Toprol XL indications and usage: Difference between revisions

Metoprolol
Clinical data
Trade names	Lopressor, Toprol-xl
AHFS/Drugs.com	Monograph
MedlinePlus	a682864
[[Regulation of therapeutic goods \|Template:Engvar data]]	US FDA: Metoprolol;
Pregnancy; category	AU: C ; US: C (Risk not ruled out) ; ;
Routes of; administration	Oral, IV
ATC code	C07AB02 (WHO) ;
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	12%
Metabolism	Hepatic via CYP2D6, CYP3A4
Elimination half-life	3-7 hours
Excretion	Renal
Identifiers
	IUPAC name (RS)-1-(Isopropylamino)-3-[4-(2-methoxyethyl)phenoxy]propan-2-ol;
CAS Number	51384-51-1 ;
PubChem CID	4171;
IUPHAR/BPS	553;
DrugBank	DB00264 ;
ChemSpider	4027 ;
UNII	GEB06NHM23;
KEGG	D02358 ;
ChEBI	CHEBI:6904 ;
ChEMBL	ChEMBL13 ;
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
Formula	C15H25NO3
Molar mass	267.364 g/mol
3D model (JSmol)	Interactive image;
Melting point	120 °C (248 °F)
	SMILES O(c1ccc(cc1)CCOC)CC(O)CNC(C)C;
	InChI InChI=1S/C15H25NO3/c1-12(2)16-10-14(17)11-19-15-6-4-13(5-7-15)8-9-18-3/h4-7,12,14,16-17H,8-11H2,1-3H3 ; Key:IUBSYMUCCVWXPE-UHFFFAOYSA-N ;
(verify)

VisualWikitext

Revision as of 18:35, 13 March 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Hypertension

TOPROL-XL is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including metoprolol.

Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).

Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.

Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.

Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (eg, on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.

TOPROL-XL may be administered with other antihypertensive agents.

Angina Pectoris

TOPROL-XL is indicated in the long-term treatment of angina pectoris, to reduce angina attacks and to improve exercise tolerance.

Heart Failure

TOPROL-XL is indicated for the treatment of stable, symptomatic (NYHA Class II or III) heart failure of ischemic, hypertensive, or cardiomyopathic origin. It was studied in patients already receiving ACE inhibitors, diuretics, and, in the majority of cases, digitalis. In this population, TOPROL-XL decreased the rate of mortality plus hospitalization, largely through a reduction in cardiovascular mortality and hospitalizations for heart failure.^[1]

References

↑ "TOPROL XL (METOPROLOL SUCCINATE) TABLET, EXTENDED RELEASE [BRYANT RANCH PREPACK]".

Adapted from the FDA Package Insert.

[dailymed.nlm.nih.gov-1] "TOPROL XL (METOPROLOL SUCCINATE) TABLET, EXTENDED RELEASE [BRYANT RANCH PREPACK]".

[1]

@@ Line 7: / Line 7: @@
 TOPROL-XL is indicated for the treatment of [[hypertension]], to lower [[blood pressure]]. Lowering [[blood pressure]] lowers the risk of fatal and non-fatal cardiovascular events, primarily [[stroke]]s and [[myocardial infarction]]s. These benefits have been seen in controlled trials of [[antihypertensive]] drugs from a wide variety of pharmacologic classes including metoprolol.
-Control of high [[blood pressure]] should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, [[diabetes]] management, [[antithrombotic]] therapy, [[smoking]] cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve [[blood pressure]] goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
+Control of high [[blood pressure]] should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, [[diabetes]] management, [[antithrombotic]] therapy, [[smoking]] cessation, [[exercise]], and limited [[sodium]] intake. Many patients will require more than 1 drug to achieve [[blood pressure]] goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
-Numerous [[antihypertensive drug]]s, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is [[blood pressure]] reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of [[stroke]], but reductions in [[myocardial infarction]] and [[cardiovascular]] [[mortality]] also have been seen regularly.
+Numerous [[antihypertensive drug]]s, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce [[cardiovascular]] [[morbidity]] and [[mortality]], and it can be concluded that it is [[blood pressure]] reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of [[stroke]], but reductions in [[myocardial infarction]] and [[cardiovascular]] [[mortality]] also have been seen regularly.
-Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
+Elevated [[systolic pressure|systolic]] or diastolic pressure causes increased [[cardiovascular]] risk, and the absolute risk increase per mmHg is greater at higher [[blood pressure]]s, so that even modest reductions of severe [[hypertension]] can provide substantial benefit. Relative risk reduction from [[blood pressure]] reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their [[hypertension]] (for example, patients with [[diabetes]] or [[hyperlipidemia]]), and such patients would be expected to benefit from more aggressive treatment to a lower [[blood pressure]] goal.
-Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (eg, on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
+Some [[antihypertensive drug]]s have smaller [[blood pressure]] effects (as monotherapy) in black patients, and many [[antihypertensive drug]]s have additional approved indications and effects (eg, on [[angina]], [[heart failure]], or [[diabetic nephropathy|diabetic kidney disease]]). These considerations may guide selection of therapy.
-TOPROL-XL may be administered with other antihypertensive agents.
+TOPROL-XL may be administered with other [[antihypertensive agent]]s.
 ===Angina Pectoris===
-TOPROL-XL is indicated in the long-term treatment of angina pectoris, to reduce angina attacks and to improve exercise tolerance.
+TOPROL-XL is indicated in the long-term treatment of [[angina pectoris]], to reduce [[angina]] attacks and to improve exercise tolerance.
 ===Heart Failure===
-TOPROL-XL is indicated for the treatment of stable, symptomatic (NYHA Class II or III) heart failure of ischemic, hypertensive, or cardiomyopathic origin. It was studied in patients already receiving ACE inhibitors, diuretics, and, in the majority of cases, digitalis. In this population, TOPROL-XL decreased the rate of mortality plus hospitalization, largely through a reduction in cardiovascular mortality and hospitalizations for heart failure.<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>
+TOPROL-XL is indicated for the treatment of stable, symptomatic ([[NYHA]] Class II or III) [[heart failure]] of [[ischemia|ischemic]], [[hypertensive]], or [[cardiomyopathy|cardiomyopathic]] origin. It was studied in patients already receiving [[ACE inhibitor]]s, [[diuretic]]s, and, in the majority of cases, [[digitalis]]. In this population, TOPROL-XL decreased the rate of [[mortality]] plus hospitalization, largely through a reduction in [[cardiovascular]] [[mortality]] and hospitalizations for [[heart failure]].<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>
 ==References==