Betasec
Generic Name
Metoprolol Succinate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| betasec 50 mg tablet | ৳ 0.77 | ৳ 7.70 |
Description
Overview of the medicine
Betasec 50 mg Tablet contains Metoprolol Succinate, a beta-blocker used to treat high blood pressure, angina (chest pain), and to improve survival after a heart attack or in certain heart failure conditions. It works by slowing down the heart rate and relaxing blood vessels.
Uses & Indications
Dosage
Adults
Hypertension: Initially 25-100 mg once daily, adjusted based on response up to 400 mg daily. Angina: Initially 100 mg once daily, increased up to 400 mg daily. Heart Failure: Initially 12.5-25 mg once daily, gradually increased over several weeks up to 200 mg daily.
Elderly
Similar to adult dosage, but caution is advised. Initiate with lower doses and titrate gradually.
Renal_impairment
No dosage adjustment is generally required for patients with renal impairment.
How to Take
Take orally, once daily, preferably with or immediately after a meal. Swallow the extended-release tablet whole; do not crush, chew, or break it.
Mechanism of Action
Metoprolol Succinate is a selective beta-1 adrenergic receptor blocker. It selectively blocks beta-1 receptors in the heart, reducing heart rate, myocardial contractility, and cardiac output, leading to a decrease in blood pressure. It also inhibits the release of renin and has anti-anginal and anti-arrhythmic effects.
Pharmacokinetics
Onset
Within 1-2 hours for initial effects; full therapeutic effect may be seen within a week.
Excretion
Excreted mainly by the kidneys; about 5% to 10% as unchanged drug.
Half life
Plasma half-life is approximately 3-7 hours for metoprolol succinate, but the extended-release formulation allows once-daily dosing.
Absorption
Well absorbed from the gastrointestinal tract. Extended-release formulation provides sustained release and absorption over 24 hours. Food increases bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 enzyme CYP2D6.
Side Effects
Contraindications
- Severe bradycardia (heart rate <45-50 bpm)
- Second or third-degree heart block
- Sick sinus syndrome (unless a pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe peripheral arterial disease
Drug Interactions
Clonidine
If clonidine is withdrawn, a hypertensive crisis may occur, especially if beta-blocker is also being withdrawn.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May attenuate the antihypertensive effects of metoprolol.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
May potentiate the cardiac depressant effects of metoprolol, leading to severe bradycardia or heart block.
CYP2D6 inhibitors (e.g., Bupropion, Fluoxetine, Paroxetine, Quinidine)
May increase plasma concentrations of metoprolol, increasing the risk of adverse effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, heart failure, and cardiogenic shock. Management involves symptomatic and supportive treatment, including atropine for bradycardia, vasopressors for hypotension, and glucagon for severe cases.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Metoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Severe bradycardia (heart rate <45-50 bpm)
- Second or third-degree heart block
- Sick sinus syndrome (unless a pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe peripheral arterial disease
Drug Interactions
Clonidine
If clonidine is withdrawn, a hypertensive crisis may occur, especially if beta-blocker is also being withdrawn.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May attenuate the antihypertensive effects of metoprolol.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
May potentiate the cardiac depressant effects of metoprolol, leading to severe bradycardia or heart block.
CYP2D6 inhibitors (e.g., Bupropion, Fluoxetine, Paroxetine, Quinidine)
May increase plasma concentrations of metoprolol, increasing the risk of adverse effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, heart failure, and cardiogenic shock. Management involves symptomatic and supportive treatment, including atropine for bradycardia, vasopressors for hypotension, and glucagon for severe cases.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Metoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metoprolol has undergone extensive clinical trials demonstrating its efficacy and safety in various cardiovascular conditions, including landmark trials like MERIT-HF for heart failure and the CAPRICORN study post-MI.
Lab Monitoring
- Regular monitoring of blood pressure and heart rate
- ECG monitoring for patients with cardiac conditions
- Blood glucose monitoring in diabetic patients (beta-blockers can mask hypoglycemia symptoms)
Doctor Notes
- Exercise caution in patients with bronchial asthma or chronic obstructive pulmonary disease (COPD).
- Monitor diabetic patients closely as beta-blockers can mask signs of hypoglycemia.
- Advise gradual withdrawal to avoid rebound effects.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor and do not stop taking it abruptly without consulting your doctor.
- Monitor your blood pressure and heart rate regularly as advised.
- Report any unusual symptoms like severe dizziness, slow heartbeat, or breathing difficulties to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Betasec may cause dizziness or fatigue, especially at the beginning of treatment or when the dose is increased. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Adopt a heart-healthy lifestyle including a balanced diet, regular exercise, and maintaining a healthy weight.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively.
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