The dosage of TOPROL-XL should be individualized. The usual initial dosage is 100 mg daily, given in a single dose. The dosage may be gradually increased 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, the dosage should be reduced gradually over a period of 1Ð 2 weeks
Dosage must be individualized and closely monitored during up-titration. Prior to initi-ation of TOPROL-XL, the dosing of diuretics, ACE inhibitors, and digitalis (if used) should be stabilized. 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. The dose should then be doubled every two weeks to the highest dosage level tolerated by the patient or up to 200 mg of TOPROL-XL. If transient worsening of heart failure occurs, it may be treated with increased doses of diuretics, and it may also be necessary to lower the dose of TOPROL-XL or temporarily discontinue it.
The dose of TOPROL-XL should not be increased until symptoms of worsening heart failure have been stabilized. Initial diffi-culty with titration should not preclude later attempts to introduce TOPROL-XL. If heart failure patients experience symptomatic bradycardia, the dose of TOPROL-XL should be reduced.
Tablets containing metoprolol succinate equivalent to the indicated weight of meto-prolol tartrate, USP, are white, biconvex, film-coated, and scored. Bottle of Unit Dose 100 Packages of
Tablet Shape Engraving NDC 100 0186-NDC 0186-
25 mg* Oval A 1088-05 1088-39 ß
50 mg Round A 1090-05 1090-39 mo
100 mg Round A 1092-05 1092-39 ms
200 mg Oval A 1094-05 N/ A my