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Toprol-XL (metoprolol)


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  • Toprol-XL (metoprolol)


    My cardiologist started me on Toprol-XL 50mg this week, and would like to get me to 100 mg if i do well on it. These were free samples so aside from being told to take one every morning i didn't get any other info. I've downloaded all the technical data i could find from pharmacy websites (thank god for the internet), and i've reviewed many of the previous posts here regarding beta-blockers. The side-effects sound a bit scary to me, and some of the scariest ones i probably shouldn't talk about here

    Since most of you have had experience with beta-blockers, what sort of side-effects should i reasonably expect even if i do tolerate it well? How should i expect to feel on a daily basis? Is it going to take some time to build up in my system? This is the first long-term medication i've ever been prescribed, so some real-world advice would be helpful. Up until now the only meds i've ever taken are the ones that they give you to kill something, and ten days later you're all done, so this is very new territory for me.

    Thanks a bunch,

    "Some days you're the dog... some days you're the hydrant."

  • #2
    The first few weeks you may be a bit tired but after that you should adjust and feel rather "normal". I have "vivid dreaming" which means I remember all my dreams and they are as clear as watching a movie. This is a side effect from the meds. Honestly - I do not mind...it is cheap entertainment!
    People think I dream alot but the truth is we all have an average of 7 dreams per nigh but most people only recall bits and pieces of one or two.
    If you read the "side effects" for any drug it is enough to make you want to live on water..until you read the report of what is in the water!
    Do not be overwhelmed with all the data you looked at...real life is what matters and I have lived on beta blockers for 15+ years just fine
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)


    • #3
      Hi there. Well, I've never taken that particular drug, but I can tell you a little about beta blockers in general. Some people find that beta blockers wipe them out. Some have very vivid dreams and/or nightmares. Some have asthma like symptoms, especially if the already have asthma. Those are the most common sede effects I've heard of. I have taken at least 2 other beta blockers and never had any trouble with any of them. My husband takes atenolol and has no trouble either. You know the rule of thumb here... we're all different. Good luck.


      Oh yeah, almost forgot. It does take a few days or so to build up in your system.

      Husband has HCM.
      3 kids - ages 23, 21, & 19. All presently clear of HCM.


      • #4
        Scary stuff, not so much

        Dear Jim,

        I've been on one "flavor" of beta-blocker or another for the last 21 years, including Toprol and Toprol XL.

        The only side effects I've ever had are weird dreams, fatigue, and the occaisional fuzzy-headed feeling when I've taken too much.

        Everyone is a little different. For me personally, I found that nadolol (corgard) gave me fewer weird dreams than metoprolol (toprol), but that may not be true for you.

        As for that one side effect you didn't mention, my brother has been on a betablocker for just as long as I have and he doesn't have that problem. ; )

        PLEASE, keep in mind that medication side effects include everything someone experienced while taking that drug --even if it really wasn't necessarily caused by it, also the percentages of people getting the really yucky stuff is very, very low.

        However, if after a few months you don't feel right, talk to your doctor about trying a different beta-blocker. There is a lot of trial and error in this.

        take care,



        • #5
          HI JIM,


          GOOD LUCK!



          • #6
            Hi All,

            Thanks for sharing your experiences with the drug. I've been taking my pulse several times a day just to keep tabs on things, and it's been in the mid-nineties (resting) consistently, which is down quite a bit from 114. I still feel it pounding when i'm trying to sleep though, and since we were aiming for closer to 60 i'm sure my doctor's going to up my dose.

            Side-effects haven't been bad so far, i've been pretty tired, with some occasional nausea, and although it's not listed on my sheet as a potential side-effect, i've had some strange episodes of blurred vision. All in all not bad though

            "Some days you're the dog... some days you're the hydrant."


            • #7

              Dear Jim,

              Please let doctor know about blurred vision. Vision is something you don't mess around with --could be other things, but always important to check. Also, some vision disturbances are an early sign of stroke (not that you had a stroke, just giving you info here).

              Anyway, try taking it after you eat by about 30 minutes and also try taking before bed.

              Keep us posted,



              • #8
                Dear Jim,

                I was on Toprol XL for over three years. The dosage was gradually increased in an effort to deal with my symptoms of shortness of breath, chest tightness, and dizziness. The problem here is that the side effects cannot easily be separated from the symptoms of HCM. When we upped my dosage from 150 mg to 200 mg daily, I noticed what I call a shimmering (like a kaleidoscope) in my vision, especially when I exerted myself or the weather was hot. I asked both my cardiologist & my internist about it; neither had any idea what was causing it. The cardiologist was certain it was not the Toprol. The internist thought it was a visual aura for migraines--a concept I've seen others talk about here. (I've also heard from two or three others who got this visual shimmering on beta-blockers.)

                When we stopped the Toprol (because I really felt yechy & wanted to try verapamil for a change), the visual symptoms stopped immediately! I'm now on nadalol (the verapamil didn't control my symptoms) at a comparably lower dose and the visual symptoms have not recurred, my resting pulse is in the 60s, and my blood pressure manages to stay over 100.

                I'm not suggesting your Toprol dose is too high--your body may just be getting accustomed to it--but I'd say if the visual stuff continues for several weeks you ask the doctor to try a different drug. Even though the literature does not describe blurred vision as a side effect or a symptom of overdose, I believe it can be. This process of finding the best drug at the best dosage can be pretty long for all of us!

                Good luck,


                • #9
                  Thanks for all your advice, you have been very helpful!
                  "Some days you're the dog... some days you're the hydrant."


                  • #10
                    Just following up on my earlier post...

                    I've been on the Toprol-XL for about six weeks now and although it is still early in my program, it has surprised me that every time my dosage is increased i experience the initial side-effects all over again and more severe. Is this normal? I kinda thought once my body adjusted, that would be it. I'm so naive

                    The biggest side-effects for me are definitely dizziness and fatigue. I really (and i mean really) have to force myself out of bed in the morning. I still get the blurred vision occasionally, but it's really the least troublesome of the side-effects. When i was increased from 100 to 150mg (where i am now), i was shocked that my heartrate and blood pressure actually shot up quite a bit rather than going down.

                    I've also experienced some things i never had before being medicated. I've had more PVC's than in the past (at least i think they are PVC's, where my heart stops beating for a second then starts back up with a thud). But now after one of these babies my heart spasms for about 4 or 5 seconds afterwards. That's new for me. It feels just like a muscle spasm i would have in my arm, only in my heart. What is the medical name for this? Oh well, i'm sure everything will be better once i get to my final dosage level and my body adjusts for good.

                    My heartrate is still high (mid-nineties) so i think several more dosage increases are inevitable. Yikes!

                    Thanks for the advice

                    "Some days you're the dog... some days you're the hydrant."


                    • #11
                      Jim, I don't know about your pvc's or heart flutters but just wanted to let you know that whenever I take any beta blockers or heart meds of any type I get ALOT of them. Way more than normal. If you find out what causes this, please let me know. So far everything I have tried to take made me feel worse than the disease. Including many more heart symptoms and exhaustion. I hope you get it straightened out soon. Doesn't sound like that drug is helping you much. Kathy


                      • #12
                        Thanks Kathy,

                        I'm just a bit nervous about making the jump from 150-200mg since the one from 100-150mg was so rough, but i'm going to hang in there with the meds for as long as possible. Ablation and myectomy aren't options for me right now, what i really need is a new mitral valve. Given that as my only surgical option, i really (really) want the meds to work for me!

                        Hope you find your way through the med situation as well, and that you get to feeling better real soon

                        Take care,

                        "Some days you're the dog... some days you're the hydrant."


                        • #13

                          Have you discussed all these effects with your cardiologist in as much detail as you have given us here? You should. And ask him (her?) about trying another beta-blocker. Each is different in its effects on each of us, so the only way to find out what will work for you is to try them.

                          It seems to me that the effects you're having (increased pulse, blood pressure, dizziness) may indicate this isn't the best drug for you.

                          And, remember, if others don't work as well for you as Toprol, you could always come back to it!



                          • #14
                            I agree with Pat.

                            I was on Metoprolol for almost a year. I had horrible side effects that never seemed to go away. What was worse I wasn't even observant enough to link them until one day when it just occured to me that this was probably it. I talked to my doctor and told them I just think this one isn't working. I was on 50 mg. of Metoprolol and since was put on Atenolol. I tolerated the Atenolol so much better. Now I am up to 200 mg. daily and will eventually (in a couple more weeks) be to 300. So far I have not been able to attribute any harsh side effects other than some tingling in my extremities on occasion. Not to say Atenolol would be better for you, it just that I have learned through all this the beta blockers are not all created equal. That is to say one may work for you much better but you have to tell your doctor that these side effects are more than you are willing to bear. Hang in there.

                            NEMC's (Boston) First Myectomy 7-22-2003


                            • #15
                              Allways remember you cannot control the wind!!
                              However you can adjust your sails!!


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