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Poor metabolizers and extensive metabolizers who concomitantly use cyp2d6 inhibiting drugs will have increased several-fold metoprolol blood levels, decreasing metoprolol s cardioselectivity see drug interactions .

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You have any allergies to metoprolol succinatethe active ingredient in TOPROL-XL tabletsor any of the ingredients listed at the end of this leafletor any other beta-blocker medicineSome of the symptoms of an allergic reaction may include shortness of breathwheezing or difficulty breathingswelling of the facelipstongue or other parts of the bodyrashitching or hives on the skin or you may feel faintyou have or have had asthma difficulty in breathingwheezingbronchitis or other lung problems in the past you have a history of allergic problemsincluding hayfever you have low blood pressure you have a very slow heartbeatless than 45-50 beats/minuteyou have certain other heart conditions you have phaeochromocytomaa rare tumour of the adrenal glandwhich is not being treated already with other medicines you have a severe blood vessel disorder causing poor circulation in the arms and legs you are receiving/having emergency treatment for shock or severely low blood pressure.

Be careful driving or operating machinery until you know how TOPROL-XL affects you.

TOPROL-XL is indicated for the treatment of stablesymptomaticNYHA Class II or IIIheart failure of ischemichypertensiveor cardiomyopathic originIt was studied in patients already receiving ACE inhibitorsdiureticsandin the majority of casesdigitalisIn this populationTOPROL-XL decreased the rate of mortality plus hospitalizationlargely through a reduction in cardiovascular mortality and hospitalizations for heart failure.

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