Metolar-XR (Metoprolol Capsules)

Metoprolol Capsules
© Clearsky Pharmacy
Metolar-XR (Metoprolol Capsules) is used for the
treatment of hypertension (blood pressure), long-
term treatment of angina pectoris, treatment of
stable, symptomatic heart failure of ischemic,
hypertensive or cardiomyopathic origin as well
as for migraine prophylaxis.

Metolar-XR Capsules
Metolar-XR Capsules are
manufactured by Cipla limited, India.
(Website: www.cipla.com)

Metoprolol Succinate Capsules – Brand Names
Metoprolol Succinate capsules and
tablets are available as Lopressor,
Toprol XL, Metolar-XR, Betaloc,
Betaone-XL, Embeta, Lopresor,
Metocard-XL, Metolar, Metscore XL,
Prolomet-XL, Met-XL, Sitelol XR,
Starpress XL, and Topol-XL .

Active Ingredient
The active ingredient contained in Metolar-XR
capsules is Metoprolol Succinate.
Each extended-release Metolar XR capsule
contains Metoprolol Succinate equivalent to
25 mg, 50 mg or 100 mg of Metoprolol
Tartrate.

Chemical Structure
The structure of Metoprolol Succinate is
given below:

Uses of Metolar-XR Capsules
Metolar-XR Capsules manufactured by
Cipla limited India, is a beta-blocker used to
treat chest pain (angina), heart failure, high
blood pressure, Maintenance treatment after
myocardial infarction, Hyperthyroidism ,
Paediatric hypertension and migraine
prophylaxis.

Metolar-XR Dosage
➢Hypertension: The usual starting adult dosage
is 25 mg to 100 mg daily in a single dose. The
dosage may be increased at weekly (or longer)
intervals until optimum blood pressure reduction
is achieved.
➢Angina Pectoris: The dosage must be
individualized. The usual starting adult dosage is
100 mg daily, given in a single dose. Gradually
the dosage has to be increased at weekly
intervals until optimum clinical response has
been obtained or there is a pronounced slowing
of the heart rate.
The dosage of Metolar-XR Capsules (Metoprolol
Succinate) is given below:

Metoprolol Succinate Dosage
➢Heart Failure: The dosage must be individualized and
closely monitored during up-titration. Before initiation
of Metolar XR, stabilize the dose of other heart failure
medication therapy. The recommended adult starting
dose is 25 mg once daily for two weeks in patients with
NYHA class II heart failure and 12.5 mg once daily in
patients with more severe heart failure. Double the
dose very two weeks to the highest dosage level
tolerated by the patient or up to 200 mg of Metolar XR.
➢Migraine Prophylaxis: The dosage is 100 mg to 200
mg once daily in the morning.
The dosage of Metolar-XR capsules (Metoprolol
Succinate) is given below:

Storage Instructions
Metolar-XR (Metoprolol Capsules) have
to be stored at controlled room
temperature i.e. at 25°C (77°F) with
excursions permitted between 15° to
30°C (59° to 86°F).
Keep this as well as all other medicines
away from children and pets.

Metolar-XR Capsules
Contraindications
Metolar-XR Capsules is contraindicated in
patients with a hypersensitivity to Metoprolol
Succinate or any other component of this
medication.
This medicine is also contraindicated in cases of
Severe bradycardia, Second- or third-degree
heart block, Cardiogenic shock, Decompensated
cardiac failure, Sick sinus syndrome (unless a
permanent pacemaker is in place), Bronchial
asthma or other obstructive lung disorders and
Severe peripheral arterial circulatory disorder.

Warnings
Heart Failure:
Beta blockers, like Metolar-XR, can cause depression of
myocardial contractility and can precipitate heart failure
and cardiogenic shock.
Do not abruptly stop Metoprolol capsules therapy in
patients with coronary artery disease.
Severe exacerbation of angina, myocardial infarction,
and ventricular arrhythmias have been observed in
patients with coronary artery disease following the
abrupt discontinuation of therapy with beta-blockers
Use of Metoprolol During Major Surgery:
Chronically administered beta-blocking therapy should
not be routinely withdrawn before major surgery;
however, the impaired ability of the heart to respond to
reflex adrenergic stimuli may augment the risks of
general anesthesia and surgical procedures.

Warnings
Bradycardia: Bradycardia, including sinus pause, heart
block, and cardiac arrest have occurred with the use of
Metoprolol Capsules.
Diabetes and Hypoglycemia:
Beta blockers such as Metolar-XR Capsules may mask
tachycardia occurring with hypoglycemia, but other
manifestations such as dizziness and sweating may not be
significantly affected.
Pheochromocytoma: If Metolar-XR Capsules are used in
the setting of pheochromocytoma, it should be given in
combination with an alpha blocker, and only after the alpha
blocker has been initiated.
Thyrotoxicosis: Lopressor may mask certain clinical signs
(e.g., tachycardia) of hyperthyroidism. Avoid abrupt
ithdrawal of beta blockade, which might precipitate a
thyroid storm.

Warnings
Risk of Anaphylactic Reactions:
While taking beta blockers, patients with a history of
severe anaphylactic reaction to a variety of allergens
may be more reactive to repeated challenge, either
accidental, diagnostic, or therapeutic.
Catecholamine-depleting drugs:
Catecholamine-depleting drugs (e.g., reserpine) may
have an additive effect when given along with beta-
blocking agents or monoamine oxidase (MAO)
inhibitors. Observe patients treated with Metolar-XR
plus a catecholamine depletor for evidence of
hypotension or marked bradycardia, which may
produce vertigo, syncope, or postural hypotension.

Warnings
Digitalis glycosides and beta blockers: Both digitalis
glycosides and beta blockers like Metolar-XR slow
atrioventricular conduction and decrease heart rate.
Concomitant use can increase the risk of
bradycardia. Monitor patients heart rate and PR
interval.
Calcium channel blockers:Concomitant
administration of a beta-adrenergic antagonist with a
calcium channel blocker may produce an additive
reduction in myocardial contractility because of
negative chronotropic and inotropic effects.
General Anesthetics:
Some inhalation anesthetics may enhance the
cardiodepressant effect of beta blockers.

Metoprolol Capsules Side Effects
➢Metolar-XR (Metoprolol Capsules) side effects
can include tiredness and dizziness, Mental
confusion, short-term memory loss, Headache,
somnolence, nightmares, and insomnia ,
Worsening angina or myocardial infarction,
Shortness of breath, bradycardia, Worsening
heart failure, Worsening AV block, Wheezing
(bronchospasm) and dyspnea, Diarrhea,
Nausea, dry mouth, gastric pain, constipation,
flatulence, digestive tract disorders, heartburn,
Pruritus or rash, Peyronie’s disease,
Musculoskeletal pain, blurred vision, decreased
libido, and tinnitus

Metoprolol Capsules Overdose
Signs and symptoms of overdosage of
Metolar XR (Metoprolol Capsules) are
severe bradycardia, hypotension and
cardiogenic shock. Other symptoms can
also include AV block, heart failure,
bronchospasm, hypoxia, impairment of
consciousness/coma, nausea and
vomiting.

Consider treating the patient with intensive care.
Patients with myocardial infarction or heart failure
may be prone to significant hemodynamic
instability.
Beta-blocker overdose can result in significant
resistance to resuscitation with adrenergic
agents, including beta-agonists. On the basis of
the pharmacologic actions of Metoprolol capsules
employ the following measures.
There is very limited experience with the use of
hemodialysis to remove metoprolol, however
metoprolol is not highly protein bound.

Bradycardia: Administer IV Atropine; repeat to effect. If
the response is inadequate, consider intravenous
isoproterenol or other positive chronotropic agents.
Evaluate the need for transvenous pacemaker
insertion.
Hypotension: Treat underlying bradycardia. Consider
intravenous vasopressor infusion, such as dopamine
or norepinephrine.
Bronchospasm: Administer a beta2-agonist, including
albuterol inhalation, or an oral theophylline derivative.
Cardiac Failure: Administer diuretics or digoxin for
congestive heart failure. For cardiogenic shock,
consider IV dobutamine, isoproterenol or glucagon.

Metoprolol During Pregnancy
Metoprolol (Metolar-XR Capsules) has been
classified by the US FDA as Pregnancy
Category C.
Controlled studies with animals have
revealed no evidence of impaired fertility or
teratogenicity. There are no adequate and
well-controlled studies conducted in pregnant
women. Since animal reproduction studies
are not always predictive of human response,
this drug should be used during pregnancy
only if clearly needed.

Metolar-XR Capsules
For more details on
Metolar-XR Capsules click here
Metolar-XR (Metoprolol Succinate Capsules)
by Cipla Limited, India .

Metolar-XR (Metoprolol Capsules)

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