Metoprolol Succinate

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 21, 2022

Warnings

What are the risks of taking Toprol XL (metoprolol succinate)?

Toprol XL can cause serious health problems, especially in certain high-risk patients. Talk to your healthcare professionals about other treatment options for high blood pressure and chest pain if a Toprol XL warning concerns you.
Other risks of Toprol XL (metoprolol succinate) use include:

CHEST PAIN OR HEART ATTACK: Suddenly stopping certain beta-blockers, including Toprol XL, can worsen chest pain and increase the risk of a heart attack. If you discontinue use after taking Toprol XL for a long time, your doctor will gradually reduce your dose over 1-2 weeks and monitor you carefully.
BRONCHOSPASTIC DISEASE: People with bronchospastic diseases like asthma should not receive beta-blockers like Toprol XL. However, this medication can be used with caution in people with asthma if they do not respond to other treatments for high blood pressure.
MAY MASK SYMPTOMS OF LOW BLOOD SUGAR: People with diabetes taking Toprol XL may not notice symptoms of low blood sugar such as fast heart rate, shakiness, sweating, and dizziness. Talk to your doctor about how often you should check blood sugar levels while taking Toprol XL.
MAY MASK SYMPTOMS OF OVERACTIVE THYROID: In some people with hyperthyroidism (overactive thyroid), taking Toprol XL can mask the signs of this condition, such as a fast heart rate. Do not suddenly stop taking Toprol XL without talking to your doctor - this can cause a potentially life-threatening condition called a thyroid storm.
SLOW HEART RATE: Toprol XL can slow your heart rate and make you feel dizzy or lightheaded. The risk is greater if you take medicines like calcium channel blockers that also lower the heart rate. Arise slowly from a sitting or lying position to prevent falls. This side effect should go away in a few weeks as your body adjusts to the medication. If it does not, tell your doctor. If your heart rate drops too low, seek immediate medical attention.

Speak to your doctor or pharmacist about other treatment options if you are at high risk for the above complications.

Before starting Toprol XL (metoprolol succinate), what should I tell my doctor?

Tell your doctor if you have an allergy to Toprol XL, any of the active or inactive ingredients in Toprol XL extended-release tablets, or any other medications. Your pharmacist can give you a list of ingredients.

Give your doctor a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, vitamins, and herbal/natural products. This can help avoid serious drug interactions.

Tell your healthcare professional about all your medical conditions. Toprol XL may not be right for people with certain health conditions. Be sure to tell your doctor if you have or have ever had asthma or other lung diseases, hyperthyroidism (overactive thyroid), diabetes, liver disease, severe allergies, pheochromocytoma (a tumor that causes fast heartbeat and high blood pressure), slow heart rate, heart failure, heart disease, or blood circulation problems.

Tell your doctor if you are pregnant, could be pregnant, or plan to become pregnant. Also, tell your doctor if you are breastfeeding or plan to breastfeed.

What precautions should I take while on Toprol XL (metoprolol succinate)?

Keep all your appointments with your healthcare provider. Write down a list of all your medications. Bring this list with you to every healthcare appointment. Your doctor may want to check your blood pressure at regular intervals to see how you respond to Toprol XL. If your doctor asks you to check your pulse rate (heart rate), ask them or your pharmacist to show you the correct way to do this. Tell your doctor if your pulse is slower or faster than the normal range.

Toprol XL can make you drowsy or dizzy. Do not drive a car, operate heavy machinery, or do anything that requires focus and full attention before knowing how this medicine affects you. You should know that alcohol can make drowsiness caused by this medicine worse.

You should be aware of an allergic reaction or that your allergies can worsen while on Toprol XL. Also, you may not respond to the usual dose of injectable epinephrine.

Tell your doctor if you become pregnant while taking Toprol XL.

Tell your healthcare providers that you take Toprol XL before surgery, including dental surgery.

What are Toprol XL (metoprolol succinate) interactions?

Taking Toprol XL with some other medications can affect how the drugs work or increase the risk of severe side effects. Your physician may choose a different medication for you, change the dose or frequency of one or both medicines, and/or monitor you carefully for side effects if there are known drug interactions between Toprol XL and your other medicines.

Toprol XL can have drug interactions with the following medications:

Bupropion (Aplenzin, Forfivo, Wellbutrin, Zyban)
Clonidine (Catapres)
Cimetidine
Ritonavir (Norvir, in Kaletra)
Terbinafine (Lamisil)

Diphenhydramine (Benadryl)
Hydroxychloroquine
Fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax)
Reserpine

Paroxetine (Brisdelle, Paxil, Pexeva)
Quinidine
Propafenone (Rythmol)
Thioridazine

This list does not describe all possible Toprol XL interactions. Give your healthcare provider a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, vitamins, and natural or herbal products. Also, tell your healthcare provider if you smoke cigarettes, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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