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Kidnely failure does not require a dosage correction while liver failure requires usage of other beta-adrenoblockers which are not destructed in liver.At the background of common tolerance to the Topme XL among side effects are noticed abdominal cramps, fatigue, insomnia, nausea, depression, memory loss, fever, impotence, lightheadedness, slow heart rate, low blood pressure, cold extremities, sore throat, diarrhea, constipation, and shortness of breath or wheezing. Your individual dosage should be prescribed by your physician. Topme XL acts mostly blocking beta-adrenoreceptors of the heart and is used to treat hypertension, chest pain (angina), abnormal rhythms of the heart, to treat and prevent myocardial infarction. Dosage depends on the treated disease and may vary between 100-450 mg daily. Do not chew, squash or break a tablet, drink a glass of water with it. Aged patients are recommended to start from 50 mg daily dose.Topme XL should be taken with food or just after a meal. Take the forgotten dose as soon as you remember. If your next dose is less than 4 hours away, skip it and return to your schedule. Topme XL influences autonomic nervous system which stipulates increased heart rate by blocking its receptors and thus reducing abnormally rapid heart rhythms. It also diminishes myocard irritability, cardiac output and causes other effects.If you notice such symptoms as uneven heartbeats, shortness of breath, dizziness, weakness or fainting, bluish-colored fingernails, seek for immediate medical help. Do not try to compensate a missed dose by taking an extra one. Vermont, Maryland, Oklahoma City, Miami, Hempstead, Louisiana, NE, HI, New Orleans, Illinois, CA, Omaha, Ohio, Arizona, Louisiana, Dallas, Michigan, North Dakota, North Carolina, Colorado, Denver, Baltimore, El Paso, Connecticut, Long Beach, Hawaii, Montana, Texas, Delaware, Colorado, Kansas, Alabama, Fresno, Maryland, Hawaii, MS, Pennsylvania, Washington, Kentucky, New Jersey, Chicago, Tucson, AZ, District of Columbia, SD, Mississippi, PA, Missouri, Minnesota, Oklahoma, WA, San Jose, Missouri, KS, Minnesota, OR, Brookhaven, MO, Indianapolis, Georgia, UT, Oregon, Detroit, NV, WI, San Diego, Philadelphia, Sacramento, Las Vegas, Maine, Massachusetts, Ohio, Kansas City, Jacksonville, District of Columbia, Wisconsin, MD, KY, Indiana, CO, MT, NY, Oakland, Fort Worth, Florida, DC, NM, IN, California, AK, AR, NH, Tennessee, San Francisco, Pennsylvania, Albuquerque, Milwaukee, New Mexico, DE, RI, MA, MI, Atlanta, Phoenix, New York, Idaho, South Dakota, LA, Massachusetts, New Mexico, Cleveland, ID, Memphis, IL, TN, FL, IA, WV, Mesa, Virginia, Illinois, Wisconsin, VT, New Hampshire, Washington, West Virginia, Alaska, Boston, Tulsa, Columbus, SC, Virginia, Charlotte, NC, Rhode Island, Los Angeles, Honolulu, Virginia Beach, Oregon, Wyoming, MN, Austin, Georgia, TX, Indiana, South Carolina, Iowa, Nevada, Minneapolis, Nebraska, ME, Seattle, CT, Houston, GA, Colorado Springs. Arizona, OH, California, Utah, ND, San Antonio, NJ, Washington, North Carolina, Michigan, Tennessee, Arkansas, Texas, Oklahoma, VA, Florida, AL, Nevada, Nashville-Davidson, OK, Portland, New York, WYNebraska, NY,