAY INTERACT with Toprol XL extended-release tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Amiodarone, bupropion, cimetidine, digoxin, diltiazem, diphenhydramine, disopyramide, flecainide, certain HIV protease inhibitors (eg, ritonavir), hormonal contraceptives (eg, birth control pills), hydralazine, hydroxychloroquine, ketanserin, mefloquine, mibefradil, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), phenothiazines (eg, thioridazine), propafenone, propylthiouracil, quinazolines (eg, alfuzosin), quinidine, reserpine, certain selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine), terbinafine, or verapamil because serious side effects, such as very slow heart rate, very low blood pressure, fainting, severe dizziness, or lightheadedness when standing, may occur
  • Clonidine because stopping either of these medicines suddenly can lead to a rapid increase in blood pressure
  • Barbiturates (eg, phenobarbital), indomethacin, or phenylpropanolamine because they may decrease Toprol XL extended-release tablets's effectiveness
  • Bupivacaine, disopyramide, flecainide, hydralazine, ketanserin, or lidocaine because the risk of their side effects may be increased by Toprol XL extended-release tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Toprol XL extended-release tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Toprol XL extended-release tablets:

Use Toprol XL extended-release tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Toprol XL extended-release tablets by mouth either always with food or immediately following a meal, at the same time each day.
  • Toprol XL extended-release tablets may be broken in half. Swallow the tablets or half tablets whole. Do not crush or chew before swallowing.
  • If you miss a dose of Toprol XL extended-release tablets, take it if you remember the same day. If you do not remember until the next day, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you miss more than one dose, check with your doctor or pharmacist.

Ask your health care provider any questions you may have about how to use Toprol XL extended-release tablets.

Important safety information:

  • Toprol XL extended-release tablets may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Toprol XL extended-release tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Toprol XL extended-release tablets may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Do not suddenly stop taking Toprol XL extended-release tablets without first consulting your doctor. If your doctor decides you should no longer use Toprol XL extended-release tablets, you will need to stop Toprol XL extended-release tablets gradually according to your doctor's instructions.
  • If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so.
  • Do not take any medicines used to treat colds or congestion without first consulting with your doctor or pharmacist.
  • Diabetes patients - Toprol XL extended-release tablets may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs or low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Tell your doctor or dentist that you take Toprol XL extended-release tablets before you receive any medical or dental care, emergency care, or surgery.
  • If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Toprol XL extended-release tablets.
  • Lab tests, including liver function and blood cholesterol levels, may be performed while you use Toprol XL extended-release tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Toprol XL extended-release tablets should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Toprol XL extended-release tablets while you are pregnant. Toprol XL extended-release tablets is found in breast milk. If you are or will be breast-feeding while you use Toprol XL extended-release tablets, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Toprol XL extended-release tablets:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; dry mouth or eyes; gas; headache; heartburn; lightheadedness; mild drowsiness; muscle aches; nausea; stomach pain; trouble sleeping; unusual tiredness or weakness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); blue or unusually cold hands or feet; chest pain; chills, fever, or sore throat; fainting; hallucinations; mood or mental changes (eg, confusion, depression, foggy thinking, short-term memory loss); pounding in the chest; severe dizziness or lightheadedness; shortness of breath; slow or irregular heartbeat; swelling of the arms, hands, and feet; unusual bruising or bleeding; vision changes; wheezing; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blue skin discoloration; difficult or slowed breathing; fainting; impaired consciousness; severe dizziness; very slow heart rate; vomiting; weakness.

Proper storage of Toprol XL extended-release tablets:

Store Toprol XL extended-release tablets at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Toprol XL extended-release tablets out of the reach of children and away from pets.

General information:

  • If you have any questions about Toprol XL extended-release tablets, please talk with your doctor, pharmacist, or other health care provider.
  • Toprol XL extended-release tablets is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Toprol XL extended-release tablets or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Toprol XL extended-release tablets. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Toprol XL extended-release tablets. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Toprol XL extended-release tablets.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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