Arlie asked
I split a metoprolol succinate and then split the half and took that in an attempt to ween myself off of it. Now I'm scared that I may have done the wrong thing and it could harm me.... help please.
Answer
Most extended release medications (e.g. XL, CR, SR,or XR in its name) may not split, but there are exceptions. Metoprolol Succinate (Brand name Toprol XL) is one of these exceptions and you may split it one time. The ability to split Toprol XL comes from the unique way that the medication and its approved generics are formulated.
Most extended release medications are composed of a coating around the active ingredient of the medication. Through a wide variety of mechanisms, this coating regulates how fast a drug is released into your system for absorption by the body. If this outer coating is split, it can cause the drug to be released all at once. If this occurs, it could vastly compromise the effectiveness of the medication, lead to potentially serious side effects and even cause an overdose.
Splitting Toprol XL
Toprol XL and its approved generics are composed of a unique micropellet design in which many small coated pellets are dispersed evenly throughout the larger tablet. These individual micropellets act similar to a conventional extended release tablet and control the release of Metoprolol once the larger tablet is in the GI tract. Due to how Toprol XL is formulated, it may be safely split one time.
Although it is ok to split Toprol XL one time (the tablet is scored to aid you in this) you should not crush, chew, or split the tablet more than 1 time. Any of these actions can damage the micropellets and disrupt the intended release of the medication.
Tapering Toprol XL
Whether or not beta-blockers, such as Toprol XL, need to be tapered depends on the individual and other factors (such as how long you have been taking the medication). Sudden withdrawal, or stopping beta-blockers cold turkey, has been associated with certain side effects such as:
- Angina
- Heart attack
- Arrhythmias
- Fast heart rate
- Low blood pressure
Although sources vary, for some patients it is recommended to taper over one to two weeks before discontinuing completely. Some patients may need to be tapered over longer periods of time, for as long as three weeks. If withdrawal symptoms do occur while tapering, it may be prudent to reinstate therapy, at least for a short period of time.
It is important to always communicate with your doctor regarding tapering your medication as you can discuss the most appropriate way to discontinue it in your specific situation. You should not discontinue Toprol XL without speaking with your doctor first.
