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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.

When gradually stopping this medicationit is recommended that you temporarily limit physical activity to decrease strain on the heartGet medical help right away if you develop chest pain/tightness/pressurechest pain spreading to the jaw/neck/armunusual sweatingtrouble breathingor fast/irregular heartbeat.

Clinical laboratory findings may include elevated levels of serum transaminasealkaline phosphataseand lactate dehydrogenase.

During pregnancythis medication should be used only when clearly neededIt may harm an unborn babyDiscuss the risks and benefits with your doctor.

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