| Dosage | : | Tablet |
| Contains | : | Metoprolol |
| Category | : | Antihypertensives |
| Uses | : | Hypertension |
| Price | : |
Metpure XL Tablet is used to reduce high blood pressure and relieve chest pain caused due to reduced blood flow to the heart. It is also used for treating other complications associated with the heart and blood vessels.
Metpure XL contains Metoprolol. Metoprolol is a selective β1 receptor blocker used in treatment of several diseases of the cardiovascular system, especially hypertension.
Metpure XL is product from Emcure Pharmaceuticals. Emcure Pharmaceuticals, headquartered at Pune in West India, is an Indian pharmaceutical company. The company’s products include tablets, capsules (both softgel capsules and hard-gel capsules), and injectables.
High blood pressure
High BP is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
There are two types of high blood pressure.
Primary (essential) hypertension
For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.
Secondary hypertension
Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
- Obstructive sleep apnea
- Kidney problems
- Adrenal gland tumors
Uncontrolled high blood pressure can lead to complications including:Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
Aneurysm- Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
Heart failure- To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart’s pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure. Also, in some cases, it can lead to vision loss, difficulty in memory and understanding.
Dosage
As directed by your Physician.
Administration
As directed by your Physician.
Adverse Reactions/ Side Effects
Bradycardia, hypotension, arterial insufficiency, chest pain, CHF, oedema, palpitation, syncope, gangrene; dizziness, fatigue, depression, confusion, headache, insomnia, short-term memory loss, nightmares, somnolence; pruritus, rash, increased psoriasis, reversible alopecia; sexual dysfunction/impotence, Peyronie’s disease; diarrhoea, constipation, flatulence, GI pain, heartburn, nausea, xerostomia; agranulocytosis (rare); musculoskeletal pain; blurred vision, dry eyes, oculomucocutaneous syndrome; tinnitus; dyspnoea, bronchospasm, wheezing, rhinitis; cold extremities.
Potentially Fatal: Heart failure, heart block, bronchospasm.
Warnings and Precautions
Compensated heart failure, bronchospastic disease, hepatic impairment, AV conduction disorders, bradycardia, peripheral arterial circulatory disorders. An α-blocker should be given concurrently in patients with phaeochromocytoma. May mask signs of acute hypoglycaemia. May mask symptoms of hyperthyroidism. Caution when used in patients with history of cardiac failure or those with minimal cardiac reserve. Avoid using anaesthetic agents that may depress the myocardium. May impair ability to drive or operate machinery. Myasthenia gravis; history of psychiatric disorder. Lactation. Avoid abrupt drug withdrawal.
Contraindications
2nd or 3rd degree AV block; sick sinus syndrome; decompensated heart failure; clinically relevant sinus bradycardia. Severe peripheral arterial circulatory disorders. Cardiogenic shock. Asthma. Phaeochromocytoma (without α-blockade), systolic BP <100 mmHg. Metabolic acidosis. Pregnancy (2nd and 3rd trimesters).
Metoprolol and Children- Safety and efficacy not established (immediate-release); safety and efficacy not established in children younger than 6 years of age (ER).
Drug Interactions
Additive effect with catecholamine-depleting drugs e.g. reserpine and MAOIs. May antagonise β1-adrenergic stimulating effects of sympathomimetics. Additive negative effects on SA or AV nodal conduction with cardiac glycosides, nondihydropyridine calcium-channel blockers. Increased oral bioavailability with aluminium/magnesium-containing antacids. Paradoxical response to epinephrine may occur. Increased plasma concentrations with CYP2D6 inhibitors (e.g. bupropion, cimetidine, diphenhydramine, fluoxetine, hydroxycholoquine, paroxetine, propafenone, quinidine, ritonavir, terbinafine, thioridazine). Increased risk of hypotension and heart failure with myocardial depressant general anaesthetics (e.g. diethyl ether). Risk of pulmonary hypertension with vasodilators e.g. hydralazine in uraemic patients. Reduced plasma levels with rifampicin. May increase negative inotropic and negative dromotropic effect of anti-arrhythmic drugs e.g. quinidine and amiodarone. Propafenone may increase serum levels of metoprolol. Concurrent use with indomethacin may reduce the antihypertensive efficacy of β-blocker. May reduce clearance of lidocaine. May increase effects of hypoglycaemics. Efficacy may be reduced by isoprenaline. Concurrent use with digoxin may lead to additive bradycardia.
Potentially Fatal: Additive or synergistic effects with verapamil; increased oral bioavailability with verapamil. Exacerbation of rebound hypertension during abrupt clonidine withdrawal.
Overdosage
–
Storage
Intravenous
Do not store above 30°C (86°F). Protect from light.
Oral
Store at 15-30°C (59-86°F).
Mechanism of Action
Metoprolol blocks β1 adrenergic receptors in heart muscle cells, thereby decreasing the slope of phase 4 in the nodal action potential (reducing Na+ uptake) and prolonging repolarization of phase 3 (slowing down K+ release).
References
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
https://www.mims.com/india/drug/info/metpure-xl/metpure-xl%20er%20tab
http://www.drugsupdate.com/brand/generic/Metoprolol/32887
https://en.wikipedia.org/wiki/Emcure_Pharmaceuticals