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  Metoprolol

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems Cardiovascular and Peripheral Vascular System
Category Selective B1 Blocker


Pharmacokinetics

It is well absorbed after oral administration, extensively metabolised in the liver with little unchanged drug appearing in the urine. Its bio-availablity is 50%.



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Indications

Meoprolol is used in the treatment of hypertension, to relieve angina and in IHD patients to help prevent recurrent Myocardial Infarction, to correct cardiac arrhythmias, in hyperthyroidism. It has a membrane stabilising effect in large doses. It causes decreased automaticity, conduction velocity and increases the refractory period to nerve impulses in nerve conduction. As a result, they decrease the heart's need for blood and oxygen by reducing its workload. They also help to maintain the cardiac rhythm.



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Routes of Administration and Dosage

For short-acting oral dose (tablets): Hypertension or angina : Adults: 100 to 450 mg a day, taken as a single dose or in divided doses. For treatment after a MI: Adults: 50 mg every six hours starting fifteen minutes after last intravenous dose. Then 100 mg two times a day for three months to 1 year. For long-acting oral dosage forms (extended-release tablets): For Hypertension or angina :Adults : Up to 400 mg once a day. For injection dosage form: For treatment of a MI: Adults: 5 mg every two minutes for three doses.



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Contra Indications

Metoprolol is contraindicated in Sinus bradycardia, 2nd & 3rd degree heart block, untreated cardiac failure, cardiogenic shock and asthma.



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Precautions

Allergies : Allergic reaction to the beta-blocker may occur. Pregnancy : Use of beta-blockers during pregnancy has been associated with hypoglycaemia, dyspnoea, bradycardia, hypotension in the new born infant. Breast-feeding : Atenolol may pass into breast milk. Problems such as dyspnoea, bradycardia, hypotension have been reported in nursing babies. Adults : Some side effects are more likely to occur in the elderly, who are usually more sensitive to the effects of beta-blockers. Also, beta-blockers may reduce tolerance to cold temperatures in elderly patients.



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Interactions

It may increase the risk of serious allergic reaction to these drugs: Aminophylline, Caffeine, Deriphylline, Oxtriphylline or Theophylline : the effects of both these drugs and beta-blockers may be blocked; in addition, theophylline levels in the body may be increased, especially in patients who smoke. Oral Antidiabetics or Insulin: There is an increased risk of hyperglycemia ; beta-blockers may cover up certain symptoms of hypoglycemia such as increases in pulse rate and hypertension, and may prolong the hypoglycemia. Calcium channel blockers (bepridil, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, verapamil ) : Effects on blood pressure may be increased. Cardiac arrhythmias may occur when beta-blockers are used with calcium channel blockers. Cocaine: Cocaine may block the effects of beta-blockers; in addition, there is an increased risk of hypertension, tachycardia, and possibly cardiac arrhythmias if cocaine is used while taking a beta-blocker. With Monoamine oxidase (MAO) inhibitors: Taking beta-blockers within 2 weeks of taking monoamine oxidase (MAO) inhibitors may cause severe hypertension.



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Brand Names

Betaloc (Astra- IDL), Lopresor (Novartis), Metocard (Torrent), Metolar (Cipla).



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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