Toprol - metoprolol
(me TOE proe lole)
Lopressor, Toprol XL
Toprol-XL, metoprolol succinate, is a beta1-selective (cardioselective) adrenoceptor blocking agent, for oral administration, available as extended release tablets. Toprol-XL has been formulated to provide a controlled and predictable release of metoprolol for once daily administration. The tablets comprise a multiple unit system containing metoprolol succinate in a multitude of controlled release pellets. Each pellet acts as a separate drug delivery unit and is designed to deliver metoprolol continuously over the dosage interval. The tablets contain 47.5 mg, 95 mg and 190 mg of metoprolol succinate equivalent to 50, 100 and 200 mg of metoprolol tartrate, USP, respectively. Its chemical name is (±) 1-(isopropylamino)-3-[p-(2-methoxyethyl) phenoxy]-2-propanol succinate (2:1) (salt).
Metoprolol succinate is a white crystalline powder with a molecular weight of 652.8. It is freely soluble in water; soluble in methanol; sparingly soluble in ethanol; slightly soluble in dichloromethane and 2- propanol; practically insoluble in ethyl-acetate, acetone, diethylether and heptane. Inactive ingredients: silicon dioxide, cellulose compounds, sodium stearyl fumarate, polyethylene glycol, titanium dioxide, paraffin.
What is the most important information I should know about Toprol?
• Do not stop taking Toprol without first talking to your doctor. Stopping Toprol abruptly may cause your condition to become worse.
• Call your doctor immediately if you experience shortness of breath.
• Use caution when driving, operating machinery, or performing other hazardous activities. Toprol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
What is Toprol?
• Toprol is in a class of drugs called beta-blockers. Beta-blockers affect the heart and circulatory system.
• Toprol is used to reduce hypertension (high blood pressure), to treat chest pain (angina), to treat heart failure, and to reduce the risk that a heart attack will recur.
• Toprol may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking Toprol?
• Before taking Toprol, tell your doctor if you have
· asthma;
· a heart problem such as low blood pressure, a slow heart rate, heart block, sick sinus syndrome, a pacemaker, heart failure, and others;
· diabetes;
· depression;
· thyroid disease;
· kidney disease;
· liver disease; or
· any type of circulatory disease.
• You may not be able to take Toprol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Toprol is in the FDA pregnancy category C. This means that it is not known whether Toprol will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Toprol passes into breast milk in small amounts and may affect a nursing baby. Do not take Toprol without first talking to your doctor if you are breast-feeding a baby.
How should I take Toprol?
• Take Toprol exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Take Toprol with food or immediately following a meal.
• Do not crush or chew the extended-release tablets and capsules (e.g., Toprol XL). The tablets can be divided in half if prescribed by your doctor and the half tablet should be swallowed whole, without crushing or chewing. These tablets are specially formulated to release the medication slowly in the body.
• It is important to take Toprol regularly to get the most benefit.
• Do not stop taking Toprol without first talking to your doctor. Stopping Toprol abruptly may cause your condition to become worse.
• Your doctor may want you to have blood pressure monitoring or other medical evaluations during treatment with Toprol to monitor progress and side effects.
• Store this medication at room temperature away from moisture and heat.
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What happens if I miss a dose?
• Take the missed dose as soon as you remember. If it is almost time for the next dose however, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.
What happens if I overdose?
• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Toprol overdose include a slow heart beat, shortness of breath, fainting, dizziness, weakness, confusion, nausea, and vomiting.
What should I avoid while taking Toprol?
• Use caution when driving, operating machinery, or performing other hazardous activities. Toprol may cause drowsiness, dizziness, and blood pressure changes. If you experience drowsiness or dizziness, avoid these activities.
• Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking this medication.
• Tell your doctor and dentist that you are taking this medication before having surgery.
What are the possible side effects of Toprol?
• If you experience any of the following serious side effects, stop taking Toprol and contact your doctor immediately or seek emergency medical treatment:
· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; hives);
· wheezing or shortness of breath;
· an unusually slow or irregular heartbeat;
· swelling of the feet and lower legs;
· leg pain or cramping;
· sudden weight gain (more than 2 pounds in one day or 5 pounds in one week);
· chest (heart) pain;
· unusually cold or blue feet and hands; or
· skin rash.
• If you experience any of the following less serious side effects, continue taking Toprol and talk to your doctor:
· fatigue or confusion;
· headache or dizziness;
· weak pulse or mildly slow heart rate;
· diarrhea, constipation, gas, nausea, or vomiting;
· depression; or
· nightmares.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Toprol?
• Before taking Toprol, tell your doctor if you are taking
· a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cardizem, Dilacor XR), clonidine (Catapres), digoxin (Lanoxin), doxazosin (Cardura), guanadrel (Hylorel), prazosin (Minipress), or terazosin (Hytrin);
· a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);
· a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen (Orudis, Orudis KT, Oruvail), and others;
· a respiratory medication such as albuterol (Ventolin, Proventil, Volmax, others), bitolterol (Tornalate), metaproterenol (Alupent, Metaprel), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), or theophylline (Theo-Dur, Theochron, Theolair, others), and others;
· the stomach medication cimetidine (Tagamet, Tagamet HB); or
· prescription or over-the-counter cough medicines, cold medicines, or diet pills.
• You may not be able to take Toprol, or you may require a dosage adjustment or special monitoring during treatment.
• Drugs other than those listed here may also interact with Toprol or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
Where can I get more information?
• Your pharmacist has additional information about Toprol written for health professionals that your may read.
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• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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