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Aged patients are recommended to start from 50 mg daily dose.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. 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. 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. Kidnely failure does not require a dosage correction while liver failure requires usage of other beta-adrenoblockers which are not destructed in liver. Dosage depends on the treated disease and may vary between 100-450 mg daily. Take the forgotten dose as soon as you remember. Your individual dosage should be prescribed by your physician.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. Do not chew, squash or break a tablet, drink a glass of water with it. It also diminishes myocard irritability, cardiac output and causes other effects.Topme XL should be taken with food or just after a meal. Denver, Mesa, Oregon, Iowa, Michigan, North Carolina, AR, Virginia, UT, Michigan, West Virginia, Minneapolis, Charlotte, OK, Miami, Washington, Jacksonville, Maine, Boston, Hawaii, Wisconsin, Kentucky, Fort Worth, Tennessee, Fresno, San Jose, MT, Delaware, Oklahoma City, Nashville-Davidson, Milwaukee, MN, Colorado, Alaska, New Mexico, ND, Arizona, Nebraska, IL, Detroit, AK, Indiana, NH, IA, Hempstead, Cleveland, WYIndianapolis, Nevada, Austin, Baltimore, Massachusetts, Pennsylvania, CO, SD, District of Columbia, Washington, Texas, Pennsylvania, District of Columbia, San Diego, Vermont, New Jersey, NM, Idaho, Colorado, NV, ME, Dallas, Virginia, CA, Missouri, San Antonio, San Francisco, Portland, MA, Rhode Island, CT, OH, New York, Memphis, MD, Omaha, Seattle, Phoenix, AZ, OR, Chicago, GA, Maryland, Nebraska, HI, VA, New Mexico, Los Angeles, Florida, Georgia, WV, El Paso, North Dakota, Washington, NY, Houston, TN, KS, Oklahoma, KY, NY, Oregon, Florida, MI, Kansas, Atlanta, Texas, Honolulu, Wisconsin, NJ, Montana, New York, New Orleans, AL, NC, Sacramento, Ohio, MS, VT, Nevada, MO, Las Vegas, Illinois, Virginia Beach, TX, Arkansas, Columbus, ID, NE, LA, Hawaii, California, Maryland, South Carolina, Tucson, Indiana, Illinois, IN, Kansas City, Tennessee, DC, Brookhaven, Minnesota, PA, SC, Colorado Springs. Arizona, WA, Missouri, Louisiana, California, Georgia, Tulsa, Mississippi, DE, Utah, Oklahoma, RI, Albuquerque, New Hampshire, Long Beach, Philadelphia, South Dakota, Ohio, FL, North Carolina, Louisiana, Oakland, Minnesota, Alabama, Massachusetts, Wyoming, Connecticut, WI,