Metocard
Generic Name
Metoprolol
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metocard 5 mg injection | ৳ 120.40 | N/A |
Description
Overview of the medicine
Metocard (Metoprolol) is a beta-blocker used to treat high blood pressure, angina, and heart failure. It helps to slow down the heart rate and relax blood vessels, improving blood flow.
Uses & Indications
Dosage
Adults
For hypertension: 50-100 mg daily, as a single dose or in divided doses. For angina: 50 mg twice daily, may be increased up to 200 mg daily. For heart failure (extended-release): Initial 25 mg once daily, gradually titrate to target dose.
Elderly
No specific dose adjustment is usually required, but caution should be exercised and lower doses may be considered.
Renal_impairment
No dose adjustment is generally needed for renal impairment.
How to Take
Take orally, preferably with or immediately after a meal to enhance absorption and reduce gastrointestinal upset. Swallow extended-release tablets whole; do not crush, chew, or break.
Mechanism of Action
Metoprolol selectively blocks beta-1 adrenergic receptors in the heart, leading to a reduction in heart rate, cardiac output, and blood pressure. It also reduces myocardial oxygen demand.
Pharmacokinetics
Onset
Onset of action typically within 15-30 minutes after oral administration.
Excretion
Excreted mainly by the kidneys; approximately 95% of the dose is recovered in urine, with less than 5% as unchanged drug.
Half life
Elimination half-life ranges from 3 to 7 hours.
Absorption
Rapid and complete absorption from the gastrointestinal tract (for tartrate salt). Bioavailability is about 50% due to first-pass metabolism.
Metabolism
Extensively metabolized in the liver, primarily by the CYP2D6 enzyme.
Side Effects
Contraindications
- Sinus bradycardia
- Second or third-degree heart block
- Cardiogenic shock
- Decompensated heart failure
- Sick sinus syndrome (unless a permanent pacemaker is in place)
Drug Interactions
NSAIDs
May reduce the antihypertensive effects of Metoprolol.
Digitalis glycosides
Increased risk of bradycardia.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
Increased plasma concentrations of Metoprolol.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, cardiac insufficiency, bronchospasm, and potentially cardiogenic shock. Treatment involves supportive measures, including atropine for bradycardia, vasopressors for hypotension, and glucagon for refractory 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; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Sinus bradycardia
- Second or third-degree heart block
- Cardiogenic shock
- Decompensated heart failure
- Sick sinus syndrome (unless a permanent pacemaker is in place)
Drug Interactions
NSAIDs
May reduce the antihypertensive effects of Metoprolol.
Digitalis glycosides
Increased risk of bradycardia.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
Increased plasma concentrations of Metoprolol.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, cardiac insufficiency, bronchospasm, and potentially cardiogenic shock. Treatment involves supportive measures, including atropine for bradycardia, vasopressors for hypotension, and glucagon for refractory 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; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metoprolol has been extensively studied in numerous clinical trials establishing its efficacy and safety in various cardiovascular conditions, including hypertension, angina, and heart failure.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function (for patients with kidney impairment)
- Blood glucose (especially in diabetic patients)
Doctor Notes
- Consider individual patient response and titrate dose accordingly.
- Monitor blood pressure and heart rate regularly.
- Caution in patients with asthma or COPD; use a cardio-selective beta-blocker like metoprolol at the lowest effective dose.
- Educate patients on the importance of gradual discontinuation to avoid rebound effects.
Patient Guidelines
- Take Metocard regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking Metocard suddenly, as this can worsen your condition. Consult your doctor for gradual dose reduction.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Avoid or limit alcohol consumption while on Metocard.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Metocard may cause dizziness or fatigue, especially at the start of treatment or when the dose is changed. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Quit smoking.
- Manage stress through relaxation techniques.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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