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When using this medication, it is important to be aware of certain safety information and warnings. The following points outline the key risks and precautions you should consider to ensure safe use:

• Do Not Abruptly Stop Medication: Do not discontinue this medication without consulting your healthcare provider, as sudden cessation can worsen certain conditions. Some individuals have experienced chest pain, heart attacks, and irregular heartbeats when stopping similar medications suddenly. Your doctor may advise a gradual reduction of dosage over 1 to 2 weeks. During this period, limit physical activities to reduce heart strain. Seek immediate medical attention if you experience chest pain, pressure, discomfort spreading to your jaw, neck, or arm, excessive sweating, difficulty breathing, or a rapid/irregular heartbeat.

• Heart Problems After Stopping: Ceasing use of metoprolol succinate (Toprol XL) suddenly can lead to increased heart rate, high blood pressure, reduced heart circulation, or heightened risk of chest pain or heart attack. Consult your healthcare provider to gradually decrease your dosage over a period of 1 to 2 weeks.

• Heart Failure Symptoms: Although metoprolol succinate (Toprol XL) is utilized for heart failure, increasing doses may exacerbate heart failure symptoms. If you notice worsening symptoms such as increased leg swelling or difficulty breathing, consult your healthcare provider. They will help adjust your medication dosage appropriately.

• Breathing Difficulties: This medication may cause lung vessel constriction, hindering breathing, particularly in individuals with respiratory conditions like asthma. Although rare with this selective beta-blocker, ensure your medical history is fully disclosed before starting treatment.

• Blood Pressure Concerns in Pheochromocytoma: If you have pheochromocytoma, inform your healthcare provider. Metoprolol succinate (Toprol XL) might elevate blood pressure in such cases, necessitating an alpha-blocker prescription to manage blood pressure effectively.

• Surgical Risks: If you are preparing for major surgery requiring anesthesia, notify your surgeon about your use of metoprolol succinate (Toprol XL). High doses near the time of surgery can result in low heart rate, low blood pressure, stroke, or even death. Your surgeon will closely monitor your heart to mitigate these risks.

• Low Blood Sugar Symptoms: Metoprolol succinate (Toprol XL) may obscure warning signs of low blood sugar, such as fast heartbeat or tremors, particularly if you are on blood sugar-lowering medications. Sweating may remain as an observable sign. Discuss blood sugar monitoring strategies with your healthcare provider.

• Thyroid Symptoms: Since metoprolol succinate (Toprol XL) reduces heart rate, symptoms of hyperthyroidism might be less noticeable. Do not stop the medication abruptly if you have an overactive thyroid, as this can exacerbate thyroid issues.

Contraindications:

• Severely low heart rate.
• Second- or third-degree heart block.
• Cardiogenic shock.
• Severe heart failure.
• Sick sinus syndrome, unless accompanied by a permanent pacemaker.

Consult your healthcare provider if any of these conditions apply before starting this medication to avoid serious health risks.

Common side effects:

• drowsiness
• dizziness
• tiredness
• diarrhea
• slow heartbeat

Less common but important to monitor:

• cold hands and feet
• decreased sexual ability

Serious side effects:

• very slow heartbeat
• fainting
• blue discoloration of fingers or toes
• worsening heart failure symptoms
• mental changes such as confusion or mood swings
• drastic drop in heart rate
• irregular heart rhythms
• heart failure symptoms like rapid weight gain or extreme fatigue
• allergic reaction (rash, swelling, trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Fingolimod

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Lumefantrine
• Propafenone
• Quinidine
• SSRI antidepressants such as Fluoxetine, paroxetine
• St. John's wort
• Albuterol
• Diltiazem
• Verapamil
• Rifampin
• Rivastigmine

Interactions with low risk that usually do not require a change in therapy:

• Cough-and-cold products
• Diet aids
• NSAIDs such as Ibuprofen, Naproxen