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Toprol XL (METOPROLOL / LOPRESSOR) is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Common uses

Toprol is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to treat or prevent heart attack.
Toprol may also be used for purposes other than those listed in this medication guide.

Before using

Do not use Toprol if you are allergic to metoprolol, or if you have:
• a heart problem such as heart block, sick sinus syndrome, or slow heart rate;
• pheochromocytoma; or
• problems with circulation (such as Raynaud's syndrome).
Before taking Toprol, tell your doctor if you have:
• congestive heart failure;
• asthma, bronchitis, emphysema;
• diabetes;
• low blood pressure;
• depression;
• liver or kidney disease;
• a thyroid disorder; or
• myasthenia gravis.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Toprol.

Directions

Take Toprol exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow your doctor's instructions.
Take this medication with a full glass of water.
Take Toprol at the same time every day.
Toprol should be taken with food or just after a meal. A Toprol XL tablet can be divided in half if your doctor has told you to do so. The half tablet should be swallowed whole, without chewing or crushing. Chewing or crushing the pill could cause too much of the drug to be released at one time. Do not skip doses or stop taking Toprol without first talking to your doctor. Stopping suddenly may make your condition worse.
To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. It is important that you not miss any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon that you are using Toprol. You may need to briefly stop using Toprol before having surgery.
Toprol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

Cautions

Do not stop taking Toprol without first talking to your doctor. Stopping suddenly may make your condition worse.
If you need to have any type of surgery, you may need to temporarily stop using Toprol. Be sure the surgeon knows ahead of time that you are using Toprol.
Toprol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking Toprol.
Toprol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.

Possible side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
• slow or uneven heartbeats;
• feeling light-headed, fainting;
• feeling short of breath, even with mild exertion;
• swelling of your ankles or feet;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• depression; or
• cold feeling in your hands and feet.
Other less serious side effects are more likely to occur, such as:
• vomiting;
• decreased sex drive, impotence, or difficulty having an orgasm;
• sleep problems (insomnia);
• tired feeling; or
• anxiety, nervousness.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
If you take too much
Seek emergency medical attention if you think you have used too much of this medicine.
Symptoms of a Toprol overdose may include uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, or seizure (convulsions).

Additional information

Toprol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking Toprol.

Drug interactions

Before taking Toprol, tell your doctor if you are using:
• digoxin (digitalis, Lanoxin);
• clonidine (Catapres);
• ritonavir (Norvir);
• terbinafine (Lamisil);
• anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox);
• medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others;
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
• a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);
• a heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);
• medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair);
• a diuretic (water pill) such as amiloride (Midamor, Moduretic), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others; or
• cold medicines, stimulant medicines, or diet pills.
If you are using any of these drugs, you may not be able to take Toprol, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect Toprol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.