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INTRODUCTION
METOLET XL 50 H TABLET is a combination of Hydrochlorothiazide and Metoprolol which belongs to the group of medicines called Antihypertensive agents. It is used to treat hypertension (high blood pressure). It can also be used to reduce the risk of heart attack (myocardial infarction), stroke, chest pain (angina) and uneven heartbeat (arrhythmia).
Before taking METOLET XL 50 H TABLET inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have diabetes, thyroid problems, asthma, low blood pressure, poor blood circulation, psoriasis, allergic reactions or gout as a precaution.
METOLET XL 50 H TABLET is not recommended for use in patients with severe heart problems apart from hypertension (such as uncontrollable heart failure or heart block). Do not take this medicine without consulting your doctor if you are pregnant or breastfeeding.
The most common side effects of taking this medicine are low blood pressure, slow heart rate, cold hands and feet, racing heartbeat, headache, dizziness, nausea, diarrhoea and constipation. Consult your doctor if any of these side effect worsens.
USES OF METOLET XL 50 H TABLET
It is used to:
- Treat Hypertension (high blood pressure)
- Prevent heart attack, stroke, angina (chest pain) or arrhythmia (uneven heartbeat)
HOW METOLET XL 50 H TABLET WORKS
METOLET XL 50 H TABLET is an antihypertensive medicine. It contains two medicines namely, metoprolol and hydrochlorothiazide. Metoprolol works by blocking the actions of certain chemical messengers (such as adrenaline) in the body that increases heart rate and blood pressure.
Hydrochlorothiazide works by reducing the thickness of the blood by removing excess fluids from the body in the form of urine. It also helps in improving blood supply across all parts of the body. Collectively, these actions reduce the strain on the heart and helps the heart to pump more blood with less pressure.
DIRECTIONS FOR USE
Take METOLET XL 50 H TABLET as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. METOLET XL 50 H TABLET can be taken with or without food.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition. Do not stop taking this medicine without consulting your doctor.
SIDE EFFECTS OF METOLET XL 50 H TABLET
COMMON
- feeling faint or dizzy while standing up
- slow heart rate
- loss of balance, fainting
- cold hands and feet
- racing heartbeat
- headache, dizziness
- nausea, diarrhoea, constipation, stomach pain
- shortness of breath even with mild physical activity
UNCOMMON
- chest pain
- weight gain
- depression
- concentration problems, nightmares
- inability to sleep
- drowsiness
- tingling in the skin
- rashes
- increased sweating, fluid retention
- muscle cramps
RARE
- worsening of diabetes
- dry mouth, runny nose, hair loss
- nervousness, anxiety
- visual disturbances
- dry or irritated eyes
- impotence or other sexual dysfunctions
- bending of penis on erection (peyronie’s syndrome)
Stop taking METOLET XL 50 H TABLET and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions (such as skin rash, itching, swelling of the face, lips, mouth or throat which can lead to difficulty in breathing or swallowing)
HOW TO MANAGE SIDE EFFECTS
Nausea:
Take METOLET XL 50 H TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Headache:
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Constipation:
Eat plenty of fibre rich foods such as fresh fruits, vegetables and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.
WARNING & PRECAUTIONS
PREGNANCY
METOLET XL 50 H TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
BREASTFEEDING
METOLET XL 50 H TABLET is not recommended for use in breastfeeding women. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
Do not drive or operate any machines if your ability is affected by METOLET XL 50 H TABLET.
ALCOHOL
Avoid consumption of alcohol while taking METOLET XL 50 H TABLET as it may make you feel dizzier and drowsier.
KIDNEY
METOLET XL 50 H TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.
LIVER
METOLET XL 50 H TABLET should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.
ALLERGY
Do not take METOLET XL 50 H TABLET if you are allergic to Hydrochlorothiazide, Metoprolol or to any other beta-blockers (such as atenolol, propranolol).
LUNGS
METOLET XL 50 H TABLET is not recommended for use in patients with severe asthma or chronic obstructive pulmonary disease. Therefore, consult your doctor for advice before taking it.
HEART DISEASE
METOLET XL 50 H TABLET is not recommended for use in patients with severe heart problems (such as heart block, uncontrollable heart failure, sick sinus syndrome or a very slow or uneven heartbeat). It should be used with caution in patients with other heart problems (such as a recent heart attack or angina attack, enlarged heart muscles or surgery in the heart within the last 4 months). Therefore, consult your doctor before taking it.
OTHERS
METOLET XL 50 H TABLET is not recommended for use if you:
- are in shock caused due to poor blood circulation
- have poor blood circulation caused due to blockage in the blood vessels
- have a very low blood pressure
- have metabolic acidosis (too much acidity in blood)
- have untreated phaeochromocytoma (tumor present in adrenal glands)
Before taking METOLET XL 50 H TABLET, inform your doctor if you:
- are prone to allergic reactions very often (such as even for insect bites)
- have problems in blood circulation around the body (especially in fingers, arms and feet)
- have diabetes
- have thyrotoxicosis (increased thyroid hormones in the body)
- are severely dehydrated
- have low sodium, potassium, or magnesium levels in the blood
- are going to undergo an operation
- have gout
- have psoriasis (white scaly patches on the skin)
Use in Pediatrics:
METOLET XL 50 H TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor for advice.
Use in Geriatrics:
METOLET XL 50 H TABLET should be used with caution in the elderly patients. Therefore, consult your doctor before taking it.
INTERACTIONS
A. Drug-Drug interactions:
Before taking METOLET XL 50 H TABLET inform to your doctor, if you are taking any of these medicines:
- lithium (a medicine used to treat mental illnesses)
- other medicines used to treat hypertension (such as clonidine, moxonidine, methyldopa, rilmenidine)
- other medicines used to treat heart problems (such as propafenone, verapamil, diltiazem and nifedipine)
- medicines used to treat uneven heartbeat (such as digoxin, disopyramide, quinidine or amiodarone)
- adrenaline (a medicine used to stimulate heart functions)
- medicines used for pain and inflammation (such as ibuprofen, indomethacin, sulindac, diclofenac)
- medicines used to treat diabetes (such as insulin, metformin, glimepiride, teneligliptin, pioglitazone)
- medicines that can depress the brain such as barbiturates (Ex. phenobarbital)
- narcotic drugs (used for pain relief) such as morphine, fentanyl, pethidine
- medicines used to reduce blood cholesterol levels (such as cholestyramine, colestipol)
- corticosteroids (used to treat inflammation) Ex. prednisolone
- corticotropin (a medicine used to correct hormone problems)
- noradrenaline (a medicine used to increase blood pressure)
- tubocurarine, dantrolene (medicines used to relax muscles)
- medicines used to treat depression (such as fluoxetine, paroxetine, bupropion)
- medicines used to treat mental illnesses (such as thioridazine)
- antihistamines (used to treat allergic reactions) such as diphenhydramine
- medicines used to treat malaria (such as hydroxychloroquine, mefloquine)
- terbinafine (a medicine used to treat fungal infection)
- cimetidine (a medicine used to treat stomach ulcers)
- phenylpropanolamine (a medicine used to reduce the swelling of the nasal mucosa)
- beta blockers used for glaucoma (such as timolol, pindolol, labetalol)
- ergotamine (a medicine used for migraine headache)
- medicines used to treat angina (such as nitroglycerin)
- anaesthetics (used to cause numbness or loss of sensation) such as lidocaine, sevoflurane, halothane
- rifampicin (used to treat tuberculosis)
- alpha blockers (used to treat high blood pressure and benign prostatic hyperplasia) such as prazosine, tamsulosin, terazosine, doxazosine
- antacids (medicines used to neutralise stomach acid) such as aluminium hydroxide, magaldrate
Overdosage:
If you or anyone else accidentally took more METOLET XL 50 H TABLET, consult your doctor immediately. Overdosage may cause low blood pressure, decreased heartbeat, problems in breathing, vomiting, feeling faint and fits.
SYNOPSIS
| Drug | : | Hydrochlorothiazide, Metoprolol |
| Pharmacological Category | : | Thiazide diuretics, Beta blockers |
| Therapeutic Indication | : | Hypertension |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep METOLET XL 50 H TABLET out of reach of children
- Store METOLET XL 50 H TABLET at room temperature
FAQs ABOUT METOLET XL 50 H TABLET
Q: What are the uses of METOLET XL 50 H TABLET?
A: METOLET XL 50 H TABLET is used to treat hypertension and arrhythmia. It can also be used to prevent the risk of heart attack, stroke, angina and arrhythmia.
Q: What type of a medicine is METOLET XL 50 H TABLET?
A: METOLET XL 50 H TABLET is an antihypertensive medicine. It slows down your heartbeat and reduces force of contraction of the heart. It also reduces the thickness of the blood by removing excess fluids from the body in the form of urine. Collectively, it reduces the strain on the heart and helps the heart to pump blood more smoothly with less pressure.
Q: What happens when I stop taking METOLET XL 50 H TABLET?
A: Do not stop taking METOLET XL 50 H TABLET without consulting your doctor as your blood pressure may raise once again. Make sure to take METOLET XL 50 H TABLET for the stipulated duration recommended by your doctor to achieve maximum results.
Q: What is the best time to take METOLET XL 50 H TABLET?
A: METOLET XL 50 H TABLET can be taken with or without meals. Your doctor will decide the best time for you to take METOLET XL 50 H TABLET based on your age, body weight and disease condition.
Q: What to do if I forgot to take a dose of METOLET XL 50 H TABLET?
A: If you forgot to take a dose of METOLET XL 50 H TABLET, take it as soon as you remember. However, if it is time for the next dose of METOLET XL 50 H TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of METOLET XL 50 H TABLET to compensate the missed ones.
Q: What precautions should be followed while taking METOLET XL 50 H TABLET?
A: Before taking METOLET XL 50 H TABLET inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have diabetes, thyroid problems, asthma, low blood pressure, poor blood circulation, dehydration or gout as a precaution. Consult your doctor before taking this medicine if you are pregnant or breastfeeding. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.
Q: Can I consume alcohol while taking METOLET XL 50 H TABLET?
A: Avoid consumption of alcohol while taking METOLET XL 50 H TABLET as it might make you feel dizzier and drowsier.
Q: What happens if I accidentally take more METOLET XL 50 H TABLET?
A: If you or anyone else accidentally took more METOLET XL 50 H TABLET, consult your doctor immediately. Overdosage may cause low blood pressure, decreased heartbeat, problems in breathing, vomiting, feeling faint and fits.
Q: Can I take METOLET XL 50 H TABLET daily?
A: Take METOLET XL 50 H TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take METOLET XL 50 H TABLET every day or not.
Q: Is METOLET XL 50 H TABLET safe to use in diabetic patients?
A: METOLET XL 50 H TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking METOLET XL 50 H TABLET as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.
Q: What are the side effects of METOLET XL 50 H TABLET?
A: The most common side effects of taking this medicine are low blood pressure, slow heart rate, cold hands and feet, racing heartbeat, headache, dizziness, nausea, diarrhoea and constipation. Consult your doctor if any of these side effect worsens.
Q: Can I stop taking METOLET XL 50 H TABLET once my symptoms subside?
A: No. Do not stop taking METOLET XL 50 H TABLET without consulting your doctor. As hypertension is a chronic condition, long term treatment may be necessary to control its symptoms. Therefore, take METOLET XL 50 H TABLET as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.
Q: Can METOLET XL 50 H TABLET be taken during pregnancy?
A: METOLET XL 50 H TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
Q: Is METOLET XL 50 H TABLET safe to use in kidney disease?
A: METOLET XL 50 H TABLET should be used with caution in patients with kidney problems. Your doctor will access your health condition and suggest a suitable dose for you.
Q: Can the use of METOLET XL 50 H TABLET affect the liver?
A: Yes. METOLET XL 50 H TABLET may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it should be used with caution in patients with liver problems. Consult your doctor before taking it.
Q: Does METOLET XL 50 H TABLET cause frequent urination?
A: Yes. METOLET XL 50 H TABLET may cause frequent urination. It is because METOLET XL 50 H TABLET contains a medicine called hydrochlorothiazide which is a diuretic (water pill). It excretes the excess water from the body in the form of urine. Therefore, it is advised to take METOLET XL 50 H TABLET at least 5 hours before bedtime to avoid the urge at night to urinate.
Q: Can I take potassium supplements along with METOLET XL 50 H TABLET?
A: Yes. Potassium supplements can be taken along with METOLET XL 50 H TABLET. However, consult your doctor before taking it.
Q: Can METOLET XL 50 H TABLET cause photosensitivity reactions?
A: METOLET XL 50 H TABLET very rarely causes skin sensitivity towards light (photosensitivity). To manage this, minimize sun exposure or exposure towards any forms of light sources. Always apply a sunscreen and wear protective clothing while going out. Consult your doctor if this side effect troubles you.
REFERENCES
1. KD. Tripathi. Antiadrenergic Drugs (Adrenergic Receptor Antagonists) and Drugs for Glaucoma & Cardiovascular drugs. Antihypertensive Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 148 & 559.
2. T Dafgard, B Forsen, T Lindahl. Comparative study of hydrochlorothiazide and a fixed combination of metoprolol and hydrochlorothiazide essential hypertension. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. 1981. [Accessed on 30th December 2022]. https://pubmed.ncbi.nlm.nih.gov/7027892/
3. Zentiva k.s. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on 30th December 2022]. https://www.medicines.org.uk/emc/files/pil.12971.pdf
4. APL Swift Services (Malta) Limited. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 30th December 2022]. https://www.medicines.org.uk/emc/files/pil.5199.pdf
5. Mylan Pharmaceuticals Inc. U.S. Food and Drug Administration. [Revised in May 2011] [Accessed on 30th December 2022]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/040735s004,040770s003lbl.pdf
6. Torrent Pharmaceuticals Ltd. Tolol H 50. [Revised in February 2020] [Accessed on 30th December 2022]. https://www.torrentian.com/pisheet/Upload/PI_Sheet/3018.pdf
7. Central Drugs Standard Control Organization. Metoprolol succinate 25mg /50mg ER + HCTZ 12.5mg tablets. November 2006. [Accessed on 30th November 2022]. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadApprovalNewDrugs/dciApprovedfdc.pdf
8. Leeford Healthcare Pvt Ltd. Metapol-H. [Accessed on 30th November 2022]. https://www.leeford.in/product/738/metapol-h
USEFUL DIAGNOSTIC TESTS
- Kidney Function Test
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