INTRODUCTION

METOSAFE XL 25MG TABLET contains Metoprolol, which belongs to the group of medicines called Beta-blockers. It is used to treat high blood pressure, angina pectoris (chest pain), and heart failure. It is also used to treat arrhythmias or palpitations, and to prevent heart attacks and migraines.

Avoid alcohol consumption while taking METOSAFE XL 25MG TABLET as it lowers blood pressure. METOSAFE XL 25MG TABLET is not recommended for use in patients with asthma, COPD, severe bradycardia, second or third-degree heart block, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is present) and untreated pheochromocytoma. METOSAFE XL 25MG TABLET should be used with caution in patients with diabetes, stroke, liver or kidney disease, myocardial infarction, angina pectoris, and heart failure.

METOSAFE XL 25MG TABLET is not recommended for use in pregnant women unless considered necessary. METOSAFE XL 25MG TABLET should be used with caution in breastfeeding women, as it may pass through breast milk. METOSAFE XL 25MG TABLET is not recommended for use in children less than 6 years of age. METOSAFE XL 25MG TABLET should be used with caution in elderly patients aged 65 years or above.

The most common side effects of taking METOSAFE XL 25MG TABLET are experiencing faints upon standing due to low blood pressure, tiredness, slow heartbeat, palpitations, dizziness, headache, cold hands, and feet, etc. Contact your physician if any of your symptoms get worse or persist.

USES OF METOSAFE XL 25MG TABLET

Treats:

• Treats high blood pressure
• Treats angina pectoris (chest pain)
• Treats heart failure
• Treats arrhythmias or palpitations
• prevents heart attack and migraine

HOW METOSAFE XL 25MG TABLET WORKS

In hypertension, METOSAFE XL 25MG TABLET works by blocking the effect of adrenaline on the heart and decreasing cardiac output, also reducing the outflow of sympathetic neurons, and suppressing renin activity (normally responsible for the increase in blood pressure). Together, these actions lower blood pressure effectively.

In angina pectoris, METOSAFE XL 25MG TABLET works by blocking adrenaline effects on the heart and decreases the heart rate, blood pressure, and extent of heart contraction. It also reduces the oxygen requirements of the heart, providing relief from angina.

In heart failure, METOSAFE XL 25MG TABLET slows down the heart rate and makes it easier for the heart to pump blood around the body.

DIRECTIONS FOR USE

Take METOSAFE XL 25MG TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your physician will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.

SIDE EFFECTS OF METOSAFE XL 25MG TABLET

HOW TO MANAGE SIDE EFFECTS

Headache:

Rest and relax. Drink plenty of fluids to keep yourself hydrated. Apply a pain-relieving balm on the head if necessary. Contact your doctor if your headache does not improve.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any machines if you feel dizzy. Do not drink alcohol, as it can aggravate your dizziness. Contact your doctor if your dizziness does not improve.

Nausea, vomiting:

Take the medicine with or just after a meal. Stick to simple meals. Avoid eating oily or spicy foods. Contact your doctor if nausea and vomiting do not improve.

Stomach pain:

Try to rest and relax. Eat small meals but take them frequently. Keep a heating pad on your stomach. Contact your doctor if the stomach pain gets worse.

Diarrhoea:

Drink lots of fluids, such as water or fruit juice, to keep you hydrated. Do not take any medicine on your own to treat diarrhoea. Contact your doctor if your diarrhoea does not improve.

Constipation:

Eat fiber-rich foods such as fresh fruits, vegetables, and cereals. Drink more water and exercise regularly. Contact your doctor if constipation does not improve.

Skin rash:

Avoid hot showers, as they may irritate the skin. Do not scratch the affected area. Use sunscreen and protective clothing when outdoors. Regularly use unscented moisturizers to soothe and hydrate the affected area. Contact your doctor if the rashes get worse.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking METOSAFE XL 25MG TABLET, inform your doctor if you are taking any of the following medicine:

• reserpine, clonidine, hydralazine, alpha-methyldopa, guanfacine, diltiazem, and verapamil (medicines used for high blood pressure)
• quinidine, amiodarone, propafenone, disopyramide (medicines used to treat arrhythmias)
• fluoxetine, paroxetine, sertraline, phenelzine, tranylcypromine (medicines used to treat depression)
• digitalis (a medicine used to treat heart failure)
• cimetidine (a medicine used to treat ulcers)
• terbinafine (a medicine used to treat fungal infection)
• hydroxychloroquine (a medicine used to treat malaria)
• medicines used to treat psychoses (Ex. chlorpromazine, triflupromazine, chlorprothixene)
• diphenhydramine (medicines used to treat allergies)
• celecoxib, indomethacin (medicines used to treat pain)
• rifampicin (medicines used to treat tuberculosis)
• other beta-blockers, Ex.  timolol eye drops
• adrenaline, noradrenaline (medicines used to treat shock)
• medicines used for diabetes mellitus Ex. glimepiride
• lidocaine (a medicine used to induce numbness)

Overdosage:

If you or anyone else has accidentally taken too much of METOSAFE XL 25MG TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdosage are nausea, vomiting, bluish discolouration of the skin, severe bradycardia, low blood pressure (fatigue, dizziness), atrioventricular block, heart failure, bronchospasm or shortness of breath, hypoxia, cardiac arrest, cardiogenic shock, impairment of consciousness or coma.

SYNOPSIS

MORE INFORMATION

• Keep METOSAFE XL 25MG TABLET out of the sight and reach from children
• Store METOSAFE XL 25MG TABLET at room temperature

FAQs ABOUT METOSAFE XL 25MG TABLET

How METOSAFE XL 25MG TABLET work?

In hypertension, METOSAFE XL 25MG TABLET works by blocking the effect of adrenaline on the heart and decreasing cardiac output, also reducing the outflow of sympathetic neurons and suppressing renin activity (normally responsible for an increase in blood pressure). Together, these actions lower blood pressure effectively.

In angina pectoris, METOSAFE XL 25MG TABLET works by blocking adrenaline effects on the heart and decreases the heart rate, blood pressure, and extent of heart contraction. It also reduces the oxygen requirements of the heart, providing relief from angina.

In heart failure, METOSAFE XL 25MG TABLET slows down the heart rate and makes it easier for the heart to pump blood around the body.

What is METOSAFE XL 25MG TABLET used for?

METOSAFE XL 25MG TABLET contains Metoprolol, which belongs to the group of medicines called Beta-blockers. It is used to treat high blood pressure, angina pectoris (chest pain), and heart failure. It is also used to treat arrhythmias or palpitations and to prevent heart attacks and migraines. Contact your doctor before taking METOSAFE XL 25MG TABLET.

Can METOSAFE XL 25MG TABLET be used for treating asthma?

METOSAFE XL 25MG TABLET is not recommended for use in patients with bronchospastic diseases like asthma or COPD. Contact your doctor before taking it.

Can METOSAFE XL 25MG TABLET cause high blood sugar?

Yes. METOSAFE XL 25MG TABLET may raise blood sugar levels and should be used with caution in patients with diabetes or low blood sugar. Contact your doctor before taking METOSAFE XL 25MG TABLET.

Can METOSAFE XL 25MG TABLET cause low blood pressure?

Yes. METOSAFE XL 25MG TABLET can cause low blood pressure and causes dizziness, headache, sweating, and faintness on standing up. Contact your doctor before taking METOSAFE XL 25MG TABLET.

Can I stop taking METOSAFE XL 25MG TABLET if I feel better?

Do not stop METOSAFE XL 25MG TABLET suddenly without informing your physician. As it may lead to an exacerbation of angina pectoris (chest pain) or myocardial infarction (heart attack). Contact your doctor before stop taking it.

REFERENCES

1. K D Tripathi. Cardiovascular drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page - 523, 545, 564.

2. Bethesda (MD). Metoprolol. National Institute of Health. NLM. National Centre for Biotechnology Information. PubMed, 2006. [Accessed on 30th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK501156/

3. Jason Morris, Alexis Dunham. Metoprolol. National Institute of Health. NLM. National Centre for Biotechnology Information. Pubmed.gov, January 2022. [Accessed on 30th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK532923/

4. Aralez Pharmaceuticals US Inc. Metoprolol. [Revised in December 2016] [Accessed on 30th June 2022] https://www.toprol-xlhcp.com/assets/Toprol-PI-Clean.pdf

5. Dr Reddy’s Laboratories Limited. Metoprolol. [Revised in April 2016] [Accessed on 30th June 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d382c97-704d-1603-e054-00144ff8d46c

6. STADA Arzneimittel AG. Metoprolol. [Accessed on 30th June 2022] https://file.wuxuwang.com/hma/DK_H_1308_001_FinalPL.pdf

USEFUL DIAGNOSTIC TESTS

• Kidney function test