Generic TOPROL-XL
Par Pharmaceutical has begun shipping metoprolol succinate extended release Generic TOPROL-XL 50 mg tablets.
Prescription Drugs
As previously announced, in November 2006 Par entered into a supply and distribution agreement with AstraZeneca in the U.S. to distribute metoprolol succinate extended release tablets, which is substitutable for AstraZeneca's TOPROL-XL extended release tablets. Par began shipping 25 mg tablets of generic Toprol-XL at that time.
TOPROL-XL is a beta-1-selective (cardioselective) adrenoceptor-blocking agent, for oral administration, available as extended release tablets. TOPROL-XL has been formulated to provide a controlled and predictable release of metoprolol for once-daily administration.
Annual U.S. sales of TOPROL-XL in the 50 mg tablet are approximately $640 million, according to IMS Health.
Important information about metoprolol succinate extended release tablets
Metoprolol succinate extended release is indicated for the treatment of hypertension, alone or in combination with other antihypertensives; the long- term treatment of angina pectoris; and the treatment of stable, symptomatic (NYHA Class II or III) heart failure of ischemic, hypertensive, or cardiomyopathic origin. It was studied in patients already receiving ACE inhibitors, diuretics, and, in the majority of cases, digitalis.
Metoprolol succinate extended release is contraindicated in severe bradycardia, heart block of greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless permanent pacemaker is in place), and in patients who are hypersensitive to any component of this product.
In clinical trials of patients with hypertension and angina pectoris, the most common adverse events reported with immediate release metoprolol tartrate are tiredness (10%), dizziness (10%), depression (5%), diarrhea (5%), pruritus or rash (5%), shortness of breath (3%), and bradycardia (3%).
In patients with heart failure, serious adverse events and adverse events leading up to discontinuation of study medication in MERIT-HF at an incidence greater then or equal to 1% in the group receiving metoprolol succinate extended release and greater than placebo by more than 0.5% were dizziness/vertigo (1.8% vs. 1.0%), bradycardia (1.5% vs. 0.4%), and accident and or injury (1.4% vs. 0.8%).
Patients taking metoprolol succinate extended release should avoid abrupt cessation of therapy. Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, is some cases, myocardial infarction have occurred. The dosage should be reduced gradually over a one-to-two-week period, and the patient should be carefully monitored.
Metoprolol succinate extended release should be used with caution in patients who have bronchospastic disease, diabetes, thyrotoxicosis, or peripheral vascular disease; who are undergoing major surgery, or who take calcium channel blockers of the verapamil and diltiazem type.
There is a risk of worsening cardiac failure during up-titration of the dose of metoprolol succinate extended release. Patients need to consult their physicians if the experience signs or symptoms of worsening heart failure such as weight gain or increased shortness of breath.
Patients should be advised to (1) avoid operating automobiles and machinery or engaging in other tasks requiring alertness until the patient's response to therapy with metoprolol succinate extended release has been determined; (2) contact a physician if any difficulty in breathing occurs; (3) inform the physician or dentist before any surgery that he or she is taking metoprolol succinate extended release.