Toprol-XL Precautions and Warnings (Cont.)

• Toprol-XL can interact with certain medications (see Toprol-XL Interactions).
   
• Toprol-XL may hide certain signs of hyperthyroidism. Do not stop taking Toprol-XL abruptly, as this can cause serious symptoms of hyperthyroidism to appear suddenly and without warning. Talk with your healthcare provider before stopping Toprol-XL so that it can be done in a safe manner.
   
• Toprol-XL may cause extreme low blood pressure and/or a slow heart rate in some people. Symptoms can include dizziness, lightheadedness, and fainting. If you develop any of these symptoms, contact your healthcare provider. Extreme low blood pressure is more likely to occur in people who are taking a diuretic, who are on dialysis, or who have diarrhea or vomiting.

Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how Toprol-XL affects you.

• Using beta blockers, such as Toprol-XL, for a long period of time can, in some cases, lead to heart failure. If you notice any of the following symptoms, contact your healthcare provider: unexplained weight gain; swelling of the ankles, feet, or legs; cough; and shortness of breath (see Symptoms of Congestive Heart Failure for more signs and symptoms of this condition).
   
• People with severe congestive heart failure who take Toprol-XL are at increased risk for worsening heart failure. This occurs more often when the dose is increased. Therefore, if your healthcare provider prescribes Toprol-XL because he or she believes that the benefits of Toprol-XL outweigh the potential risks, he or she may choose to monitor your situation more closely, especially during dosage changes. Contact your healthcare provider if you notice any congestive heart failure symptoms.
   
• People taking Toprol-XL should not stop it abruptly. In clinical studies, this has been shown to increase a person's chances for developing angina (chest pain), heart attack, or serious irregular heart rhythms (arrhythmias). This risk is even greater in people with existing heart disease.
   
• Healthcare providers should use particular caution when prescribing Toprol-XL for people with certain lung diseases, such as asthma, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease (COPD). Beta blockers affect the lungs and can cause a narrowing of the airways. This risk is increased in people with certain lung diseases. If you develop problems breathing or experience wheezing, call your healthcare provider.
   
• If you have allergies, taking Toprol-XL may increase the reaction to the specific allergens, and your body may not respond to the usual doses of epinephrine.
   
• If you are going to have surgery, let your healthcare provider or dentist know that you are taking Toprol-XL.
   
• Toprol-XL is a pregnancy Category C medicine. This means that Toprol-XL may not be safe to use during pregnancy. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking Toprol-XL, contact your healthcare provider (see Toprol-XL and Pregnancy for more information).
   
• Toprol-XL passes through breast milk. Therefore, if you are breastfeeding or plan to breastfeed, be sure to talk with your healthcare provider about this.