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Pronounced: low-PRESS-or
Generic name: Metoprolol tartrate
Other brand name: Toprol-XL

Why is this drug prescribed: Lopressor, a type of medication known as a beta blocker, is used in the treatment of high blood pressure, angina pectoris (chest pain, usually caused by lack of oxygen to the heart due to clogged arteries), and heart attack. When prescribed for high blood pressure, it is effective when used alone or in combination with other high blood pressure medications. Beta blockers decrease the force and rate of heart contractions, thereby reducing the demand for oxygen and lowering blood pressure. Occasionally doctors prescribe Lopressor for the treatment of aggressive behavior, prevention of migraine headache, and relief of temporary anxiety. An extended-release form of this drug, called Toprol-XL, is prescribed for high blood pressure, angina, and heart failure.

Most important fact about this drug: If you have high blood pressure, you must take Lopressor regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Lopressor; and you must continue taking it even if you are feeling well. Lopressor does not cure high blood pressure; it merely keeps it under control.

How should you take this medication: Lopressor should be taken with food or immediately after you have eaten. Take Lopressor exactly as prescribed, even if your symptoms have disappeared. Try not to miss any doses. If this medication is not taken regularly, your condition may worsen. --If you miss a dose... If it is within 4 hours of your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time. --Storage instructions... Store Lopressor at room temperature in a tightly closed container, away from light. Protect from moisture. Store Toprol-XL at room temperature.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lopressor. More common side effects may include: Depression, diarrhea, dizziness, itching, rash, shortness of breath, slow heartbeat, tiredness Less common or rare side effects may include: Blurred vision, cold hands and feet, confusion, congestive heart failure, constipation, difficult or labored breathing, dry eyes, dry mouth, gas, hair loss, headache, heart attack, heartburn, low blood pressure, muscle pain, nausea, nightmares, rapid heartbeat, ringing in the ears, short-term memory loss, stomach pain, swelling due to fluid retention, trouble sleeping, wheezing, worsening of heart irregularities

Why should this drug not be prescribed: If you have a slow heartbeat, certain heart irregularities, low blood pressure, inadequate output from the heart, or heart failure, you should not take this medication.

Special warnings about this medication: If you have a history of congestive heart failure, Lopressor should be used with caution. If you are taking the extended release form of this drug, Toprol-XL, to relieve heart failure, the condition may temporarily be worsened as your dosage is increased. Be sure to alert your doctor to any signs of worsening heart failure such as weight gain or increasing shortness of breath. Do not stop Lopressor abruptly. This can cause increased chest pain and heart attack. Dosage should be gradually reduced. If you suffer from asthma, seasonal allergies or other bronchial conditions, or liver disease, this medication should be used with caution. Ask your doctor if you should check your pulse while taking Lopressor. This medication can cause your heartbeat to become too slow. This medication may mask some symptoms of low blood sugar in diabetics or alter blood sugar levels. If you are diabetic, discuss this with your doctor. Lopressor may cause you to become drowsy or less alert; therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know how you respond to this medication. Notify your doctor or dentist that you are taking Lopressor if you have a medical emergency, or before you have surgery or dental treatment. Notify your doctor if you have any difficulty in breathing.

Possible food and drug interactions when taking this medication: If Lopressor is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lopressor with certain high blood pressure drugs such as reserpine (Ser-Ap-Es). Other medications that might interact with Lopressor include: Albuterol (Proventil, Ventolin) Amiodarone (Cordarone) Barbiturates such as phenobarbital Calcium channel blockers such as Calan and Cardizem Cimetidine (Tagamet) Ciprofloxacin (Cipro) Clonidine (Catapres) Epinephrine (EpiPen) Fluoxetine (Prozac) Hydralazine (Apresoline) Insulin Nonsteroidal anti-inflammatory drugs such as Motrin and Indocin Oral diabetes drugs such as Glucotrol and Micronase Paroxetine (Paxil) Prazosin (Minipress) Propafenone (Rythmol) Quinidine (Quinaglute) Ranitidine (Zantac) Rifampin (Rifadin)

Special information if you are pregnant or breastfeeding: The effects of Lopressor during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Lopressor appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with this medication is finished.

Recommended dosage: ADULTS: Dosages of Lopressor should be individualized by your doctor. It should be taken with or immediately following meals. High Blood Pressure The usual starting dosage of Lopressor is a total of 100 milligrams a day taken in 1 or 2 doses, whether taken alone or with a diuretic. The initial dosage of Toprol-XL ranges from 50 to 100 milligrams once a day. Your doctor may gradually increase the dosage up to 400 milligrams a day. Generally, the effectiveness of each dosage increase will be seen within a week. Angina Pectoris The usual starting dosage is a total of 100 milligrams a day taken in 2 doses of Lopressor or a single dose of Toprol-XL. Your doctor may gradually increase the dosage up to 400 milligrams a day. Generally, the effectiveness of each dosage increase will be seen within a week. If treatment is to be discontinued, your doctor will withdraw the drug gradually over a period of 1 to 2 weeks. Heart Attack Lopressor can be used for treatment of heart attack both in the hospital during the early phases and after the individual's condition has stabilized. Your doctor will determine the dosage according to your needs. Heart Failure The recommended starting dose of Toprol-XL is 25 milligrams once daily for 2 weeks (12.5 milligrams in severe cases). Your doctor will double the dose every 2 weeks up to the highest level that works without side effects. The maximum recommended dose is 200 milligrams daily. CHILDREN: The safety and effectiveness of Lopressor have not been established in children.

Overdosage: Any medication taken in excess can cause symptoms of overdose. If you suspect an overdose, seek medical attention immediately. The symptoms of Lopressor overdose may include: Asthma-like symptoms, coma, heart failure, irregular heartbeat, low blood pressure, nausea and vomiting, shock, slow heartbeat, stopped heart

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