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Toprol XL

Drug Name: Toprol XL

Drug ID: 63

Nutritional Considerations

  • As with all Beta-blockers, the use of alcohol should be avoided or limited. It could increase Central Nervous System (CNS) side effects. Alcohol also increases the risk of lowering blood pressure too much.

    1. Mindell, E, Hopkins V: Prescription Alternatives. New Canaan, CT: Keats Publishing, Inc, 1998; p. 143.
    2. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
    3. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • Beta-blockers may also contribute to deficiencies in CoQ10. Supplementation is highly recommended with high quality Coenzyme Q10.

    1. Shand, D.G.: Clinical pharmacology of the beta-blocking drugs: implications for the postinfarction patient. Circulation, 1983, 67(Supp 1): 12-15.
    2. Product Information: Inderal, propranolol hydrochloride. Wyeth-Ayerst Laboratories, PA. 1993.
    3. Kishi H, Kishi T, Folkers K: Bioenergetics in clinical medicine III . Inhibition of coenzyme Q10-enzymes by clinically used antihypertensive drugs, Res Commun Chem Pathol Pharmacol, 1975, 12(3):533-40.
  • Calcium may interfere with the absorption of beta-blockers. Consider taking calcium supplements separately from all medications.

    1. The Medical Letter Handbook of Adverse Drug Interactions, 1995.
    2. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
  • Take with food to increase drug bioavailability.

    1. Pronsky, Z Food Medication Interactions, 11th edition, 1999
    2. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
    3. Wang BO, Semple HA. Inhibition of metoprolol metabolism by amino acids in perfused rat livers. Insights into the food effect? Drug Metab Dispos. 1997 Mar;25(3):287-95.

Herbal Considerations

  • These herbs may adversely affect the action of beta-blockers due to their cardiac properties: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot.

    1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
    2. PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
  • Natural licorice products, Ginseng and Ephedra (Ma huang) may cause hypertension and should be avoided by those with high blood pressure.

    1. Pronsky, ZM: Food-Medication Interactions, 11th edition, 1999
    2. Farese, RV et al., Licorice-induced hypermineralcorticoidism. NEJM. 1991, 325:1,1223-1,227.
    3. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
  • Some herbs possess diuretic properties that may intensify the action of antihypertensive drugs, which could result in an excessive lowering of blood pressure. Such herbs include:Alfalfa, Angelica, Astragalus, Basil, Bean Pod, Buckthorn, Burdock, Butcher’s Broom, Buchu, Celery, Cleavers, Cornflower, Dandelion, Elecampane, Elder, Goat's Rue, Hempnettle, Horsetail, Indian-Hemp, Juniper, Marigold, Meadowsweet, Parsley, Rauwolfia, Sarsaparilla, Sweet clover, Turmeric, and Vervain

    1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
    2. Facts and Comparisons, Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
    3. PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000

NDC Codes

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