Consider possible infant exposure when metoprolol succinate extended-release is administered to a nursing woman.
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If you feel a worsening of your condition in the early stages of taking TOPROL-XLtell your doctor immediately.
Consider treating the patient with intensive carePatients with myocardial infarction or heart failure may be prone to significant hemodynamic instabilitySeek consultation with a regional poison control center and a medical toxicologist as neededBeta-blocker overdose may result in significant resistance to resuscitation with adrenergic agentsincluding beta-agonistsOn the basis of the pharmacologic actions of metoprololemploy the following measures.
Elevated systolic or diastolic pressure causes increased cardiovascular riskand the absolute risk increase per mmHg is greater at higher blood pressuresso that even modest reductions of severe hypertension can provide substantial benefitRelative risk reduction from blood pressure reduction is similar across populations with varying absolute riskso the absolute benefit is greater in patients who are at higher risk independent of their hypertensionfor examplepatients with diabetes or hyperlipidemiaand such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
PATIENTS WITH BRONCHOSPASTIC DISEASES SHOULDIN GENERALNOT RECEIVE BETA-BLOCKERSBecause of its relative beta1 cardio-selectivityhoweverTOPROL-XL may be used in patients with bronchospastic disease who do not respond toor cannot tolerateother antihypertensive treatmentBecause beta1selectivity is not absoluteuse the lowest possible dose of TOPROL-XLBronchodilatorsincluding beta2agonistsshould be readily available or administered concomitantlysee DOSAGE AND ADMINISTRATION
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