Metocard
Generic Name
Metoprolol Tartrate Injection
Manufacturer
Square Pharmaceuticals Ltd.
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 5 mg Injection contains Metoprolol Tartrate, a beta-blocker used to treat conditions like acute myocardial infarction, supraventricular tachycardia, and sometimes severe hypertension by blocking beta-1 receptors in the heart.
Uses & Indications
Dosage
Adults
Acute Myocardial Infarction: Initially, 5 mg IV given slowly (over 2 minutes), repeated every 5 minutes up to a total of 15 mg. Supraventricular Tachycardia: 2.5-5 mg IV slowly, repeated as needed up to 10-15 mg total.
Elderly
No specific dose adjustment for elderly, but careful monitoring is advised due to potential for increased sensitivity and co-morbidities.
Renal_impairment
No dosage adjustment necessary for renal impairment as metoprolol is primarily metabolized by the liver.
How to Take
Administer intravenously slowly (over 1-2 minutes) under close medical supervision, with continuous ECG and blood pressure monitoring. Do not administer by rapid bolus.
Mechanism of Action
Metoprolol is a beta-1 selective adrenergic receptor blocker. It reduces heart rate, myocardial contractility, and blood pressure by blocking the effects of catecholamines on the heart. This reduces myocardial oxygen demand and helps stabilize heart rhythm.
Pharmacokinetics
Onset
Within minutes (IV)
Excretion
Excreted primarily via the kidneys (urine), with less than 5% as unchanged drug.
Half life
3-7 hours
Absorption
Rapidly and completely absorbed after oral administration, but bioavailability is reduced due to first-pass metabolism. For IV, 100% bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6.
Side Effects
Contraindications
- Second- or third-degree heart block
- Sick sinus syndrome (unless permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe bradycardia
- Hypotension (systolic <100 mmHg)
- Severe peripheral arterial disease
- Severe uncontrolled asthma
Drug Interactions
NSAIDs
May reduce the hypotensive effects of metoprolol.
Clonidine
If clonidine is withdrawn, metoprolol should be withdrawn first to avoid hypertensive crisis.
MAO Inhibitors
May cause severe hypertension.
Digitalis Glycosides
Increased risk of bradycardia and AV block.
Other Antiarrhythmics (e.g., Amiodarone)
Increased risk of bradycardia and cardiac depression.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Storage
Store at controlled room temperature (20-25°C), protected from light. Do not freeze.
Overdose
Symptoms: Bradycardia, hypotension, cardiac insufficiency, cardiogenic shock, bronchospasm, vomiting, impaired consciousness. Management: Symptomatic and supportive treatment. Atropine for bradycardia, glucagon for myocardial depression, vasopressors for hypotension, bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Metoprolol is excreted in breast milk; caution advised during lactation.
Side Effects
Contraindications
- Second- or third-degree heart block
- Sick sinus syndrome (unless permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure
- Severe bradycardia
- Hypotension (systolic <100 mmHg)
- Severe peripheral arterial disease
- Severe uncontrolled asthma
Drug Interactions
NSAIDs
May reduce the hypotensive effects of metoprolol.
Clonidine
If clonidine is withdrawn, metoprolol should be withdrawn first to avoid hypertensive crisis.
MAO Inhibitors
May cause severe hypertension.
Digitalis Glycosides
Increased risk of bradycardia and AV block.
Other Antiarrhythmics (e.g., Amiodarone)
Increased risk of bradycardia and cardiac depression.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Storage
Store at controlled room temperature (20-25°C), protected from light. Do not freeze.
Overdose
Symptoms: Bradycardia, hypotension, cardiac insufficiency, cardiogenic shock, bronchospasm, vomiting, impaired consciousness. Management: Symptomatic and supportive treatment. Atropine for bradycardia, glucagon for myocardial depression, vasopressors for hypotension, bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Metoprolol is excreted in breast milk; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture.
Availability
Hospitals, Clinics, Pharmacies (with prescription)
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials support the efficacy and safety of metoprolol in various cardiovascular conditions. Ongoing research continues to explore its applications.
Lab Monitoring
- Blood pressure
- Heart rate
- ECG
- Renal function (if applicable)
- Liver function (long-term therapy)
Doctor Notes
- Ensure continuous cardiac monitoring during IV administration.
- Titrate dose carefully, especially in elderly or patients with compromised renal/hepatic function.
- Educate patients about the importance of not abruptly stopping therapy.
Patient Guidelines
- This medicine will be administered by a healthcare professional.
- Report any discomfort, dizziness, or shortness of breath immediately.
- Do not stop beta-blocker therapy abruptly without consulting your doctor.
Missed Dose Advice
As an injection administered in a clinical setting, missed doses are unlikely. If a scheduled dose is missed in an outpatient setting, contact your doctor immediately.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment. Patients should be advised to exercise caution when driving or operating machinery until they know how the drug affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol intake.
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