Toprol XL

1 What is Toprol XL?

Brand: Toprol XL, Lopressor,

Generic: Metoprolol

Toprol XL is used in the treatment of hypertension, angina (chest pain). It is a selective beta-1 blocker. It works on the heart and decreases heart rate.

It also prevents the release of renin in the kidney (a hormone which causes vessels constriction) and so dilates and relaxes vessels, which lowers blood pressure to normal and increases the supply of oxygen and blood to the heart.

It is also used to treat or prevent a heart attack. It is available in the form of a tablet and only with doctor’s prescription.

2 What to Know Before Using

Your doctor will inform you of what you need to know before using Toprol XL.

Before starting the treatment your doctor should be informed about condition such as:

Allergy: Inform your doctor if you are allergic to any food, preservatives, dyes, or had an allergic reaction when you used this drug before.

Children: There are no adequate studies done which prove Metoprolol harmful effects in is not approved to be used by anyone younger than 18 years of age.

Elderly: This medicine does not cause any different side effects or problem than it does in younger adults. However, it should be used with caution if there are liver or heart problems.

Pregnancy: It is a category C drug. It should not be used in pregnancy. It is not known if it can cause harm or death to an unborn baby. Inform your doctor right away if you suspect you become pregnant while using it.

Breast Feeding: It can pass into breast milk and may harm your baby. If you are using Metoprolol while nursing, discuss it with your doctor for possible risk factors.

Drug Interactions: Metoprolol may interact with other drugs. Your doctor should be informed of any other medicines which you are taking. He may want to change the dosage or drug.

Some of them are listed below:

  • Prazosin.
  • Terbinafine.
  • An antidepressant : Bupropion, clomipramine, desipramine, duloxetine, fluoxetine, fluvoxamine, paroxetine, sertraline.
  • An ergot medicine: dihydroergotamine, ergonovine, ergotamine, methylergonovine.
  • Heart or blood pressure medications: Amlodipine, clonidine, digoxin, diltiazem, dipyridamole, hydralazine, methyldopa, nifedipine, quinidine, reserpine, verapamil, and others.
  • A mao inhibitor: Isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine.
  • Medicine to treat mental illness - Chlorpromazine, fluphenazine haloperidol, thioridazine.

Several other conditions may reduce its effectiveness.

Make sure you inform your doctor of conditions such as:

  • Asthma, chronic obstructive pulmonary disease (COPD), sleep apnea or other breathing disorder.
  • Diabetes (taking Metoprolol may make it harder for you to tell when you have low blood sugar).
  • Liver disease.
  • Heart diseases (heart failure, slow heartbeat, heart attack, heart block, heart rhythm problem).
  • Problems with circulation (such as Raynaud's syndrome).
  • Thyroid disorder.
  • Pheochromocytoma (tumor of the adrenal gland).
  • Blood circulation problem.

3 Proper Usage

To use Toprol XL properly, you must follow all instructions given by your doctor. Toprol XL only helps in reducing blood pressure. It does not cure blood pressure related problems.

It is very important to continue to take medicine as directed in order to keep blood pressure within normal range. You may need to use it for the rest of your life.

With Metoprolol, you should also control your weight and diet. Avoid foods which are rich in sodium (salt).

You should swallow it as a whole with a glass of water. Do not crush or chew it. Take it with or just after your meal.

Dosage: It is different for different patients. Dosage mentioned below is an average dose. You must follow your doctor’s command.

For High Blood Pressure:

Tablet form:

  • Adults: 100 milligrams (mg) per day as a single or in divided dose. The dose should not exceed 450 mg per day.

Extended release tablet form:

  • Adults: 25 to 100 milligrams (mg) per day. The dose should not exceed 400 mg per day.
  • Children 6 years of age and older: The dose is usually 1 milligram (mg) per kilogram (kg) of body weight per day. The dose should not exceed 50 mg per day.

For Chest Pain:

Extended release form and tablet form both:

  • Adults: 100 milligrams (mg) once a day. The dose should not exceed 400 mg per day.

For Acute Heart Attack and Heart Failure:

Tablets form:

  • Adults: At first, 50 milligrams (mg) every 6 hours for 2 days. Then 100 mg two times a day.

Extended-release tablets:

  • Adults: At first, 25 milligrams (mg) once a day for 2 weeks. In patients with severe heart failure, the starting dose is 12.5 mg once a day. Your doctor may adjust your dose as needed.

Missed dose: If you miss a dose, take it as soon as you remember it. If it almost a time for your next dose skips the missed dose and continue your daily schedule. Doubling the dose is harmful.

Storage: Store it at room temperature. Keep it away from children.

4 Precautions to Take

Before using Toprol XL, there are some precautions you must take. Your doctor should check your daily progress at regular visits. This drug may cause heart failure in some patients.

Inform your doctor if you are having chest pain or discomfort, difficulty in breathing, fatigue, swelling of the face, hands, legs and sudden weight gain. These are signs of heart failure.

Your doctor will gradually reduce the dose of Metoprolol before stopping it completely. It is dangerous to suddenly stop taking the drug.

Your blood sugar level may change while using this drug. It can also suppress signs of low blood sugar level such as high pulse rate.

Tell your doctor or dentist that you take Metoprolol before you receive any medical or dental care, emergency care, or surgery.

While using Metoprolol get up slowly from lying or sitting position as you may feel Dizziness, lightheadedness, or even fainting on sudden rising up from bed or chair.

5 Potential Side Effects

Make sure you meet with your doctor in using Toprol XL to avoid unwanted potential side effects. All medicines have some side effects. Some people may experience none or minor side effects.

Consult with your doctor if they become problematic or frequent:

More common are:

Less common:

  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • Cough
  • Decreased urine output
  • Difficult or labored breathing
  • Difficulty with speaking
  • Dilated neck veins
  • Disturbed color perception
  • Double vision
  • Extreme fatigue
  • Fast, pounding, or racing heartbeat or pulse
  • Halos around lights
  • Headache
  • Inability to move the arms, legs, or facial muscles
  • Inability to speak
  • Irregular breathing

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.