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Introduction About METO ER
METO ER contains Metoprolol, which belongs to the group of medicines called Beta-blockers. It is used to manage high blood pressure, angina pectoris (chest pain), and heart failure. It is also used to manage arrhythmias or palpitations, and to manage heart attacks and migraines.
Avoid alcohol consumption while taking METO ER as it lowers blood pressure. METO ER 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 unmanageed pheochromocytoma. METO ER should be used with caution in patients with diabetes, stroke, liver or kidney disease, myocardial infarction, angina pectoris, and heart failure.
METO ER is not recommended for use in pregnant women unless considered necessary. METO ER should be used with caution in breastfeeding women, as it may pass through breast milk. METO ER is not recommended for use in children less than 6 years of age. METO ER should be used with caution in elderly patients aged 65 years or above.
The most common side effects of taking METO ER 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 METO ER
Manage:
- Manage high blood pressure
- Manage angina pectoris (chest pain)
- Manage heart failure
- Manage arrhythmias or palpitations
- prevents heart attack and migraine
How METO ER Works
In hypertension, METO ER 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, METO ER 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, METO ER slows down the heart rate and makes it easier for the heart to pump blood around the body.
How to use METO ER
Take METO ER 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 METO ER
Common
- feeling faint on standing because of low blood pressure
- tiredness
- slow heartbeat
- difficulty in maintaining balance with fainting,
- cold hands and feet
- palpitations
- dizziness, headache
- nausea, diarrhoea, constipation, abdominal pain
- shortness of breath on excessive physical activity
Uncommon
- fluid retention (swelling)
- worsening of heart failure
- chest pain
- pins and needles
- muscle cramps
- vomiting
- weight gain
- depression, reduced concentration
- difficulty in sleeping
- drowsiness
- nightmare
- shortness of breath
- skin rash
- increased sweating
Rare
- worsening of diabetes
- nervousness, anxiety
- visual disturbances
- dry or irritated eyes
- conjunctivitis
- impotence
- bending of penis on erection
- irregular heartbeat
- heart conduction disturbances
- dry mouth
- runny nose
- hair loss
- changes in liver function tests
Stop taking METO ER and contact your physician immediately if you experience any of the following side effects:
- symptoms of an allergic reaction such as skin rash, itching, flushing, swelling of the face, lips, tongue or throat, difficulty in breathing or swallowing
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 manage 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
Pregnancy
METO ER is not recommended for use in pregnant women unless considered necessary by your doctor. Contact your doctor before taking METO ER.
Breastfeeding
METO ER should be used with caution in breastfeeding women as it may pass through breast milk. Contact your doctor before taking METO ER.
Driving and Using Machines
Do not drive or operate any machines if you feel dizzy and tired after taking METO ER.
Alcohol
Avoid alcohol consumption while taking METO ER as it lowers your blood pressure.
Kidney
METO ER should be used with caution in patients with kidney diseases such as abnormal function. Contact your doctor before taking METO ER.
Liver
METO ER should be used with caution in patients with liver diseases. Contact your doctor before taking METO ER.
Allergy
Do not take METO ER if you are allergic to Metoprolol or any other ingredients in this medicine.
Lungs
METO ER is not recommended for use in patients with bronchospastic diseases like asthma or COPD. Contact your doctor before taking METO ER.
Heart Disease
METO ER is not recommended for use in patients with severe bradycardia, low blood pressure, second or third-degree heart block, cardiogenic shock, decompensated cardiac failure, or sick sinus syndrome (unless a permanent pacemaker is present) and should be used with caution in patients with 1st-degree heart block, myocardial infarction, angina pectoris, heart failure, diseases of the heart valve, or enlarged heart muscle. Contact your doctor before taking METO ER.
Others
METO ER is not recommended for use if you have:
- severe peripheral arterial disease
- metabolic acidosis
- unmanageed phaeochromocytoma
Before taking METO ER, inform your doctor if you have:
- major surgery or anaesthesia
- stroke
- diabetes or low blood sugar
- hyperthyroidism
- history of severe anaphylactic reactions
- peripheral vascular disease
- psoriasis
Use in paediatrics:
METO ER is not recommended for use in children less than 6 years of age. Contact your doctor before taking METO ER.
Use in geriatrics:
METO ER should be used with caution in elderly patients aged 65 years or above. Contact your doctor before taking METO ER.
Interactions
A. Drug-Drug interactions:
Before taking METO ER, 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 manage arrhythmias)
- fluoxetine, paroxetine, sertraline, phenelzine, tranylcypromine (medicines used to manage depression)
- digitalis (a medicine used to manage heart failure)
- cimetidine (a medicine used to manage ulcers)
- terbinafine (a medicine used to manage fungal infection)
- hydroxychloroquine (a medicine used to manage malaria)
- medicines used to manage psychoses (Ex. chlorpromazine, triflupromazine, chlorprothixene)
- diphenhydramine (medicines used to manage allergies)
- celecoxib, indomethacin (medicines used to manage pain)
- rifampicin (medicines used to manage tuberculosis)
- other beta-blockers, Ex. timolol eye drops
- adrenaline, noradrenaline (medicines used to manage 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 METO ER, 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
| Drug | : |
Metoprolol |
| Pharmacological Category | : |
Beta-blockers |
| Therapeutic Indication | : |
High blood pressure, Angina pectoris, Heart failure |
| Dosage Forms | : |
Tablet, Capsule, Injection |
More Information
- Keep METO ER out of the sight and reach from children
- Store METO ER at room temperature
FAQs About METO ER
How METO ER work?
In hypertension, METO ER 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, METO ER 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, METO ER slows down the heart rate and makes it easier for the heart to pump blood around the body.
What is METO ER used for?
METO ER contains Metoprolol, which belongs to the group of medicines called Beta-blockers. It is used to manage high blood pressure, angina pectoris (chest pain), and heart failure. It is also used to manage arrhythmias or palpitations and to manage heart attacks and migraines. Contact your doctor before taking METO ER.
Can METO ER be used for managing asthma?
METO ER is not recommended for use in patients with bronchospastic diseases like asthma or COPD. Contact your doctor before taking it.
Can METO ER cause high blood sugar?
Yes. METO ER may raise blood sugar levels and should be used with caution in patients with diabetes or low blood sugar. Contact your doctor before taking METO ER.
Can METO ER cause low blood pressure?
Yes. METO ER can cause low blood pressure and causes dizziness, headache, sweating, and faintness on standing up. Contact your doctor before taking METO ER.
Can I stop taking METO ER if I feel better?
Do not stop METO ER 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
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