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Abrupt withdrawal from this drug in instances of coronary artery disease which can exacerbate angina pectoris or cause a heart attack abrupt withdrawal from this drug can instigate a thyroid storm in patients with pre-existing thyroid conditions history of bronchospastic disease diabetes mellitus which can lead to masked symptoms of hypoglycemia as well as tachycardia heart failure rates may increase as dosages of this drug increase preexisting hepatic function impairment major noncardiac surgery upon initiation of high-dose extended release metoprolol succinate therapy.

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Metop succinate metoprolol succinate would provider longer, and more stable beta blocking effects.

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May potentiate cyp2d6 substrates eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, thioridazine, tolterodine, venlafaxine ; reduce dose of these.

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oral maintenance therapy with metoprolol or placebo was then continued for 3 months.

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