Ischemic Heart Disease:
Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred. When discontinuing chronically administered TOPROL-XL, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1−2 weeks and the patient should be carefully monitored. If angina markedly worsens or acute coronary insufficiency develops, TOPROL-XL administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician’s advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue TOPROL-XL therapy abruptly even in patients treated only for hypertension.
TABLETS: 25 MG, 50 MG, 100 MG, AND 200 MG
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 23.75, 47.5, 95 and 190 mg of metoprolol succinate equivalent to 25, 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).
TOPROL-XL is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.
TOPROL-XL is indicated in the long-term treatment of angina pectoris.
TOPROL-XL is indicated for the treatment of stable, symptomatic (NYHA Class II or III) heart failure of ischemic, hypertensive, or cardiomyopathic origin. It was studied in patients already receiving ACE inhibitors, diuretics, and, in the majority of cases, digitalis. In this population, TOPROL-XL decreased the rate of mortality plus hospitalization, largely through a reduction in cardiovascular mortality and hospitalizations for heart failure.
Published Studies Related to Toprol-XL (Metoprolol)
Effect of fixed dose combinations of metoprolol and amlodipine in essential hypertension: MARS ? A randomized controlled trial. [2011.12]
Abstract Aim. To compare two strengths of a fixed drug combination (FDC) containing metoprolol XL and amlodipine (metoprolol/amlodipine 50/5; and metoprolol/amlodipine 25/2.5) with its components in hypertension...
Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure-a randomized study. [2011.10.15]
ABSTRACT: BACKGROUND: Carvedilol has been shown to be superior to metoprolol tartrate to improve clinical outcomes in patients with heart failure (HF), yet the mechanisms responsible for these differences remain unclear. We examined if there were differences in endothelial function, insulin stimulated endothelial function, 24 hour ambulatory blood pressure and heart rate during treatment with carvedilol, metoprolol tartrate and metoprolol succinate in patients with HF... CONCLUSION: Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF. TRIAL REGISTRATION: Current Controlled Trials NCT00497003.
beta-Blockers in patients with intermittent claudication and arterial hypertension: results from the nebivolol or metoprolol in arterial occlusive disease trial. [2011.08]
The use of beta-receptor blockers in peripheral arterial disease is controversial for their impact on vasomotor tone... In the direct comparison, there was no significant difference between nebivolol and metoprolol.
Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness. [2011.06]
The aim of this study was to investigate the effects of the vasodilating beta-blocker nebivolol and the cardioselective beta-blocker metoprolol succinate on aortic blood pressure and left ventricular wall thickness... This proof-of-principle study provides evidence to suggest that beta-blockers with vasodilating properties may offer advantages over conventional beta-blockers in antihypertensive therapy; however, this remains to be tested in a larger trial.
The effect of nebivolol versus metoprolol succinate extended release on asymmetric dimethylarginine in hypertension. [2011.05]
This study sought to determine if metoprolol succinate ER (MET), and nebivolol (NEB), a beta1-AR with increased bioavailability of nitric oxide (NO), would have differing effects on plasma asymmetric dimethylarginine concentration in hypertensives. It was hypothesized that NEB, a beta1-AR antagonist and beta3-AR agonist with NO-releasing properties, and MET, only a beta1-AR antagonist, would have different effects on plasma asymmetric dimethylarginine (ADMA) concentration...
Clinical Trials Related to Toprol-XL (Metoprolol)
Comparative Effects of Nebivolol and Metoprolol on Femal Sexual Function [Recruiting]
Beta-blockers (BB) are an important treatment for high blood pressure and heart disease.
However beta-blockers can cause sexual dysfunction (SD) and this common side effect limits
successful use of this class of medications. Sexual side effects often result in drug
discontinuation, compromising therapy goals. The investigators are conducting the study to
determine if nebivolol, a newer beta blocker that is selective for receptors in the heart
and causes vasodilation in the body causes fewer sexual side effects, or even improves
sexual function, compared with metoprolol succinate.
Evaluation of Succinate Metoprolol on Heart Rate in the Stable Angina Patients [Not yet recruiting]
The Impact of Nebivolol Versus Metoprolol on Quality of Life [Recruiting]
In an open label analysis, nebivolol has been shown to have a positive impact on quality of
life in the general hypertensive population. That is, patients treated with nebivolol
reported less side effects compared to those treated with metoprolol. Also, more nebivolol
treated patients reached normalization of blood pressure. Although there is no data, it is
believed that the impact would be similar in renal transplant recipients.
The primary goal of this study is to determine if nebivolol will improve the quality of life
measurements of kidney transplant recipients as compared to those treated with metoprolol
succinate. This will be measured by comparing the scores of four quality of life
questionnaires taken before and after 12 weeks of treatment with study drug. Other aims of
this study are to determine if the use of nebivolol is cost-effective in the renal
transplant recipient; determine if there is a change in urine protein excretion and renal
function with the use of nebivolol; and determine the number of patients that maintain or
achieve a target blood pressure of ≤ 120/80 mmHg.
Effect of METOprolol in CARDioproteCtioN During an Acute Myocardial InfarCtion. The METOCARD-CNIC Trial. [Recruiting]
The purpose of this study is to test whether early pre-reperfusion metoprolol administration
in patients suffering and acute myocardial infarction might reduce the size of myocardial
Influence of CPB and Mini CPB to the Absorption of the Metoprolol [Not yet recruiting]
Reports of Suspected Toprol-XL (Metoprolol) Side Effects
Drug Dose Omission (308),
Myocardial Infarction (161),
Drug Ineffective (139),
Cerebrovascular Accident (138),
Cardiac Disorder (113),
Dizziness (109), more >>
PATIENT REVIEWS / RATINGS / COMMENTS
Based on a total of 2 ratings/reviews, Toprol-XL has an overall score of 8. The effectiveness score is 7 and the side effect score is 10. The scores are on ten point scale: 10 - best, 1 - worst.
Toprol-XL review by 47 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Considerably Effective|
|Side effects:|| || No Side Effects|
|Condition / reason:|| || High Blood pressure|
|Dosage & duration:|| || 50 mg. taken 1 daily for the period of 2 years|
|Other conditions:|| || breast cancer|
|Other drugs taken:|| || Dexameth 4mg., Vicodin 500mg., Compazine 10mg. Chemotherapy- Taxotere/Cytoxan 4tx., Neulasta |
|Benefits:|| || Vicodin 500mg- reduced bone pain caused by Neulasta shot.
Dexameth 4mg.- reduced drug reactions caused by chemotherapy.
Compazine 10mg.- reduced nausea caused by chemotherapy.
Taxotere/Cytoxan- going thru tx. at this time. hope to be cancer free!
Neulasta shot- increased whit blood count so we could continue with chemotherapy.|
|Side effects:|| || Vicodin 500mg.- some drowsiness
Dexameth 4mg.- hot flashes, flushed face,insomnia
Compazine 10mg.- none
Taxotere- hairloss, very dry skin, some gum bleeding, tiredness, metalic taste in mouth, short term memory loss, confusion, liver toxin level increasing.
Cytoxan- ? since I receive the Taxotere at the same time I'm not sure which side effects are which.
Neulasta shot- extreme bone pain
|Comments:|| || Vicodin 500mg- take as needed for bone pain caused by Neluasta shot.
Dexameth 4mg.- Take 2 tablets night before chemo tx., 2 tablets morning of tx, tablets evening of tx., two tablets am after tx.
Compazine 10mg.- take one tablet every six hours as needed for nasuea from chemo.
Taxotere/Cytoxan- total of four treatments for IDC breast cancer, Grade 1, Stage 2, 0ne lymph node involved. Prior treatment completed- Dec.08 lumpectomy and sentiel node removal, Jan 09 full mastectomy with lypmh node dissection (removed 18), started chemotherapy Feb 22 09 once every three weeks, just had third tx on Mar 31 09.
Neulasta shot- total of four treatments given 48 hours after chemotherapy tx. Shot is given in the stomach area to reduce the side effects. |
Toprol-XL review by 45 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Moderately Effective|
|Side effects:|| || No Side Effects|
|Condition / reason:|| || high blood pressure and |
|Dosage & duration:|| || 25mg taken once daily for the period of one year to date|
|Other conditions:|| || none|
|Other drugs taken:|| || tylenol and advil; ketorolac: frova|
|Benefits:|| || It seems to keep my blood pressure and headaches in check, especially during hormonal changes right before my period begins. I am also sleeping better at night (falling asleep and staying asleep; able to get back to sleep during the night), whereas before I was getting only a couple of hours of sleep a night. |
|Side effects:|| || none so far|
|Comments:|| || I had been dealing with more frequent "migraine" headaches (headaches unresponsive to OTC pain relievers)and began to notice a pattern that was related to my menstrual cycle. During treatment for the headaches with frova and ketorolac I had an episode where I had sudden and severe pain in my head and felt like my head was going to explode, which sent me to the emergency room. The cause was never really determined but in the process it was noticed that my blood pressure was elevated and remained elevated during following doctor visits. Since being on toprol, the headaches and blood pressure have remained managable throughout monthly hormonal changes. |
Page last updated: 2011-12-09