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Do not stop taking this medication without consulting your doctorSome conditions may become worse when you suddenly stop this drugSome people who have suddenly stopped taking similar drugs have had chest painheart attackand irregular heartbeatIf your doctor decides you should no longer use this drughe or she may direct you to gradually decrease your dose over 1 to 2 weeks.

Some people may experience an apparent worsening of their condition in the early stages of treatment with TOPROL-XLIt is important to tell your doctor if this happens to youalthough it is usually temporaryIf your condition continues to worsenyou should see your doctor as soon as possible.

Worsening cardiac failure may occur during up-titration of TOPROL-XLIf such symptoms occurincrease diuretics and restore clinical stability before advancing the dose of TOPROL-XLsee DOSAGE AND ADMINISTRATIONIt may be necessary to lower the dose of TOPROL-XL or temporarily discontinue itSuch episodes do not preclude subsequent successful titration of TOPROL-XL.

Other beta-blocker medicinesincluding beta-blocker eye drops calcium channel blockers or calcium antagonistsmedicines used to treat high blood pressure and anginafor example verapamil and diltiazem medicines used to treat high blood pressurefor example clonidinehydralazineand prazosin medicines used to treat abnormal or irregular heartbeatfor example amiodaronedisopyramide and quinidine medicines used to treat arthritispainor inflammationfor example indomethacin and ibuprofen digoxina medicine used to treat heart failure medicines used to treat diabetes medicines used to treat bacterial infectionsfor example rifampicin cimetidinea medicine used to treat stomach ulcers medicines used to treat depression warfarina medicine used to prevent blood clots monoamine-oxidase inhibitorsMAOIs)

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