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INTRODUCTION
METOLAR TL 25MG TABLET is a combination of Metoprolol and Telmisartan which belongs to the group of medicines called Anti-hypertensives. It is used to treat hypertension.
Hypertension is an abnormal condition in which blood pressure rises higher than normal limits in the blood vessels which is characterized by symptoms such as severe headache, nose bleeding, fatigue, disturbed vision, chest pain and shortness of breath.
Your doctor might advise you to take kidney function tests (to assess the function of your kidney), monitoring of blood pressure and regular blood tests to check the electrolytes such as potassium levels in the blood.
METOLAR TL 25MG TABLET is not recommended for use in patients with bronchospastic lung diseases such as asthma, emphysema or other lung infections, severe liver problems, impaired kidney function, heart disease such as severely low heart rate, heart block, cardiogenic shock and planned for non-cardiac surgery.
Before taking METOLAR TL 25MG TABLET, inform your doctor if you have pheochromocytoma (tumour of adrenal glands), diabetes, low blood pressure due to dehydration or have undergone kidney transplant surgery.
METOLAR TL 25MG TABLET is not recommended for use in pregnant and breastfeeding women. METOLAR TL 25MG TABLET is not recommended for use in children and adolescents (aged below 18 years).
The common side effects associated with the use of METOLAR TL 25MG TABLET are low blood pressure, tiredness, dizziness, depression, diarrhoea, shortness of breath, slow heartbeat or rash. Consult your doctor if any of the side effects worsens.
USES OF METOLAR TL 25MG TABLET
- Treats high blood pressure (hypertension)
HOW METOLAR TL 25MG TABLET WORKS
METOLAR TL 25MG TABLET helps in treating high blood pressure where metoprolol works by preventing certain chemical messengers to bind their respective receptors in the heart and vessels, causing heart to beat slowly with less force and telmisartan blocks the effect of angiotensin II receptor (a chemical messenger that narrow down your blood vessels) that causes relaxation and widening of blood vessels resulting in lowering of blood pressure.
DIRECTIONS FOR USE
Take METOLAR TL 25MG TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Try to have the medicine at the same time daily. Your doctor will decide the correct dose and duration of METOLAR TL 25MG TABLET for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF METOLAR TL 25MG TABLET
COMMON
- tiredness
- dizziness
- depression
- shortness of breath
- slow heartbeat
- low blood pressure
- diarrhoea
- itchy skin
- rash
- vertigo (sudden internal or external spinning sensation)
UNCOMMON
- urinary tract infections
- upper respiratory tract infections such as sore throat, inflammation in sinuses or common cold
- signs of anaemia (reduced red blood cell count) such as weakness, shortness of breath, and irregular heartbeat
- sleep disturbances
- syncope (fainting)
- dizziness on standing up (orthostatic hypotension)
- cough
- abdominal pain or discomfort
- bloating, vomiting
- excessive sweating
- muscle cramps and pain, back pain
- kidney impairment including acute kidney failure characterized by decreased urine output, fluid retention in feet and ankles, shortness of breath and fatigue
- weakness, chest pain
- myocardial infarction (restricted or blocked blood supply to heart)
- pneumonia (an infection in lungs)
- cerebrovascular disorder (group of diseases affecting blood flow in the brain) such as stroke or aneurysms
- coronary artery disorder (damage of vessels supplying blood to the heart)
- ventricular tachycardia/arrhythmia (a type of abnormal heart rhythm)
- diabetes or worsening of diabetes
RARE
- severe allergic reactions including anaphylaxis (serious life-threatening allergic reaction)
- signs of allergic reaction such as rash, itching, breathlessness, noisy breathing or swelling of the face
- low blood sugar levels in diabetic individuals
- anxiety, sleepiness
- impaired vision
- fast heartbeat
- dry mouth, taste disturbance
- eczema (redness of skin), hives (itchy and raised welts)
- severe drug rashes
- pain in extremities (legs and arms)
- tendon or joint pain
- flu like illness such as fever, chills, headache, muscle or body aches
- cold extremities (arms and legs)
- arterial insufficiency (condition marked by low blood flow in arteries)
- Raynaud's phenomenon (condition marked by decreased blood flow to the fingers)
- congestive heart failure
- wheezing
- flatulence
- peyronie’s disease (noncancerous condition of penis)
- reversible alopecia (loss of hair)
- signs of agranulocytosis such as fever, chills, weakness, sore throat
- dry eyes
Stop taking METOLAR TL 25MG TABLET and contact your doctor if you experience any of the following side effects:
- sepsis (a life-threatening severe infection occurring due to damage of whole-body immune response)
- angioedema (rapid and serious swelling of the skin and mucosa)
HOW TO MANAGE SIDE EFFECTS
Dizziness
Lie down until the dizziness passes and get up slowly. Do not bend down suddenly. Get a lot of rest. Walk slowly and carefully. Take plenty of fluids. Avoid drinking coffee, alcohol or smoking. Consult your doctor if the condition persists for long or gets worsened.
Diarrhoea
Drink lot of fluids such as water to keep yourself hydrated. Try to avoid taking any medicine on your own to treat diarrhoea and consult your doctor if the symptom gets worse.
Nausea and vomiting
Try to take METOLAR TL 25MG TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if the symptom gets worse.
Stomach pain:
Rest and relax. Eat and drink slowly or try to have smaller and frequent meals. Keep a heat pad on your stomach. Do not self-treat on your own and consult your doctor if the symptom did not improve on its own.
WARNING & PRECAUTIONS
PREGNANCY
METOLAR TL 25MG TABLET is not recommended for use in pregnant women. Consult your doctor before taking METOLAR TL 25MG TABLET.
BREASTFEEDING
METOLAR TL 25MG TABLET is not recommended for use in breastfeeding women. Consult your doctor before taking METOLAR TL 25MG TABLET.
DRIVING AND USING MACHINES
Do not drive or operate machines if you feel dizzy or tired after taking METOLAR TL 25MG TABLET. Consult your doctor before taking METOLAR TL 25MG TABLET.
ALCOHOL
Avoid consumption of alcohol while taking METOLAR TL 25MG TABLET since it may aggravate the low blood pressure.
KIDNEY
METOLAR TL 25MG TABLET is not recommended for use if have impaired kidney function and treated with a blood pressure lowering medicine containing aliskiren. It should be used with caution if you have certain kidney disease such as renal artery stenosis (narrowing of the blood vessels to one or both kidneys) or have undergone kidney transplant. Consult your doctor for advice before taking METOLAR TL 25MG TABLET.
LIVER
METOLAR TL 25MG TABLET is not recommended for use in patients with severe liver problems such as cholestasis or biliary obstruction (disease causing difficulty in drainage of the bile from the liver and gall bladder). It should be used with caution in patients with liver diseases such as hepatic impairment. Consult your doctor before taking METOLAR TL 25MG TABLET.
ALLERGY
METOLAR TL 25MG TABLET is not recommended for use if you are allergic to metoprolol, telmisartan or any other ingredients of this medicine.
LUNGS
METOLAR TL 25MG TABLET should be used with caution in patients bronchospastic disease (disease causing tightening of airway muscles) such as asthma, emphysema, chronic obstructive pulmonary disease or lung infections. Consult your doctor before taking METOLAR TL 25MG TABLET.
HEART DISEASE
METOLAR TL 25MG TABLET is not recommended for use in patients with heart disease such as severe bradycardia (low heart rate), heart block greater than first degree (condition in which heart beats very slowly or in abnormal rhythm), cardiogenic shock (sudden life-threatening condition in which heart fails to pump sufficient blood in the body), decompensated cardiac failure (inability of heart to accommodate and/or eject sufficient blood) or sick sinus syndrome (disorder of heart’s natural pacemaker). It should be used with caution in patients having heart trouble. Consult your doctor for advice before taking METOLAR TL 25MG TABLET.
OTHERS
METOLAR TL 25MG TABLET is not recommended for use if you:
- are planned for non-cardiac surgery
Before taking METOLAR TL 25MG TABLET, inform your doctor if you:
- have pheochromocytoma (tumour of adrenal glands located on the kidneys)
- have diabetes or hypoglycaemia (low blood sugar levels)
- have history of anaphylactic reactions (signs include itching and flushed or pale skin, low blood pressure, nausea, vomiting)
- have thyrotoxicosis (too high thyroid levels in the blood)
- have peripheral vascular disease (flow to limbs due to narrowing of vessels)
- raised aldosterone levels (water and salt retention in the body along with imbalance of various blood minerals)
- low blood pressure due to dehydration (excessive loss of water from the body)
- have deficiency of salt due to diuretic therapy (water tablets), low-salt diet, diarrhoea or vomiting
- have elevated potassium levels in the blood
Use in Paediatrics
METOLAR TL 25MG TABLET is not recommended for use in children and adolescents (aged below 18 years). Consult your doctor before taking METOLAR TL 25MG TABLET.
Use in Geriatrics:
METOLAR TL 25MG TABLET should be used with caution in elderly patients (aged 65 years and above). Consult your doctor before taking METOLAR TL 25MG TABLET.
INTERACTIONS
A. Drug-Drug Interactions
Before taking METOLAR TL 25MG TABLET, inform your doctor, if you are taking any of the following medicines:
- lithium, fluoxetine, paroxetine and antidepressants such as amitriptyline (used to treat depression)
- medicines that may increase blood potassium levels such as potassium-sparing diuretics (medicines used to treat high blood pressure) Ex. spironolactone
- angiotensin-converting enzyme (ACE) inhibitors (Ex. captopril, enalapril) angiotensin II receptor antagonists (Ex. irbesartan), diuretics (Ex. furosemide), diltiazem, clonidine, verapamil and aliskiren (medicines used to treat high blood pressure)
- non-steroidal anti-inflammatory drugs (medicines used to treat pain and inflammation) Ex. aspirin, ibuprofen
- anticoagulants (medicines used to prevent blood clot formation) Ex. heparin
- immunosuppressives (medicines used to prevent organ rejection after transplant) Ex. cyclosporin or tacrolimus
- antibiotics (medicines used to treat bacterial infections) Ex. trimethoprim
- medicines used to treat inflammation or pain such as corticosteroids Ex. dexamethasone
- baclofen (used to relax muscle in the body)
- amifostine (used to treat certain cancers)
- barbiturates such as phenobarbital (used to treat seizures)
- narcotics such as morphine (used to treat severe pain)
- quinidine, propafenone and digoxin (used to treat irregular heartbeat)
Overdosage:
If you or anyone else accidentally takes too much of METOLAR TL 25MG TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of METOLAR TL 25MG TABLET are low blood pressure, fast or slow heartbeat, dizziness, heart block, heart failure, bronchospasm (constriction of lung muscles), hypoxia (lack of oxygen supply to body cells), higher levels of creatinine in the blood, sudden kidney failure, impairment of consciousness, nausea, vomiting and coma.
SYNOPSIS
| Drug | : | Metoprolol, Telmisartan |
| Pharmacological Category | : | Beta-blockers, Angiotensin II receptor antagonists |
| Therapeutic Indication | : | Hypertension (high blood pressure) |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep METOLAR TL 25MG TABLET out of reach of children
- Store METOLAR TL 25MG TABLET at room temperature
FAQs ABOUT METOLAR TL 25MG TABLET
What is METOLAR TL 25MG TABLET used for?
METOLAR TL 25MG TABLET is used to treat hypertension. Hypertension is an abnormal condition in which blood pressure rises higher than normal limits in the blood vessels. It is characterized by severe headache, nose bleeding, weakness, disturbed vision, chest pain and shortness of breath.
What happens if you take more METOLAR TL 25MG TABLET than your required dose?
If you or anyone else accidentally takes too much of METOLAR TL 25MG TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are low blood pressure, fast or slow heartbeat, dizziness, heart block, heart failure, bronchospasm (constriction of lung muscles), hypoxia (lack of oxygen supply to body cells), higher levels of creatinine in the blood, sudden kidney failure, impairment of consciousness or nausea, vomiting and coma.
What side effects are seen with METOLAR TL 25MG TABLET?
The common side effects associated with the use of METOLAR TL 25MG TABLET are low blood pressure, tiredness, dizziness, depression, diarrhoea, shortness of breath, slow heartbeat and rash. Consult your doctor if any of the side effect worsens.
Who should avoid taking METOLAR TL 25MG TABLET?
METOLAR TL 25MG TABLET is not recommended for use if you are having asthma, emphysema, chronic obstructive pulmonary disease, lung infections, cholestasis or biliary obstruction, impaired kidney function, severely low heart rate, heart block, cardiogenic shock, decompensated cardiac failure or sick sinus syndrome. It is also not recommended for use in pregnant and breastfeeding women, children and adolescents (aged below18 years). Consult your doctor before taking METOLAR TL 25MG TABLET.
Is METOLAR TL 25MG TABLET safe to use in children?
METOLAR TL 25MG TABLET is not recommended for use in children and adolescents (aged below 18 years). If METOLAR TL 25MG TABLET is accidentally ingested by a child or adolescent, go to the hospital immediately and consult the doctor for further management.
Can I drink alcohol while taking METOLAR TL 25MG TABLET?
Avoid consumption of alcohol while taking METOLAR TL 25MG TABLET since it may aggravate the low blood pressure. However, if you are habitual of drinking alcohol, you must consult your doctor before taking this medicine.
Is METOLAR TL 25MG TABLET safe to use in patients with kidney problems?
METOLAR TL 25MG TABLET is not recommended for use if have impaired kidney function and treated with a blood pressure lowering medicine containing aliskiren. It should be used with caution if you have certain kidney disease such as renal artery stenosis (narrowing of the blood vessels to one or both kidneys) or have undergone kidney transplant. Consult your doctor for advice before taking METOLAR TL 25MG TABLET.
REFERENCES
1. KD. Tripathi. Antihypertensive Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 561, 563.
2. Jaekyu Shin, Marco Gonzales, and Mark J Pletcher. Risk of Emergent Bradycardia Associated with Initiation of Immediate- or Slow-Release Metoprolol. NIH National Library of Medicine. National Centre for Biotechnology Information. PubMed Central. June 2013. [Accessed on 1st July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797244/
3. Accord Healthcare. Electronic Medicine Compendium (EMC). [Revised in July 2021] [Accessed on 1st July 2022] https://www.medicines.org.uk/emc/files/pil.12399.pdf
4. AstraZeneca AB. Food and Drug Administration (FDA). [Revised in March 2006] [Accessed on 1st July 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/019962s032lbl.pdf
5. Camber Pharmaceuticals, Inc. Metoprolol Succinate Extended-Release Tablets. [Revised in November 2020] [Accessed on 1st July 2022] https://www.camberpharma.com/wp-content/uploads/2021/06/Metoprolol-SER-Tablets-USP-Leaflet-2060738.pdf
USEFUL DIAGNOSTIC TESTS
- Kidney function test
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