Generic Name and Formulations:
Metoprolol succinate 25mg, 50mg, 100mg, 200mg; scored ext-rel tabs.
Company:
AstraZeneca Pharmaceuticals
 
Select therapeutic use: Angina
CHF and arrhythmias
Hypertension
Indications for TOPROL-XL:
Long-term management of angina.

Adult:
Initially 100mg once daily. May increase at 1-week intervals; max 400mg/day.

Children:
Not recommended.

Contraindications:
Severe bradycardia. Heart block >1st degree. Cardiogenic shock. Overt heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:
Mild or compensated heart failure. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Hepatic dysfunction. Surgery. Diabetes. Hyperthyroidism. Avoid abrupt cessation. Elderly. Pregnancy (Cat.C). Nursing mothers.

Interactions:
May potentiate hypotension with prazosin, reserpine, hydralazine, cimetidine, antithyroid drugs. May increase cardiac effects of verapamil, lidocaine. Indomethacin, barbiturates, rifampin may decrease effectiveness. Potentiated by felodipine, possibly quinidine, fluoxetine, paroxetine, propafenone. May block epinephrine.

Pharmacological Class:
Beta-blocker.

Adverse Reactions:
Fatigue, dizziness, rash, depression, GI upset, dyspnea, bradycardia, cold extremities, palpitations, CHF, edema, syncope, chest pain, hypotension, bronchospasm, heart block, MI, angina.

How Supplied:
Tabs—100
Indications for TOPROL-XL:
Stable, symptomatic (NYHA Class II or III) ischemic, hypertensive, or cardiomyopathic heart failure.

Adult:
Class II: initially 25mg once daily; more severe: 12.5mg once daily. May double dose as tolerated every 2 weeks; reduce if symptomatic bradycardia occurs; max 200mg/day.

Children:
Not recommended.

Contraindications:
Severe bradycardia. Heart block >1st degree. Cardiogenic shock. Overt heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:
Mild or compensated heart failure. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Hepatic dysfunction. Surgery. Diabetes. Hyperthyroidism. Avoid abrupt cessation. Elderly. Pregnancy (Cat.C). Nursing mothers.

Interactions:
May potentiate hypotension with prazosin, reserpine, hydralazine, cimetidine, antithyroid drugs. May increase cardiac effects of verapamil, lidocaine. Indomethacin, barbiturates, rifampin may decrease effectiveness. Potentiated by felodipine, possibly quinidine, fluoxetine, paroxetine, propafenone. May block epinephrine.

Pharmacological Class:
Beta-blocker.

Adverse Reactions:
Fatigue, dizziness, rash, depression, GI upset, dyspnea, bradycardia, cold extremities, palpitations, CHF, edema, syncope, chest pain, hypotension, bronchospasm, heart block, MI, angina.

How Supplied:
Tabs—100
Indications for TOPROL-XL:
Hypertension.

Adult:
Initially 25–100mg once daily, alone or with a diuretic. May increase at 1-week intervals; max 400mg/day.

Children:
Not recommended.

Contraindications:
Severe bradycardia. Heart block >1st degree. Cardiogenic shock. Overt heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:
Mild or compensated heart failure. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Hepatic dysfunction. Surgery. Diabetes. Hyperthyroidism. Avoid abrupt cessation. Elderly. Pregnancy (Cat.C). Nursing mothers.

Interactions:
May potentiate hypotension with prazosin, reserpine, hydralazine, cimetidine, antithyroid drugs. May increase cardiac effects of verapamil, lidocaine. Indomethacin, barbiturates, rifampin may decrease effectiveness. Potentiated by felodipine, possibly quinidine, fluoxetine, paroxetine, propafenone. May block epinephrine.

Pharmacological Class:
Beta-blocker.

Adverse Reactions:
Fatigue, dizziness, rash, depression, GI upset, dyspnea, bradycardia, cold extremities, palpitations, CHF, edema, syncope, chest pain, hypotension, bronchospasm, heart block, MI, angina.

How Supplied:
Tabs—100