Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.
Question:
What are the consequences of stopping Toprol XL for an extended period of time?
Answer:
Toprol XL is the trade name for a long-acting form of metoprolol. Metoprolol is a beta blocker. Beta blockers are used to treat high blood pressure, coronary artery disease, heart rhythm abnormalities and heart failure.
Doctors prescribe beta blockers for other conditions such as migraine, essential tremor and hyperthyroidism (an overactive thyroid gland).
When a person takes a beta blocker, the body becomes accustomed to a slowed heart rate. If the beta blocker is suddenly stopped, there is a risk that the heart rate can speed up and stress the heart. In general, doctors prefer to slowly taper the dose of a beta blocker if a person is going to stop it.
If you have not been taking the beta blocker for long, this rebound effect should not be a problem. However, there may be reasons why you should start taking the medication again. For example, people who have had a heart attack should remain on a beta blocker indefinitely to prevent a second heart attack.
If cost is an issue, consider a generic drug. Many beta blockers are now available as generic drugs.
Don't just restart the Toprol XL on your own. Talk to your doctor about whether you need to restart a beta blocker. Also, your doctor may want to start you back on a lower dose than you were previously taking.
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