Methox
Generic Name
Metoprolol Tartrate
Manufacturer
Acme Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| methox 25 mg tablet | ৳ 5.52 | ৳ 55.20 |
Description
Overview of the medicine
Methox 25 mg Tablet contains Metoprolol Tartrate, a beta-blocker primarily used to treat high blood pressure, angina (chest pain), and certain heart rhythm disorders. It also helps improve survival after a heart attack and manages stable chronic heart failure.
Uses & Indications
Dosage
Adults
Hypertension: Initially 25-50 mg twice daily. The dosage can be increased gradually up to 100-200 mg daily in divided doses. Angina: 50-100 mg twice daily. Post-MI: 25-50 mg every 6 hours for 48 hours, then 100 mg daily.
Elderly
No specific dosage adjustment is generally required, but close monitoring is advised, starting with the lower end of the dosage range.
Renal_impairment
No dosage adjustment is necessary for patients with impaired renal function.
How to Take
Take Methox 25 mg Tablet orally, preferably with or immediately after meals to enhance absorption. Swallow the tablet whole with water. Do not crush, chew, or break it.
Mechanism of Action
Metoprolol Tartrate selectively blocks beta-1 adrenergic receptors, primarily located in the heart. This action reduces heart rate, myocardial contractility, and cardiac output, leading to a decrease in blood pressure and myocardial oxygen demand.
Pharmacokinetics
Onset
Within 15-30 minutes after oral administration.
Excretion
Mainly via kidneys, with about 95% excreted as metabolites and less than 5% as unchanged drug.
Half life
Approximately 3-7 hours.
Absorption
Rapid and complete oral absorption, but extensive first-pass metabolism results in a bioavailability of about 50%.
Metabolism
Primarily hepatic, largely via CYP2D6.
Side Effects
Contraindications
- Known hypersensitivity to metoprolol or other beta-blockers
- Sinus bradycardia (slow heart rate)
- Second- or third-degree atrioventricular (AV) block
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe peripheral arterial disease
- Severe asthma or chronic obstructive pulmonary disease (COPD)
Drug Interactions
Clonidine
If discontinuing concomitant clonidine and metoprolol, discontinue metoprolol first, then taper clonidine to avoid rebound hypertension.
MAO Inhibitors
May potentiate the hypotensive effect.
Other Antihypertensive Agents
Additive hypotensive effects.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effects of metoprolol.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
CYP2D6 Inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
May increase metoprolol plasma concentrations, leading to increased beta-blocking effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, cardiac failure, and hypoglycemia. Treatment is symptomatic and supportive; may involve atropine for bradycardia, vasopressors for hypotension, and glucagon for severe heart failure.
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; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Known hypersensitivity to metoprolol or other beta-blockers
- Sinus bradycardia (slow heart rate)
- Second- or third-degree atrioventricular (AV) block
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe peripheral arterial disease
- Severe asthma or chronic obstructive pulmonary disease (COPD)
Drug Interactions
Clonidine
If discontinuing concomitant clonidine and metoprolol, discontinue metoprolol first, then taper clonidine to avoid rebound hypertension.
MAO Inhibitors
May potentiate the hypotensive effect.
Other Antihypertensive Agents
Additive hypotensive effects.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effects of metoprolol.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
CYP2D6 Inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
May increase metoprolol plasma concentrations, leading to increased beta-blocking effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, cardiac failure, and hypoglycemia. Treatment is symptomatic and supportive; may involve atropine for bradycardia, vasopressors for hypotension, and glucagon for severe heart failure.
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; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
FDA 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 hypertension, angina, and heart failure. It has a well-established safety profile.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- ECG (especially in patients with pre-existing cardiac conditions)
- Liver function tests (periodically during long-term therapy)
- Blood glucose (in diabetic patients)
Doctor Notes
- Emphasize the importance of gradual withdrawal to prevent rebound hypertension or exacerbation of angina.
- Caution in patients with obstructive airway disease (e.g., asthma, COPD) due to potential for bronchoconstriction.
- Monitor for signs of bradycardia and hypotension, especially at initiation or dose titration.
- Advise diabetic patients to monitor blood glucose levels closely due to masking of hypoglycemic symptoms.
Patient Guidelines
- Do not stop taking Methox 25 mg Tablet abruptly without consulting your doctor, as this can worsen your condition.
- Report any symptoms like severe dizziness, very slow heartbeat, or difficulty breathing to your doctor immediately.
- Take your medication regularly as prescribed, preferably with food.
- Monitor your blood pressure and heart rate regularly at home as advised by your doctor.
- Inform your doctor or dentist about Methox before any surgery or dental procedures.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Methox 25 mg Tablet may cause dizziness, fatigue, or blurred vision, especially at the beginning of treatment or when changing dosage. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
Lifestyle Advice
- Adopt a heart-healthy diet low in saturated fats, cholesterol, and sodium.
- Engage in regular physical activity as advised by your doctor.
- Manage stress through techniques like meditation or yoga.
- Limit alcohol consumption and avoid smoking.
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