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| __NOTOC__
| | #REDIRECT [[Metoprolol succinate#Adult Indications and Dosage]] |
| {{Metoprolol}}
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| {{CMG}}
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| TOPROL-XL is an extended-release tablet intended for once daily administration. For treatment of [[hypertension]] and [[angina]], when switching from immediate-release metoprolol to TOPROL-XL, use the same total daily dose of TOPROL-XL. Individualize the dosage of TOPROL-XL. Titration may be needed in some patients.
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| TOPROL-XL tablets are scored and can be divided; however, do not crush or chew the whole or half tablet.
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| ===Hypertension===
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| '''Adults''': The usual initial dosage is 25 to 100 mg daily in a single dose. The dosage may be increased at weekly (or longer) intervals until optimum [[blood pressure]] reduction is achieved. In general, the maximum effect of any given dosage level will be apparent after 1 week of therapy. Dosages above 400 mg per day have not been studied.
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| '''Pediatric Hypertensive Patients ≥ 6 Years of age''': A pediatric clinical [[hypertension]] study in patients 6 to 16 years of age did not meet its primary endpoint (dose response for reduction in [[SBP]]); however some other endpoints demonstrated effectiveness ''[see [[Toprol XL use in specific populations|Use in Specific Populations]]]''. If selected for treatment, the recommended starting dose of TOPROL-XL is 1.0 mg/kg once daily, but the maximum initial dose should not exceed 50 mg once daily. Dosage should be adjusted according to [[blood pressure]] response. Doses above 2.0 mg/kg (or in excess of 200 mg) once daily have not been studied in [[pediatric]] patients ''[see [[Toprol XL clinical pharmacology|Clinical Pharmacology]]]''.
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| TOPROL-XL is not recommended in pediatric patients < 6 years of age ''[see [[Toprol XL use in specific populations|Use in Specific Populations]]]''.
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| ===Angina Pectoris===
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| Individualize the dosage of TOPROL-XL. The usual initial dosage is 100 mg daily, given in a single dose. Gradually increase the dosage at weekly intervals until optimum clinical response has been obtained or there is a pronounced slowing of the [[heart rate]]. Dosages above 400 mg per day have not been studied. If treatment is to be discontinued, reduce the dosage gradually over a period of 1 - 2 weeks ''[see [[Toprol XL warnings and precautions|Warnings and Precautions]]]''.
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| ===Heart Failure===
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| Dosage must be individualized and closely monitored during up-titration. Prior to initiation of TOPROL-XL, stabilize the dose of other [[heart failure]] drug therapy. The recommended starting dose of TOPROL-XL is 25 mg once daily for two weeks in patients with [[NYHA]] Class II [[heart failure]] and 12.5 mg once daily in patients with more severe [[heart failure]]. Double the dose every two weeks to the highest dosage level tolerated by the patient or up to 200 mg of TOPROL-XL. Initial difficulty with titration should not preclude later attempts to introduce TOPROL-XL. If patients experience symptomatic [[bradycardia]], reduce the dose of TOPROL-XL. If transient worsening of [[heart failure]] occurs, consider treating with increased doses of [[diuretic]]s, lowering the dose of TOPROL-XL or temporarily discontinuing it. The dose of TOPROL-XL should not be increased until symptoms of worsening [[heart failure]] have been stabilized.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = TOPROL XL (METOPROLOL SUCCINATE) TABLET, EXTENDED RELEASE [BRYANT RANCH PREPACK] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=01038198-b4f0-41f3-9a9c-5c84e5a0d3b9 | publisher = | date = | accessdate = }}</ref>
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| ==References==
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| {{Reflist}}
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| {{FDA}}
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| [[Category:Beta blockers]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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