Worsening cardiac failure may occur during up-titration of metoprolol succinate extended-release tablets. Sick sinus syndrome without a pacemaker.Known hypersensitivity to product components.Metoprolol Succinate Extended-Release Tablets are contraindicated in patients with:
Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue metoprolol succinate extended-release tablets therapy abruptly even in patients treated only for hypertension Warn patients against interruption or discontinuation of therapy without the physician’s advice.
If angina markedly worsens or acute coronary insufficiency develops, metoprolol succinate extended-release tablets administration should be reinstated promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. When discontinuing chronically administered metoprolol succinate extended-release tablets, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored. Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have occurred.
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