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References

Prescribing Information for Toprol-XL, AstraZeneca LP, Wilmington, DE.
Darmansjah I, Wong E, Setiawati A, et al. Pharmacokinetic and pharmacodynamic properties of controlled release (CR/ZOK) metoprolol in healthy Oriental subjects: a comparison with conventional formulations of metoprolol and atenolol. J Clin Pharmacol. 1990;30(2 suppl):S39-S45.
Papademetriou V, Hainer JW, Sugg J, Munzer D, for the ATTACH Study Group. Factorial antihypertensive study of an extended-release metoprolol and hydrocholorothiazide combination. Am J Hypertens. 2006;19(12):1217-1225.
Data on File, 282877, AstraZeneca LP.

Indication for Toprol-XL

Toprol-XL is indicated for the treatment of hypertension, alone or in combination with other antihypertensives; the long-term treatment of angina pectoris; and 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

Important Risk Information about Toprol-XL

WARNING: 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. Warn patients 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.

Toprol-XL is contraindicated in severe bradycardia, heart block of second or third degree, cardiogenic shock, decompensated cardiac failure, and sick sinus syndrome (unless permanent pacemaker is in place) and in patients who are hypersensitive to any component of this product
TOPROL-XL should be used with caution in patients who have bronchospastic disease, diabetes, thyrotoxicosis, peripheral vascular disease, or who take calcium channel blockers of the verapamil and diltiazem type. Avoid initiation of high-dose TOPROL-XL in patients undergoing non-cardiac surgery
There is a risk of worsening cardiac failure during up-titration of the dose of metoprolol succinate extended-release. Patients need to consult their physicians if they experience signs or symptoms of worsening heart failure such as weight gain or increased shortness of breath
Patients should be advised to (1) avoid operating automobiles and machinery or engaging in other tasks requiring alertness until the patient's response to therapy with metoprolol succinate extended release has been determined; (2) contact a physician if any difficulty in breathing occurs; (3) inform the physician or dentist before any surgery that he or she is taking Toprol-XL
The most common (>2%) adverse reactions are tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus and rash

Click here for full Prescribing Information, including boxed warning regarding abrupt cessation of therapy.

If you would like additional information regarding AstraZeneca products, please contact the Information Center at AstraZeneca in the US at 1-800-236-9933, Monday through Friday, 8:00 am to 6:00 pm ET, excluding holidays.

This product information is intended for US health care professionals only.

Generic metoprolol succinate extended-release tablets are manufactured for Par Pharmaceutical Company, Inc., Spring Valley, NY, by AstraZeneca AB, Södertälje, Sweden.

Toprol-XL is a registered trademark and AZ&Me is a trademark of the AstraZeneca group of companies.