Nepco CR
Generic Name
Metoprolol Succinate Extended-Release
Manufacturer
Nepco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nepco cr 165 mg tablet | ৳ 35.00 | ৳ 350.00 |
| nepco cr 825 mg tablet | ৳ 25.00 | ৳ 250.00 |
Description
Overview of the medicine
Nepco CR 50 mg is an extended-release formulation of metoprolol succinate, a cardioselective beta-blocker used primarily to treat hypertension, angina pectoris, and heart failure.
Uses & Indications
Dosage
Adults
Initial dose 25-50 mg once daily; usual maintenance dose 50-200 mg once daily.
Elderly
Start with the lowest effective dose; dose adjustment may be necessary based on response and tolerability.
Renal_impairment
No initial dose adjustment required for patients with renal impairment.
How to Take
Swallow the tablet whole with water. Do not crush, chew, or divide the tablet. Can be taken with or without food, preferably at the same time each day.
Mechanism of Action
Metoprolol selectively blocks beta-1 adrenergic receptors in the heart, reducing heart rate, myocardial contractility, and blood pressure. The controlled-release formulation ensures a sustained therapeutic effect over 24 hours.
Pharmacokinetics
Onset
Onset of action typically within 1-2 hours for the extended-release formulation.
Excretion
Primarily excreted via the kidneys (approx. 95% as metabolites, 5% unchanged drug).
Half life
Elimination half-life ranges from 3-7 hours.
Absorption
Well absorbed from the gastrointestinal tract, with the extended-release formulation providing sustained plasma concentrations.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6.
Side Effects
Contraindications
- Severe Bradycardia
- Second or third-degree Heart Block
- Cardiogenic Shock
- Decompensated Heart Failure
- Severe Peripheral Arterial Disease
Drug Interactions
0
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine): Can increase metoprolol plasma concentrations.
1
Calcium Channel Blockers (e.g., verapamil, diltiazem): Can enhance bradycardia and hypotension.
2
NSAIDs: May reduce the antihypertensive effect of beta-blockers.
3
Other antihypertensives: May have additive hypotensive 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, heart failure, bronchospasm, and cardiogenic shock. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Metoprolol is excreted in human breast milk; exercise caution when administered to a nursing woman.
Side Effects
Contraindications
- Severe Bradycardia
- Second or third-degree Heart Block
- Cardiogenic Shock
- Decompensated Heart Failure
- Severe Peripheral Arterial Disease
Drug Interactions
0
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine): Can increase metoprolol plasma concentrations.
1
Calcium Channel Blockers (e.g., verapamil, diltiazem): Can enhance bradycardia and hypotension.
2
NSAIDs: May reduce the antihypertensive effect of beta-blockers.
3
Other antihypertensives: May have additive hypotensive 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, heart failure, bronchospasm, and cardiogenic shock. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Metoprolol is excreted in human breast milk; exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Available in all pharmacies and hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of metoprolol succinate extended-release in hypertension, angina, and chronic heart failure. Data supports its once-daily dosing regimen for sustained blood pressure control.
Lab Monitoring
- Routine monitoring of blood pressure and heart rate.
- Periodic monitoring of renal function, especially in patients with pre-existing impairment.
Doctor Notes
- Educate patients on the importance of adherence and not discontinuing abruptly.
- Consider potential drug interactions, especially with other cardiovascular medications.
- Regularly assess patient's cardiac function and blood pressure.
Patient Guidelines
- Take Nepco CR regularly as prescribed, even if you feel well.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Monitor your blood pressure and heart rate regularly as advised by your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nepco CR may cause dizziness or fatigue, especially at the beginning of treatment. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as recommended by your doctor.
- Avoid smoking and limit alcohol consumption.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.