Home Page > Categories > Heart & Cholesterol > Toprol XL (Metoprolol)

Toprol XL (Metoprolol)

 

Metoprolol (generic Toprol XL) Review

brand name: Lopressor
generic names: Metoprolol Tartrate, Metoprolol, Metoprolol tartrate

How does it work?

Metoprolol belongs to a group of medicines called beta-blockers, which block beta receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals as they are responsible for the body's reaction to stressful situations.

Blocking the beta receptors in the heart causes the heart to beat more slowly and with less force. The heart therefore uses less energy and the pain of angina is prevented. Abnormal heart rhythms are also prevented.

Due to the heart beating more slowly and with less force, the pressure at which blood is pumped out of the heart to the rest of the body is reduced. This is just one of the ways in which beta blockers help to reduce blood pressure, however the whole mechanism is not fully understood.

Metoprolol is used to decrease symptoms such as rapid heart rate, sweating and tremor which are associated with thyrotoxicosis.

It is also used to prevent migraine, although it is not fully understood how metoprolol works in this area.

What do the pills look like?

Metoprolol (Toprol) is available with a prescription under the brand names Lopressor and Toprol XL. Other brand or generic formulations of this medication may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Toprol XL 200 mg extended-release tablets--white, oval, film-coated, scored tablets
• Toprol XL 100 mg extended-release tablets--white, round, film-coated, scored tablets
• Toprol XL 50 mg extended-release tablets--white, round, film-coated, scored tablets
• Lopressor 100 mg--light-blue, capsule-shaped, scored tablets
• Lopressor 50 mg--pink, capsule-shaped, scored tablets

• 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, allergic reactions, drug interactions, warnings, precautions, directions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
• Remember, never share your medicines with others, keep this and all other medicines out of the reach of children, and use this medication only for the indication prescribed.

Copyright 1996-2006 Cerner Multum, Inc. Version: 9.05. Revision Date: 06/07/2007 2:21:50 PM.

Special warnings about Lopressor

If you have a history of congestive heart failure, Lopressor should be used with caution. If you are taking the extended release form of this drug, Toprol-XL, to relieve heart failure, the condition may temporarily be worsened as your dosage is increased. Be sure to alert your doctor to any signs of worsening heart failure such as weight gain or increasing shortness of breath. If you have peripheral vascular disease, use Toprol-XL with caution.

If you have pheochromocytoma and your doctor prescribes Toprol-XL, you will first need to take an alpha-blocking drug (a different type of blood pressure medication).

Notify your doctor if you have any difficulty in breathing.

Lopressor may cause you to become drowsy or less alert; therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know how you respond to this medication.

Notify your doctor or dentist that you are taking Lopressor if you have a medical emergency, or before you have surgery or dental treatment.

This medication may mask some symptoms of low blood sugar in diabetics or alter blood sugar levels. If you are diabetic, discuss this with your doctor.

Ask your doctor if you should check your pulse while taking Lopressor. This medication can cause your heartbeat to become too slow.

Do not stop Lopressor abruptly. This can cause increased chest pain and heart attack. Dosage should be gradually reduced.

If you suffer from asthma, seasonal allergies or other bronchial conditions, or liver disease, this medication should be used with caution.

How can this medicine affect other medicines?

When taken with other medicines that decrease blood pressure there is an increased risk of a large drop in blood pressure.

There may be an increased risk of slow heart rate when Metoprolol (Toprol) is taken with digoxin.

In diabetic people, Metoprolol can prolong the lowering of blood sugar (hypoglycaemia) caused by insulin or other antidiabetic medicines. Individuals should monitor their blood sugar, as Metoprolol can also mask the signs of hypoglycaemia.

When Metoprolol (Toprol) is taken with calcium channel blockers such as the risk of slow heart rate, verapamil, hypotension and heart failure may be increased. Verapamil should be avoided with this medicine.

If Metoprolol is taken together with clonidine, there is a risk of a rebound increase in blood pressure if clonidine is stopped. Metoprolol should be stopped several days before slowly stopping the clonidine.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin may reduce the antihypertensive effects of Metoprolol (Toprol).

Care should be taken when adrenaline is given with Metoprolol as this combination can cause severely high blood pressure and slow heart rate.

Rifampicin increases the removal of this medicine from the body.

The use of certain anaesthetics with Metoprolol (Toprol) may increase the risk of low blood pressure and slow heart rate.

When lignocaine is taken together with Metoprolol the blood level of lignocaine may be increased.

Anti-arrhythmic medicines such as amiodarone or dipyridamole may increase the risk of slow heart rate when taken with this medicine.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a Metoprolol overdose may include uneven heartbeats, fainting, weakness, dizziness, bluish-colored fingernails, shortness of breath, or seizure (convulsions).

Overdosage

Any medication taken in excess can cause symptoms of overdose. If you suspect an overdose, seek medical attention immediately.

• The symptoms of Lopressor overdose may include:
  Asthma-like symptoms, slow heartbeat, shock, nausea and vomiting, low blood pressure, irregular heartbeat, heart failure, coma, stopped heart