Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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TOPROL-XL |
| Manufacturer |
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AstraZeneca Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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β-blocker. |
| Generic Name |
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Metoprolol succinate 25mg, 50mg, 100mg, 200mg; scored ext rel tabs. |
| Indications |
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Stable, symptomatic (NYHA Class II or III) ischemic, hypertensive, or cardiomyopathic heart failure. |
| Children |
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Not recommended. |
| Adults |
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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. |
| Contraindications |
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Severe bradycardia. Heart block >1st degree. Cardiogenic shock. Overt heart failure. Sick sinus syndrome (unless paced). |
| Precautions |
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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 |
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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. |
| Adverse Reactions |
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Fatigue, dizziness, rash, depression, GI upset, dyspnea, bradycardia, cold extremities, palpitations, CHF, edema, syncope, chest pain, hypotension, bronchospasm, heart block, MI, angina. |
| How Supplied |
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Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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