Metoprolol is a racemic mixture of R- and S- enantiomers, and is primarily metabolized by CYP2D6. Dosages above 400 mg per day have not been studied. There were no notable differences in efficacy or the rate of adverse reactions between older and younger patients.In general, use a low initial starting dose in elderly patients given their greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.No studies have been performed with Toprol-XL in patients with hepatic impairment. If they are taken together, your blood pressure and heart rate should be closely monitored. Tablets containing metoprolol succinate equivalent to the indicated weight of metoprolol tartrate, USP, are white, biconvex, film-coated, and scored.Store at 25°C (77°F).

You must continue to take it as directed if you expect to lower your blood pressure and keep it down. Swallow the extended-release capsule and tablet whole. Cindy L. Grines, M.D., Director of Interventional Cardiology Fellowship; Vice Chief of Academic Affairs, William Beaumont HospitalI Hate Taking My Beta Blocker. TOPROL-XL, metoprolol succinate, is a beta1-selective(cardioselective) adrenoceptor blocking agent, for oral administration,available as extended-release tablets. (See USP Controlled Room Temperature. )Advise patients to take Toprol-XL regularly and continuously, as directed, preferably with or immediately following meals. Only a small fraction of the drug (about 12%) is bound to human serum albumin. Advertising revenue supports our not-for-profit mission.Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.Things to remember when you fill your prescription.WebMD does not provide medical advice, diagnosis or treatment. In patients with severely damaged hearts, adequate ventricular function may depend on sympathetic drive. Select one or more newsletters to continue. All rights reserved. The combined endpoints of all-cause mortality plus all-cause hospitalization and of mortality plus heart failure hospitalization showed consistent effects in the overall study population and the subgroups, including women and the US population. Integra Lifesciences et al., ... AstraZeneca loses Toprol-XL patent over double patenting. with immediate-release metoprolol 50 mg t.i.d. Anesth Prog 1991 Nov-Dec;38(6):217-20. Observe patients treated with Toprol-XL plus a catecholamine depletor for evidence of hypotension or marked bradycardia, which may produce vertigo, syncope, or postural hypotension.Drugs that inhibit CYP2D6 such as quinidine, fluoxetine, paroxetine, and propafenone are likely to increase metoprolol concentration. [Guideline] Camm AJ, Kirchhof P, Lip GY, et al, for the European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery.

Many patients will require more than 1 drug to achieve blood pressure goals. Your doctor will tell you which of these are most important for you.

The patents are due to expire on Sept. 17, 2007. Contact your healthcare professional (e.g. In 2-year studies in rats at three oral dosage levels of up to 800 mg/kg/day (41 times, on a mg/mAll genotoxicity tests performed on metoprolol tartrate (a dominant lethal study in mice, chromosome studies in somatic cells, a No evidence of impaired fertility due to metoprolol tartrate was observed in a study performed in rats at doses up to 22 times, on a mg/mIn five controlled studies in normal healthy subjects, the same daily doses of Toprol-XL and immediate-release metoprolol were compared in terms of the extent and duration of betaIn a double-blind study, 1092 patients with mild-to-moderate hypertension were randomized to once daily Toprol-XL (25, 100, or 400 mg), PLENDILIn controlled clinical studies, an immediate-release dosage form of metoprolol was an effective antihypertensive agent when used alone or as concomitant therapy with thiazide-type diuretics at dosages of 100-450 mg daily. Dixit S, Stein PK, Dewland TA, et al. Hydrochlorothiazide is commonly prescribed for high blood pressure. J Am Heart Assoc.