Introduction About TOLOL XR 12.5 TABLET

Tolol XR 12.5 is a once-daily extended-release tablet containing Metoprolol Succinate. It belongs to the Beta-1 selective adrenergic receptor blockers group and is widely used in cardiovascular conditions (management of high blood pressure, angina pectoris (chest pain), heart failure, arrhythmias or palpitations, heart attacks and migraine headaches). This formulation supports consistent release over 24 hours, enhancing convenience and minimizing dose fluctuations.

Take Tolol XR 12.5 only under medical supervision. It is usually taken with or immediately after meals. Do not stop taking this medicine without consulting your doctor.

Avoid alcohol consumption while taking this medicine as it may lower blood pressure. It is not recommended for use in patients with asthma, COPD, severe bradycardia, second or third-degree heart block, cardiogenic shock, cardiac failure, sick sinus syndrome (unless a permanent pacemaker is present) and unmanaged pheochromocytoma.

Before taking this medicine, inform your doctor if you have diabetes, stroke, liver or kidney disease or if you are pregnant or breastfeeding women.

The most common side effects are low blood pressure, tiredness, dizziness, headache, cold hands and feet. These above side effects are usually manageable. However, consult your doctor if they worsen or persist for a longer duration.

Uses Of TOLOL XR 12.5 TABLET

It is used for:

• Essential hypertension
• Angina pectoris
• Arrhythmias
• Heart attack and heart failure
• Migraine

Benefits of TOLOL XR 12.5 TABLET

1. Helps manage high blood pressure (Hypertension):

• Tolol XR 12.5mg can assist in controlling high blood pressure, which may help reduce the risk of serious health issues like stroke, heart attack, or kidney problems
• By lowering blood pressure, it contributes to maintaining a healthier cardiovascular system

2. Improves Heart Function:

• This medication is often prescribed for individuals with heart conditions, as it may help to reduce the workload on the heart
• By helping the heartbeat more regularly and with less effort, it can improve heart function over time

3. Reduces Symptoms of Angina:

• Angina (chest pain) is typically caused by reduced blood flow to the heart
• Tolol XR 12.5mg can reduce the frequency and severity of angina attacks, allowing individuals to lead a more active life without the discomfort associated with chest pain

4. Extended-release beta-1 blocker formulation:

• Tolol XR 12.5mg is an extended-release formulation, meaning it provides a steady, controlled release of the medication throughout the day
• This reduces the need for multiple doses, making it easier for patients to stick to their medication regimen

5. Helps support heart rate and rhythm control under medical supervision:

• The medication can help regulate abnormal heart rhythms (arrhythmias) and manages complications from conditions like atrial fibrillation, by ensuring that the heart beats at a normal, steady rate

How TOLOL XR 12.5 TABLET Works

• For Hypertension: Tolol XR 12.5mg works by blocking the effect of adrenaline on the heart and decreasing cardiac output, also reducing the outflow of sympathetic neurons, and suppressing renin activity (normally responsible for the increase in blood pressure). Together, these actions lower blood pressure effectively
• For angina pectoris: Tolol XR 12.5mg works by blocking adrenaline effects on the heart and decreases the heart rate, blood pressure, and extent of heart contraction. It also reduces the oxygen requirements of the heart, providing relief from angina
• For Heart failure: Tolol XR 12.5mg slows down the heart rate and makes it easier for the heart to pump blood around the body

How to use TOLOL XR 12.5 TABLET

1. Recommended dosage schedule for Tolol XR 12.5:

• Initial Dosage: For most patients, the typical starting dosage is 12.5 mg once daily.
• Adjustment: Depends on your doctor’s assessment, the dosage may be gradually increased. Your doctor may adjust your dose over time based on your response to the medication
• Common dosage range: The dosage may range from 12.5 mg to 100 mg per day, depending on the specific condition and patient's individual needs

2. Dosage for specific conditions

High Blood Pressure (Hypertension):

• Starting Dose: Typically, 12.5 mg once daily
• Maximum Dose: Up to 200 mg per day, depending on your individual needs and doctor recommendations

Heart Failure:

• Starting Dose: For patients with heart failure, the initial dosage is usually 12.5 mg daily
• Maximum Dose: The dose may be increased to a maximum of 200 mg daily

Angina (Chest Pain)

• Starting Dose: Typically, 12.5 mg once daily

Arrhythmias (Irregular Heartbeat)

• Starting Dose: Usually begins with 12.5 mg daily

3. How to take Tolol XR 12.5mg

• Take once a day: Tolol XR 12.5mg is an extended-release tablet that should be taken once daily, at the same time each day, to maintain consistency
• Swallow whole: Do not crush, chew, or break the tablet. Swallow it whole with a glass of water
• With or without food: Tolol XR 12.5mg can be taken with or without food but taking it with food can help reduce any stomach upset
• Do not split the tablet: Extended-release tablets should be taken whole to maintain the extended release of the medication throughout the day

Understanding the Once-daily administration format:

• Tolol XR 12.5mg is an extended-release formulation, designed for once-daily use. This means the medication is released slowly over time, helping to maintain consistent blood levels of the active ingredient throughout the day
• The extended-release format also makes it easier to incorporate the medication into your daily routine, reducing the need for multiple doses

How long should you continue taking Tolol XR 12.5?

• The duration of management with Tolol XR 12.5mg will depend on your doctor’s assessment. For chronic conditions like hypertension or heart failure, you may need to take it long-term
• Your doctor will monitor your condition and adjust the treatment as necessary
• Do not stop taking the medication without consulting your doctor, as doing so may lead to an increased risk of health complications

What if I forgot to take TOLOL XR 12.5 TABLET

• If you miss a dose of Tolol XR 12.5mg, take it as soon as you remember
• If it is close to the time of your next dose, skip the missed dose and continue with your regular dosing schedule
• Do not take two doses at the same time to make up for a missed dose, as this may increase the risk of side effects

Overdose

• Seek medical attention: If you suspect an overdose, seek immediate medical attention
• Symptoms of overdose: Symptoms may include extreme tiredness, dizziness, shortness of breath, or slow heart rate. These symptoms require prompt medical intervention

Side Effects Of TOLOL XR 12.5 TABLET

What are the commonly reported side effects of Tolol XR 12.5?

Common side effects:

• feeling faint on standing because of low blood pressure
• tiredness, drowsiness
• cold hands and feet
• palpitations
• dizziness
• headache
• diarrhoea, constipation, abdominal pain
• fluid retention (swelling)
• muscle cramps

When to consult a doctor?

• symptoms of an allergic reaction such as skin rash, itching, flushing, swelling of the face, lips, tongue or throat, difficulty in breathing or swallowing

Are the side effects temporary or long-term?

1. Temporary side effects

• Some side effects of Tolol XR 12.5mg are temporary and may diminish as your body adjusts to the medication
• These side effects typically resolve within a few days or weeks of starting the medication like fatigue or tiredness, dizziness or lightheadedness, gastrointestinal distress (nausea, diarrhea, constipation), cold hands or feet and sleep disturbances

What to do:

• If these symptoms persist beyond a few weeks, or if they interfere with daily activities, you should consult your healthcare provider for guidance

2. Long-term side effects

• Some side effects may persist longer and might require ongoing management or medical attention
• Long-term side effects are less common but can occur, especially if the medication is not well-tolerated like slow heart rate, low blood pressure, sexual dysfunction, mood changes or depression, respiratory issues and swelling of legs or ankles

What to do:

• If any long-term side effects develop, it is important to discuss them with your healthcare provider

Warning & Precautions

Pregnancy

Contraindicated

Tolol XR 12.5 is not recommended for use in pregnant women. Animal and human studies suggest close monitoring is needed.

Breastfeeding

Consult your doctor

Metoprolol may pass into breast milk. Your doctor may recommend alternative options.

Driving and Using Machines

Use with Caution

Tolol XR 12.5 may cause fatigue, drowsiness, especially when starting or adjusting the dose. Avoid driving, operating heavy machinery, or doing tasks requiring focus until you understand how your body reacts.

Alcohol

Consult your doctor

Avoid alcohol consumption while taking this medicine as it may enhance drowsiness or lower blood pressure.

Kidney

Use with Caution

Tolol XR 12.5 should be used with caution in patients with kidney diseases such as abnormal kidney function.

Liver

Use with Caution

Tolol XR 12.5 should be used with caution in patients with liver diseases. Dosage will be adjusted if necessary.

Allergy

Contraindicated

Do not take Tolol XR 12.5 if you are allergic to Metoprolol or any other ingredients in this medicine.

Lungs

Contraindicated

Beta-blockers may affect breathing in some individuals so Tolol XR 12.5 is not recommended for use in patients with bronchospastic diseases like asthma or COPD.

Heart Disease

Consult your doctor

Tolol XR 12.5 is not recommended for use in patients with severe bradycardia, low blood pressure, second or third-degree heart block, cardiogenic shock, decompensated cardiac failure, or sick sinus syndrome (unless a permanent pacemaker is present) and should be used with caution in patients with 1st-degree heart block, myocardial infarction, angina pectoris, heart failure, diseases of the heart valve, or enlarged heart muscle.

Use In Pediatrics

Consult your doctor

Safety and effectiveness of Tolol XR 12.5 in paediatric patients have not been established.

Use In Geriatrics

Use with Caution

Tolol XR 12.5 should be used with caution in elderly patients aged 65 years or above.

Other Warnings for TOLOL XR 12.5 TABLET

Before taking this medicine, inform your doctor if you have:

• major surgery or anaesthesia
• stroke
• diabetes or low blood sugar
• hyperthyroidism
• peripheral vascular disease
• psoriasis

Who should not take [GBNKEYWORD

Tolol XR 12.5 is not recommended for use if you have:

• severe peripheral arterial disease
• metabolic acidosis
• unmanaged phaeochromocytoma

Diet and Lifestyle Advice

1. Eat a Heart-Friendly Diet

Focus on a diet that helps support healthy blood pressure and cardiovascular function:

• Include: Fresh fruits, vegetables, whole grains, legumes, nuts, and seeds.
• Choose: Low-fat dairy, lean protein (chicken, fish, tofu), and plant-based oils like olive oil
• Limit: Excess salt, saturated fat, processed foods, and sugary snacks

2. Manage Salt (Sodium) Intake

High sodium can affect how well your body responds to medications like Tolol XR.

• Use herbs and spices instead of salt to flavour food
• Check labels for "low-sodium" or "no added salt" versions of packaged items

3. Stay Active with Regular Exercise

Light to moderate exercise can support overall cardiovascular wellness

• Aim for 30 minutes of brisk walking, swimming most days of the week
• Avoid intense exercise without consulting your healthcare provider, especially if you are adjusting doses

4. Avoid Smoking and Limit Alcohol

Lifestyle choices play a major role in the effectiveness of your medication:

• Quit smoking - it adds extra strain on the heart
• Limit alcohol to light or moderate intake and always consult your doctor about safe levels

5. Stay Hydrated

Dehydration can affect blood pressure and heart function:

• Drink adequate water throughout the day
• Avoid excessive caffeine, which may interfere with blood pressure

6. Manage Stress effectively

Chronic stress can interfere with heart health and overall wellness

• Try deep breathing, guided meditation, or relaxation techniques
• Maintain a healthy work-life balance and get enough sleep (7–8 hours/night)

7. Take Medication at the Same Time Daily

• Choose a time you can remember daily
• Consider using a pill organizer or phone reminder

8. Monitor Weight and Health Indicators

• Keep a blood pressure journal
• Weigh yourself weekly and watch for significant changes
• Record any new symptoms and discuss them during check-ups

Drug - Drug interaction

1. Blood Pressure-Lowering Medications (Antihypertensives)

• Calcium Channel Blockers (e.g., Diltiazem, Verapamil): Both metoprolol and calcium channel blockers like diltiazem and verapamil lower blood pressure
• When used together, these medications may cause severe hypotension (low blood pressure) and may slow the heart rate excessively
• Clonidine: Clonidine, when taken with beta-blockers like metoprolol, may increase the risk of rebound hypertension (a sudden increase in blood pressure) if clonidine is suddenly discontinued

2. Antiarrhythmic Medications

• Amiodarone, Sotalol: Both metoprolol and antiarrhythmic medications like amiodarone or sotalol can lower heart rate. The combination may lead to severe bradycardia or heart block

3. Insulin and Oral Hypoglycemic Agents

• Insulin and Oral Antidiabetic Drugs (e.g., Metformin, Glibenclamide): Metoprolol can mask the symptoms of hypoglycemia (low blood sugar), such as tachycardia (increased heart rate), which is a key indicator of low blood sugar. While it does not lower blood sugar directly, it can make it harder for patients to notice low blood sugar, especially in diabetic individuals

4. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

• Ibuprofen, Naproxen, Aspirin: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may reduce the blood pressure-lowering effects of metoprolol. NSAIDs can lead to fluid retention and sodium retention, which can counteract the effects of beta-blockers

5. Rifampin (Antibiotic)

• Rifampin, an antibiotic used to manage tuberculosis and other infections, can decrease the effectiveness of metoprolol by increasing its metabolism in the liver. This may lower blood levels of metoprolol, reducing its blood pressure-lowering effects

6. CYP2D6 Inhibitors

• Fluoxetine, Paroxetine, Quinidine: These medications are CYP2D6 inhibitors and can increase the blood levels of metoprolol. This may enhance the effects of metoprolol, increasing the risk of bradycardia and hypotension

7. Antidepressants (Tricyclic Antidepressants, MAOIs)

• Tricyclic Antidepressants (e.g., Amitriptyline, Nortriptyline) and Monoamine Oxidase Inhibitors (MAOIs): Tricyclic antidepressants and MAOIs can increase the risk of severe hypotension when combined with metoprolol

8. Other Beta-Blockers and Anti-Arrhythmic Medications

Other Beta-Blockers (e.g., Atenolol, Carvedilol): Combining Tolol XR 12.5mg with other beta-blockers can lead to severe bradycardia, heart block, and hypotension

Synopsis

More Information

Compare Tolol XR 12.5mg with 25mg and 50mg

Understanding the Body's Response to Metoprolol Succinate (Tolol XR 12.5mg)

The body’s response to metoprolol can vary based on individual factors such as age, pre-existing medical conditions, and the use of other medications. Here how the body typically reacts:

1. Immediate Physiological Effects

• Heart Rate Reduction: One of the primary actions of metoprolol is to slow the heart rate. This can be noticeable, especially when you first start the medication or when the dosage is adjusted
• Lowered Blood Pressure: By blocking beta receptors, metoprolol reduces the force of the heart's contractions and dilates blood vessels, leading to lower blood pressure
• Improved Heart Function: In patients with heart failure or chronic conditions affecting the heart, metoprolol helps the heart pump more efficiently by reducing the heart workload

2. Common Early Reactions

• As your body adjusts to metoprolol, certain effects may be noticeable during the initial phase of management like fatigue or drowsiness, dizziness and cold extremities

Regular check-ups and blood tests

Regular follow-ups with your healthcare provider are essential for assessing how your body is responding to metoprolol. During these visits, your doctor may:

• Measure your heart rate and blood pressure to ensure they are within the desired range
• Perform blood tests to monitor for any changes in kidney function or other important parameters, as beta blockers can sometimes affect these systems

3. Adjusting dosage based on tolerance

If you experience persistent or troubling side effects, your doctor may consider:

• Adjusting the dosage: If you experience significant fatigue or dizziness, your doctor may lower the dose of metoprolol.
• Switching medications: If metoprolol is not well-tolerated, your doctor may switch you to another beta blocker or a different class of medication entirely.

Related products:

• Prolomet XL 12.5mg Tablet 10'S
• Tolol XR 12.5mg Tablet 10'S

FAQs About TOLOL XR 12.5 TABLET

References

1. K D Tripathi. Cardiovascular drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page - 523, 545, 564.

2. Bethesda (MD). Metoprolol. National Institute of Health. NLM. National Centre for Biotechnology Information. PubMed, 2006. [Accessed on 9th May 2025] 

3. Aralez Pharmaceuticals US Inc. Metoprolol. [Revised in December 2016] [Accessed on 9th May 2025] 

4. Dr Reddy’s Laboratories Limited. Metoprolol. [Revised in April 2016] [Accessed on 9th May 2025] 

5. STADA Arzneimittel AG. Metoprolol. [Accessed on 9th May 2025] e

Useful Diagnostic Tests

• Cardiac Risk Profile
• Lipid Profile
• Lipid Profile-Extended
• Kidney function test (KFT)

Author Details

Written By Dr. Janet.C - Pharm.D

Reviewed By Dr. Sankara Babu Gorle - MBBS, MD(Pharmacology) View profile

Last updated on 10 May 2025 | 07:16 PM(IST)