Toprol XL dosing

[Mindyt]

Dr Fett,
I am on Toprol XL. I take 50 mg. in the morning and 50 mg. at night. I am having a lot of fatigue during the day and I am wondering if it is related to my beta blocker. Being that it is a long-acting medication, do I really need to split the dose? Wouldn't it be the same thing if I took 100 mg. in one dose at bedtime? Maybe that would help with the fatigue some during the day.....
Thanks a lot!!!!

[SerenaWelsh]

Call your doctor to be sure what he wants you to do. The XL part of Toprol is extended release...so that you should only have to take it once a day.

I take mine at night to help me over the fatigue hump it causes... But again, make sure it's something your doc approves of.

[Heather]

Yes, Serena is right check with you doctor and I also take my beta blocker at night, it really made a difference for me.

[JAMESFETT]

Mindy, Serena is right about checking with your doctor, and I know you will be doing that, since this forum is a source of information, always to be reviewed with your physician(s). Toprol-XL is a long-acting medication that is designed for once daily administration, and it is frequently taken that way; the time of day can vary according to individual needs and preferences, the steady state of medication level in the blood encouraged by taking it the same time every day.

JD

[Deb]

Today my PCP finally agreed to try me on toprol XL again to see if it helps with my moodiness and he said to take it once per day. I remembered taking it twice a day previously, so I thought maybe I was wrong - my husband and I both looked at my bottle and it says "one tablet twice daily."

Weird....

[JAMESFETT]

Either way, once daily or every 12 hours (approximately) will work. It is designed to take once per 24 hours, and with steady state and slow release the level will be the almost exactly the same, so long as the total dose is the same (that is, for example, either 100 mg once daily or 50 mg twice daily).

JD

[Mindyt]

I tried taking all 100mg. of my Toprol XL last night. I feel terrible today...worse than the last few days. I am tired, seriously fatigued, more short of breath and generally miserable. My blood pressure is low- 90's over upper 50's. It gets worse in the heat. I have been on the toprol for quite a while so I don't know why I am suddenly having trouble now.....maybe because of the heat? I have a call into my doctor so we will see what she says.....
Is 100 mg. a large dose? I am a small person who has always been sensitive to medications. Maybe 100 mg. is just too much for me?

[SerenaWelsh]

Did you discuss with your Dr. first, to make sure there wasn't a reason he had you splitting it?

[Mindyt]

Yes, I did call and talked to the cardio nurse. She said there was no reason to split it and that I would probably feel better if I took it all at night. I am feeling better this afternoonthan I did this morning but still feel exhausted. I put in another call to ask about my blood pressure. I don't have any swelling or anything that would seem "heart-related". But, I still worry that my heart is getting worse. I just feel like a miserable, dizzy, slightly nauseous slug........

[SerenaWelsh]

maybe your body adjusting to that high of a dose all at once? I sure hope that's all it is and that you soon feel an improvement.

[Miraclex2]

Hi Mindy

I am not on toprol XL ,but I know that everytime they increased my corg , I felt so bad I thought I was getting worse. After about a week or so I guess my boby got used to it and I felt much better . Maybe that is what you are feeling . I hope that you feel better soon

[Mindyt]

I felt so terrible that I only took 75 mg. last night (the nurse never called me back after I called again). I woke up this morning still feeling crummy. I took my BP and it is running in the 90's over 50/60's and my pulse upon waking up was 47! It is up now in the 70's now that I am up and moving but I still feel weak. Anyway, 47 is a really slow pulse, isn't it???

[JAMESFETT]

Those numbers are not worrisome. As a good compromise perhaps it is easier for you to split the dose 50/50; nothing wrong with doing it that way.

JD