Toprol XL (Metoprolol) – Oral

What Is Toprol XL?

Toprol XL (metoprolol) is a prescription drug commonly used to treat high blood pressure (hypertension) and some types of chest pain (angina). It controls heart rate and reduces the risk of hospitalization or dying from a heart attack.

Toprol XL belongs to a drug class known as selective beta-blockers. It works by blocking certain chemicals in your body that affect your blood vessels and heart (like epinephrine). This helps lower blood pressure, heart rate, and stress on your heart.

Toprol XL is an extended-release (ER) version of metoprolol. Extended release means the drug is slowly released into the body over a longer period of time.

What Is Toprol XL Used For?

Toprol XL is used to treat:

• High blood pressure
• Angina
• Heart failure
• Heart attack

For those with heart failure, Toprol XL can help reduce the chance of going to the hospital or dying from a heart attack.

How to Take Toprol XL

Food increases how well your body absorbs this medicine. Although it is preferred to take this drug with food or immediately after meals, you may take it with or without food.

Most extended-release drugs should not be broken. However, Toprol XL is one of the exceptions. It is scored, and you may break the tablet in half. However, you should not crush or chew it.

Continue taking your treatment even if you feel well. Do not suddenly stop taking your medication without speaking to your healthcare provider. Stopping your treatment suddenly can worsen your condition and may lead to a heart attack.

Storage

Store Toprol XL at room temperature (68–77 degrees F) in a dry place.

However, you may store it between cool and mildly hot temperatures (59–86 degrees F) when traveling. Do not store in a moist area such as a bathroom. Keep away from heat, children, and pets.

Toss any unused and expired medications. Do not throw them down the sink, toilet, or drain. Ask your pharmacist about the best ways to dispose of your medicine. Find out more about drug take-back programs in your area.

Off-Label Uses

Toprol XL is used off-label—for conditions not indicated by the Food and Drug Administration (FDA)— to treat:

• Supraventricular tachycardia (abnormally fast heart rate)
• Thyroid storms (a life-threatening thyroid problem)
• Atrial fibrillation or atrial flutter

What Are the Side Effects of Toprol?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Toprol include but are not limited to:

• Diarrhea
• Shortness of breath
• Bradycardia (slow heart rate)
• Feeling tired, weak, or dizzy
• Rash

Severe Side Effects

Toprol XL can cause many side effects. Some may be severe or life-threatening. Call your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you have a medical emergency. Severe side effects include:

• Slow heartbeat
• Swelling in the arms or legs (edema)
• Shortness of breath
• Low mood (depression)
• Excess weight gain
• Extreme dizziness, light-headedness, or passing out
• New or worsening abnormal heartbeat

Toprol may mask the signs and symptoms of hypoglycemia (very low blood sugar level) in people with diabetes. It also masks some symptoms of thyroid disease, like tachycardia (a very high heart rate).

Dosage: How Much Toprol XL Should I Take?

Modifications

Metoprolol crosses the placenta and can increase the risk of side effects in a developing fetus. Your healthcare provider may continue this drug during pregnancy only if medically necessary. Otherwise, fetal growth should be watched. After birth, the baby should be monitored for low blood sugar, low heart rate, and respiratory depression for 48 hours after delivery.

Metoprolol is present in breast milk. There are other preferred drugs to use when breastfeeding. However, if on Toprol XL while breastfeeding, watch for side effects of this drug in your infant, like:

• Bradycardia
• Listlessness

Missed Dose

Take the missed dose once you think of it. Skip the missed dose if it is close to the time for your next dose. Do not take extra doses or double the dose.

Overdose: What Happens If I Use Too Much Toprol XL?

Overdose symptoms with Toprol XL may include:

• Cardiac shock
• Heart failure
• Severe hypotension (low blood pressure)
• Bronchospasm (narrowing of the airways)
• Nausea and vomiting
• Cyanosis (bluish discoloration of the skin, lips, or nails)
• Coma

Precautions

What Are Reasons I Shouldn't Take Toprol XL?

Do not take Toprol XL if you have:

• Hypersensitivity to metoprolol or any part of its formulation
• Hypersensitivity to other beta-blockers
• Heart block greater than first degree
• Severely low heart rate 
• Sick sinus syndrome (a heart rhythm disorder) without a pacemaker
• Cardiogenic shock (life-threatening condition in which the heart cannot pump enough blood to the heart or rest of the body)
• Decompensated heart failure, or heart failure severe enough to require immediate medical attention

What Other Medications Interact With Toprol XL?

Certain medications interact with Toprol XL and increase the risk of severe side effects, including anticholinergic side effects like dry mouth. Examples of medications that interact with Toprol XL are:

• Calan SR (verapamil)
• Cardioquin (quinidine)
• Cardizem (dilitiazem)
• Catapres (clonodine)
• Exelon (rivastigmine)
• Lamisil (terbinafine)
• Lanoxin (digoxin)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Rythmol (propafenone)

This is not a comprehensive list of drugs that may interact with Toprol XL. Tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

What Medications Are Similar?

Other drugs similar to Toprol XL that are used to treat high blood pressure include:

• Tenormin (atenolol)
• Tenoretic (atenolol and chlorthalidone)
• Ziac (bisoprolol and hydrochlorothiazide)
• Brevibloc (esmolol)
• Bystolic (nebivolol)

This is a list of drugs also prescribed to treat high blood pressure. It is not a list of medicines recommended to take with Toprol XL. You should not take these drugs together unless your healthcare provider tells you to. Talk to your pharmacist or a healthcare provider if you have questions.

How Can I Stay Healthy While Taking Toprol XL?

Living well with high blood pressure is possible as you work with your healthcare provider to manage your condition. In addition to taking your medicine routinely, you should:

• Check blood pressure as directed by your healthcare provider.
• Closely watch your blood sugar as this drug may hide the signs of low blood sugar.
• Do not stop taking your medicine all of a sudden, even if you feel well. You may cause worsening heart issues or a heart attack.
• Speak to your healthcare provider before starting, adjusting, or stopping any medicine, including OTC drugs.

Lifestyle changes, such as eating a healthy diet and exercising, can also help get your blood pressure under control. Work with your healthcare provider to create an optimal lifestyle strategy. Consider consulting a registered dietitian (RD) or registered dietitian nutritionist (RDN) for dietary recommendations.

If you are unsure how to check your blood pressure or test your blood sugar, remember that your neighborhood pharmacist is always there to help. Talk to your healthcare provider about any concerns or questions you may have.