Megron-ER
Generic Name
Metoprolol Succinate Extended-Release 25 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| megron er 25 mg tablet | ৳ 30.00 | ৳ 420.00 |
Description
Overview of the medicine
Megron-ER 25 mg Tablet is an extended-release beta-blocker primarily used for the management of hypertension, angina pectoris, and for the prophylaxis of migraine headaches. It works by blocking the action of certain natural chemicals in the body, such as epinephrine, on the heart and blood vessels.
Uses & Indications
Dosage
Adults
For Migraine Prophylaxis: Initial 25-50 mg once daily; usual maintenance 50-200 mg once daily. For Hypertension: Initial 25-100 mg once daily; maintenance 100-400 mg once daily.
Elderly
Similar to adult dosage, but caution with initial lower doses and careful titration, especially in patients with renal or hepatic impairment.
Renal_impairment
No dosage adjustment needed for renal impairment, but caution in severe cases.
How to Take
Take orally once daily, preferably with or immediately after a meal. Swallow whole; do not crush, chew, or divide.
Mechanism of Action
Metoprolol is a beta-1 selective adrenergic receptor blocker. It reduces heart rate, myocardial contractility, and blood pressure by blocking beta-1 receptors in the heart. For migraine prophylaxis, its exact mechanism is not fully understood but is thought to involve reducing central adrenergic tone and stabilizing cerebral vasculature.
Pharmacokinetics
Onset
Within 1 hour for blood pressure reduction; migraine prophylaxis takes several weeks for full effect.
Excretion
Renal (about 95% as metabolites, 5% as unchanged drug).
Half life
Approximately 3-7 hours for metoprolol succinate.
Absorption
Well absorbed from the GI tract; extensive first-pass metabolism. Bioavailability is about 50% for standard tablets, slightly higher for ER due to slower absorption.
Metabolism
Primarily hepatic, mainly by CYP2D6.
Side Effects
Contraindications
- Cardiogenic shock
- Sinus bradycardia (heart rate < 45 bpm)
- Second or third-degree heart block (without a pacemaker)
- Sick sinus syndrome (without a pacemaker)
- Severe peripheral arterial disease
- Decompensated heart failure
- Hypersensitivity to metoprolol or other beta-blockers
Drug Interactions
Digoxin
Increased risk of bradycardia.
Clonidine
Withdrawal of clonidine may result in rebound hypertension if metoprolol is stopped too soon.
MAO inhibitors
Increased risk of hypertension and bradycardia.
NSAIDs (e.g., ibuprofen)
May reduce the antihypertensive effect of metoprolol.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and heart block.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, cardiac failure. Management involves supportive measures, atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Metoprolol is excreted in breast milk; caution is advised during breastfeeding.
Side Effects
Contraindications
- Cardiogenic shock
- Sinus bradycardia (heart rate < 45 bpm)
- Second or third-degree heart block (without a pacemaker)
- Sick sinus syndrome (without a pacemaker)
- Severe peripheral arterial disease
- Decompensated heart failure
- Hypersensitivity to metoprolol or other beta-blockers
Drug Interactions
Digoxin
Increased risk of bradycardia.
Clonidine
Withdrawal of clonidine may result in rebound hypertension if metoprolol is stopped too soon.
MAO inhibitors
Increased risk of hypertension and bradycardia.
NSAIDs (e.g., ibuprofen)
May reduce the antihypertensive effect of metoprolol.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and heart block.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, cardiac failure. Management involves supportive measures, atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Metoprolol is excreted in breast milk; caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials support the efficacy of metoprolol in hypertension, angina, heart failure, and migraine prophylaxis.
Lab Monitoring
- Blood pressure
- Heart rate
- ECG (especially with co-morbidities)
- Renal function (periodically)
Doctor Notes
- Advise patients not to abruptly discontinue the medication due to rebound effects.
- Monitor heart rate and blood pressure regularly.
- Counsel on potential CNS side effects, especially in initial weeks.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor.
- Take your dose at the same time each day.
- Report any unusual side effects like severe dizziness or very slow heart rate.
- Avoid alcohol while on this medication as it may increase side effects.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet and regular exercise to manage hypertension and overall heart health.
- Monitor blood pressure and heart rate regularly as advised by your doctor.
- Avoid smoking.
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