Natcocil M Tablet 10'S
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Introduction About NATCOCIL M TABLET
NATCOCIL M TABLET is a combination of Cilnidipine and Metoprolol which belongs to the group of medicines called Antihypertensive agents. It is used to manage hypertension (high blood pressure). It can also be used to reduce the risk of heart attack (myocardial infarction), stroke, chest pain (angina) or uneven heartbeat (arrhythmia).
Before taking NATCOCIL M 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.
NATCOCIL M 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, swelling of ankles or other body parts, flushing, headache, dizziness, nausea, diarrhoea and constipation. Consult your doctor if any of these side effect worsens.
Uses Of NATCOCIL M TABLET
It is used to:
- Manage Hypertension (high blood pressure)
- Prevent heart attack, stroke, angina (chest pain) or arrhythmia (uneven heartbeat)
How NATCOCIL M TABLET Works
NATCOCIL M TABLET is an antihypertensive medicine. It contains two medicines namely, metoprolol and cilnidipine. Metoprolol reduces the heart rate and force of contraction of heart muscles.
Cilnidipine relaxes the blood vessels and allows blood to flow more smoothly across the blood vessels with less pressure. It also improves blood flow and oxygen supply to the heart muscles. Collectively, this medicine reduces the strain on the heart, improves heart functions and manages the risks of heart attack or stroke.
How to use NATCOCIL M TABLET
Take NATCOCIL M TABLET as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.
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 NATCOCIL M TABLET
Common
- swelling of the ankles or other body parts
- headache, dizziness, sleepiness
- low blood pressure
- slow or fast heart rate
- flushing (redness and warmth of the skin)
- stomach pain, nausea, vomiting, diarrhea, constipation, indigestion
- shortness of breath even with mild physical activity
- changes in bowel habit
- tiredness, weakness
- gingival hyperplasia (enlargement of gums with inflammation)
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 NATCOCIL M 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
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.
Dizziness Or Drowsiness
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.
Nausea And Vomiting
Take NATCOCIL M 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.
Warning & Precautions
Pregnancy
ContraindicatedNATCOCIL M TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
Breastfeeding
ContraindicatedNATCOCIL M TABLET is not recommended for use in breastfeeding women. Therefore, consult your doctor before taking it.
Driving and Using Machines
Use with CautionDo not drive or operate any machines if your ability is affected by NATCOCIL M TABLET.
Alcohol
Consult your doctorAvoid consumption of alcohol while taking NATCOCIL M TABLET as it may make you feel dizzier and drowsier.
Kidney
Use with CautionNATCOCIL M TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.
Liver
Use with CautionNATCOCIL M TABLET should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.
Allergy
ContraindicatedDo not take NATCOCIL M TABLET if you are allergic to Metoprolol, Cilnidipine or to any other beta-blockers (such as atenolol, propranolol).
Lungs
ContraindicatedNATCOCIL M 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
Consult your doctorNATCOCIL M 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
NATCOCIL M 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 unmanageed phaeochromocytoma (tumor present in adrenal glands)
Before taking NATCOCIL M 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)
- have edema (swelling of body parts)
Use in Pediatrics:
NATCOCIL M TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor for advice.
Use in Geriatrics:
NATCOCIL M TABLET should be used with caution in the elderly patients. Therefore, consult your doctor before taking it.
Interactions
A. Drug - Drug interactions:
Before taking NATCOCIL M TABLET, inform your doctor if you are taking any of the following medicines such as:
- medicines used to manage advanced renal cell carcinoma (Ex. aldesleukin)
- medicines used to manage epilepsy (Ex. carbamazepine, phenytoin, phenobarbital)
- medicines used for bacterial infections (Ex. erythromycin)
- medicines used to manage tuberculosis (Ex. rifampicin)
- medicines used to manage hypertension and heart problems (Ex. quinidine, propranolol, digoxin, amlodipine, diltiazem, verapamil, propafenone, clonidine, moxonidine, methyldopa, rilmenidine)
- medicines used for psychosis (Ex. risperidone, quetiapine, olanzapine)
- medicines used to manage diabetes (such as insulin, metformin, glimepiride, teneligliptin, pioglitazone)
- cimetidine (a medicine used to manage stomach ulcers)
- medicines used to manage uneven heartbeat (such as digoxin, disopyramide, quinidine or amiodarone)
- medicines used for pain and inflammation (such as ibuprofen, indomethacin, sulindac, diclofenac)
- medicines used to manage depression (such as fluoxetine, paroxetine, bupropion)
- medicines used to manage mental illnesses (such as thioridazine)
- ritonavir (a medicine used to manage HIV infection)
- antihistamines (used to manage allergic reactions) such as diphenhydramine
- medicines used to manage malaria (such as hydroxychloroquine, mefloquine)
- terbinafine (a medicine used to manage fungal infection)
- adrenaline (a medicine used to stimulate heart functions)
- 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 manage angina (such as nitroglycerin)
- anaesthetics (used to cause numbness or loss of sensation) such as lidocaine, sevoflurane, halothane
- alpha blockers (used to manage 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 NATCOCIL M TABLET, consult your doctor immediately. Overdosage may cause low blood pressure, decreased heartbeat, problems in breathing, vomiting, feeling faint and fits.
Synopsis
| Drug | : | Cilnidipine, Metoprolol |
| Pharmacological Category | : | Calcium Channel Blockers, Beta-blockers |
| Therapeutic Indication | : | Hypertension, Angina, Heart attack, Stroke |
| Dosage Forms | : | Tablet |
More Information
- Keep NATCOCIL M TABLET out of the sight and reach of children
- Store NATCOCIL M TABLET at room temperature
FAQs About NATCOCIL M TABLET
Q: What are the uses of NATCOCIL M TABLET?
A: NATCOCIL M TABLET is used to manage hypertension. It can also be used to manage the risk of heart attack, stroke, angina and arrhythmia.
Q: What type of a medicine is NATCOCIL M TABLET?
A: NATCOCIL M TABLET is an antihypertensive medicine. It slows down your heartbeat and reduces force of contraction of the heart. It also relaxes blood vessels supplying the heart which reduces the strain on the heart and helps the heart to pump more blood with lesser force.
Q: What happens when I stop taking NATCOCIL M TABLET?
A: Do not stop taking NATCOCIL M TABLET without consulting your doctor as your blood pressure may raise once again. Make sure to take NATCOCIL M TABLET for the stipulated duration recommended by your doctor to achieve maximum results.
Q: What is the best time to take NATCOCIL M TABLET?
A: NATCOCIL M TABLET can be taken with or without meals. Your doctor will decide the best time for you to take NATCOCIL M TABLET based on your age, body weight and disease condition.
Q: What to do if I forgot to take a dose of NATCOCIL M TABLET?
A: If you forgot to take a dose of NATCOCIL M TABLET, take it as soon as you remember. However, if it is time for the next dose of NATCOCIL M TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of NATCOCIL M TABLET to compensate the missed ones.
Q: What precautions should be followed while taking NATCOCIL M TABLET?
A: Before taking NATCOCIL M 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 NATCOCIL M TABLET?
A: Avoid consumption of alcohol while taking NATCOCIL M TABLET as it might make you feel dizzier and drowsier.
Q: What happens if I accidentally take more NATCOCIL M TABLET?
A: If you or anyone else accidentally took more NATCOCIL M 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 NATCOCIL M TABLET daily?
A: Take NATCOCIL M TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take NATCOCIL M TABLET every day or not.
Q: Is NATCOCIL M TABLET safe to use in diabetic patients?
A: NATCOCIL M TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking NATCOCIL M 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 NATCOCIL M 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 NATCOCIL M TABLET once my symptoms subside?
A: No. Do not stop taking NATCOCIL M TABLET without consulting your doctor. As hypertension is a chronic condition, long term management may be necessary to control its symptoms. Therefore, take NATCOCIL M TABLET as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.
Q: Can NATCOCIL M TABLET be taken during pregnancy?
A: NATCOCIL M TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
Q: Is NATCOCIL M TABLET safe to use in kidney disease?
A: NATCOCIL M 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 NATCOCIL M TABLET affect the liver?
A: Yes. NATCOCIL M 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 NATCOCIL M TABLET cause frequent urination?
A: Yes. NATCOCIL M TABLET may cause frequent urination. It is because NATCOCIL M 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 NATCOCIL M TABLET at least 5 hours before bedtime to avoid the urge at night to urinate.
Q: Can I take potassium supplements along with NATCOCIL M TABLET?
A: Yes. Potassium supplements can be taken along with NATCOCIL M TABLET. However, consult your doctor before taking it.
Q: Can NATCOCIL M TABLET cause photosensitivity reactions?
A: NATCOCIL M 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.
2. Lionel H. Opie. Calcium channel blockers. Drugs for the heart. 8th Edition. 2013. Page- 88-89.
3. Junichi Minami, Yuhei Kawano, Yuriko Makino, Hiroaki Matsuoka and Shuichi Takishita. Effects of cilnidipine, a novel dihydropyridine calcium antagonist, on autonomic function, ambulatory blood pressure and heart rate in patients with essential hypertension. NIH. National Library of Medicine, National Center for biotechnology information. PMC. PubMed Central. September 2016. [Accessed on 17th January 2023]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2015014/
4. Jason Morris; Alexis Dunham. Metoprolol. StatPearls. NIH. National Library of Medicine, National Center for biotechnology information. PMC. PubMed Central. October 2022. [Accessed on 17th January 2023]. https://www.ncbi.nlm.nih.gov/books/NBK532923/
5. Zentiva k.s. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on 17th January 2023]. https://www.medicines.org.uk/emc/files/pil.12971.pdf
6. APL Swift Services (Malta) Limited. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 17th January 2023]. https://www.medicines.org.uk/emc/files/pil.5199.pdf
7. Unique pharmaceutical laboratories. Cilacar 20mg. September 2017. [Accessed on 17th January 2023]. https://medicaldialogues.in/uploads/2020/05/20/file_upload-129064.pdf
8. Cilnidipine. Centaurpharma.com. [Accessed on 17th January 2023]. https://www.centaurpharma.com/downloads/CENTAPRES.pdf
9. Cilocab. Cilnidipine. ACL limited. [Accessed on 17th January 2023]. https://www.acipharma.net/assets/files/product-pdf/cilocab.pdf
Useful Diagnostic Tests
- Kidney Function Test
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