Slideshows Images Quizzes

Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. See additional information.

Toprol XL

Last reviewed on RxList: 10/22/2020
Toprol XL Side Effects Center

Pharmacy Editor: Eni Williams, PharmD, PhD

What Is Toprol XL?

Toprol XL (metoprolol) is a beta-blocker prescribed for treating high blood pressure, heart pain, abnormal rhythms of the heart, and some neurologic conditions. Toprol XL is available as a generic drug.

What Are Side Effects of Toprol XL?

Common side effects of Toprol XL include

Tell your doctor if you experience serious side effects of Toprol XL including

Dosage for Toprol XL

Toprol XL usual adult dose is 100-450 mg daily in single or divided doses.

What Drugs, Substances, or Supplements Interact with Toprol XL?

Drug interactions include calcium channel blockers (for example, verapamil [Isoptin]) and digoxin (Lanoxin).

Toprol XL During Pregnancy and Breastfeeding

There are no adequate studies of Toprol XL in pregnant women and is secreted in human breast milk.

Additional Information

Our Toprol XL Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. articles.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SLIDESHOW

How to Lower Blood Pressure: Exercise Tips See Slideshow
Toprol XL Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • very slow heartbeats;
  • a light-headed feeling, like you might pass out;
  • shortness of breath (even with mild exertion), swelling, rapid weight gain; or
  • cold feeling in your hands and feet.

Common side effects may include:

  • dizziness, tired feeling;
  • depression, confusion, memory problems;
  • nightmares, trouble sleeping;
  • diarrhea; or
  • mild itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Toprol XL (Metoprolol Succinate)

QUESTION

Salt and sodium are the same. See Answer
Toprol XL Professional Information

SIDE EFFECTS

The following adverse reactions are described elsewhere in labeling:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates.

Hypertension And Angina

Most adverse reactions have been mild and transient. The most common ( > 2%) adverse reactions are tiredness, dizziness, depression, diarrhea, shortness of breath, bradycardia, and rash.

Heart Failure

In the MERIT-HF study comparing TOPROL-XL in daily doses up to 200 mg (mean dose 159 mg once-daily; n=1990) to placebo (n=2001), 10.3% of TOPROL-XL patients discontinued for adverse reactions vs. 12.2% of placebo patients.

The table below lists adverse reactions in the MERIT-HF study that occurred at an incidence of ≥ 1% in the TOPROL-XL group and greater than placebo by more than 0.5%, regardless of the assessment of causality.

Adverse Reactions Occurring in the MERIT-HF Study at an Incidence ≥ 1% in the TOPROL-XL Group and Greater Than Placebo by More Than 0.5%

  TOPROL-XL
n=1990
% of patients
Placebo
n=2001
% of patients
Dizziness/vertigo 1.8 1.0
Bradycardia 1.5 0.4
Accident and/or injury 1.4 0.8

Post-operative Adverse Events

In a randomized, double-blind, placebo-controlled trial of 8351 patients with or at risk for atherosclerotic disease undergoing non-vascular surgery and who were not taking beta–blocker therapy, TOPROL-XL 100 mg was started 2 to 4 hours prior to surgery then continued for 30 days at 200 mg per day. TOPROL-XL use was associated with a higher incidence of bradycardia (6.6% vs. 2.4%; HR, 2.74; 95% CI 2.19, 3.43), hypotension (15% vs. 9.7%; HR 1.55; 95% CI 1.37, 1.74), stroke (1.0% vs. 0.5%; HR 2.17; 95% CI 1.26, 3.74) and death (3.1% vs. 2.3%; HR 1.33; 95% CI 1.03, 1.74) compared to placebo.

Post-Marketing Experience

The following adverse reactions have been identified during post-approval use of TOPROL-XL or immediate-release metoprolol. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cardiovascular: Cold extremities, arterial insufficiency (usually of the Raynaud type), palpitations, peripheral edema, syncope, chest pain and hypotension.

Respiratory: Wheezing (bronchospasm), dyspnea.

Central Nervous System: Confusion, short-term memory loss, headache, somnolence, nightmares, insomnia, anxiety/nervousness, hallucinations, paresthesia.

Gastrointestinal: Nausea, dry mouth, constipation, flatulence, heartburn, hepatitis, vomiting.

Hypersensitive Reactions: Pruritus.

Miscellaneous: Musculoskeletal pain, arthralgia, blurred vision, decreased libido, male impotence, tinnitus, reversible alopecia, agranulocytosis, dry eyes, worsening of psoriasis, Peyronie’s disease, sweating, photosensitivity, taste disturbance.

Potential Adverse Reactions

In addition, there are adverse reactions not listed above that have been reported with other beta-adrenergic blocking agents and should be considered potential adverse reactions to TOPROL-XL.

Central Nervous System: Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, clouded sensorium, and decreased performance on neuropsychometrics.

Hematologic: Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura.

Hypersensitive Reactions: Laryngospasm, respiratory distress.

Laboratory Test Findings

Clinical laboratory findings may include elevated levels of serum transaminase, alkaline phosphatase, and lactate dehydrogenase.

Read the entire FDA prescribing information for Toprol XL (Metoprolol Succinate)

Health Solutions From Our Sponsors

CONTINUE SCROLLING FOR RELATED SLIDESHOW