Metolar (Generic Metoprolol Tartarate Tablets)

Metolar (Generic Metoprolol Tartarate Tablets) are used for the treatment of hypertension, long-term treatment of angina pectoris and the treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality.

1. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy

2. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Metolar (Generic Metoprolol Tartarate Tablets)
are used for the treatment of hypertension, long-
term treatment of angina pectoris and the
treatment of hemodynamically stable patients
with definite or suspected acute myocardial
infarction to reduce cardiovascular mortality.

3. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Metolar Tablets are
manufactured by Cipla
Limited, India in the strength of
25 mg, 50 mg and 100 mg.

4. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy

Chemical Structure

5. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
The active ingredient contained in
Metolar tablets is Metoprolol Tartarate.
Each Metolar tablet contains 25 mg, 50
mg or 100 mg of Metoprolol Tartarate.

6. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Uses of Metolar 25 mg, 50 mg and 100 mg tablets:
Metolar (Generic Metoprolol Tartarate Tablets) is used to treat
Hypertension, Angina pectoris, Cardiac arrhythmias, especially
supraventricular tachyarrhythmias, Definite or suspected acute
myocardial infarction, Migraine prophylaxis and Adjunctive
management of thyrotoxicosis.
Metoprolol Tartrate tablets are used for the treatment of
hypertension. They may be used alone or in combination with
other antihypertensive agents.
Metoprolol Tartrate tablets are indicated in the long-term treatment
of angina pectoris.

7. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Uses of Metolar 25 mg, 50 mg and 100 mg tablets:
Metoprolol Tartrate tablets are indicated in the treatment of
hemodynamically stable patients with definite or suspected acute
myocardial infarction to reduce cardiovascular mortality when used
alone or in conjunction with intravenous Metoprolol.
Early intervention of Metolar (Metoprolol Tartrate tablets) in acute
myocardial infarction reduces infarct size and the incidence of
ventricular fibrillation. Pain relief may also decrease the need for opiate
analgesics.

8. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Recommended Adult Dosage
The dose of Metolar (Generic Metoprolol Tartarate Tablets) for
various indications is given below:
Hypertension: The dosage of Metoprolol tablets should be individualized. Metolar
tablets should be taken with or immediately following meals.
The usual initial dosage of Metoprolol tablets is 100 mg daily in single or divided
doses, whether used alone or added to a diuretic. The dosage may be increased at
weekly (or longer) intervals until optimum blood pressure reduction is achieved.
In general, the maximum effect of any given dosage level will be apparent after one
week of therapy. The effective dosage range of Metoprolol tablets is 100 to 450 mg
per day. Dosages above 450 mg per day have not been studied.

9. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Recommended Adult Dosage
Angina Pectoris: The dosage of Metoprolol tablets should be individualized.
Metolar tablets should be taken with or immediately following meals.
The usual initial dosage of Metoprolol tablets is 100 mg daily, given in two
divided doses. The dosage may be gradually increased at weekly intervals until
optimum clinical response has been obtained or there is pronounced slowing
of the heart rate. The effective dosage range of Metoprolol tablets is 100 mg to
400 mg per day. Dosages above 400 mg per day have not been studied.
If treatment is to be discontinued, the dosage should be reduced gradually
over a period of 1 to 2 weeks.

10. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Recommended Adult Dosage
Cardiac Arrhythmias: A dosage of 50 mg of Metolar tablets two or three
times daily is usually sufficient. If necessary the dose can be increased
up to 300 mg per day administered in divided doses.
Migraine Prophylaxis: Dose is 100 mg to 200 mg daily given in divided
doses (morning and evening).
Hyperthyroidism: Usual dose of Metolar tablets is 50 mg four times
daily. The dosage should be progressively reduced as euthyroid state is
slowly achieved.

11. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Contraindications
➔Metolar is contraindicated in patients with a known hypersensitivity to
Metoprolol Tartarate or any component of the tablet.
➔Uncontrolled heart failure
➔Bradycardia
➔Sick-sinus syndrome
➔Prinzmetal's angina
➔Untreated phaeochromocytoma
➔Metabolic acidosis
➔Severe peripheral arterial disease

12. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Contraindications
➔Myocardial infarction complicated by significant bradycardia,
first degree heart block, systolic hypotension (less than
100mmHg) and/or severe heart failure and cardiogenic shock.
➔History of bronchospasm and asthma.
➔Hypotension
➔Diabetes if associated with frequent episodes of
hypoglycaemia
➔Chronic obstructive pulmonary disease
➔Renal or hepatic failure

13. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Contraindications
➔Therapy resistant hypokalaemia and hyponatraemia,
hypercalcaemia, symptomatic hyperuricaemia, anuria.
➔Concomitant intravenous administration of calcium
blockers of the type Verapamil or Diltiazem or other
antiarrhythmics (such as disopyramide) is contraindicated
(exception: intensive care unit).

14. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Storage Instructions
Metolar (Generic Metoprolol Tartarate
Tablets) have to be stored at controlled
room temperature i.e. from 20°C to 25°C
(68°F to 77°F) with excursions permitted
between 15° to 30°C (59° to 86°F).
Keep this as well as all other medicines
away from children and pets.

15. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Warnings
Heart Failure: Beta-blockers, like Metoprolol, can cause depression of myocardial
contractility and may precipitate heart failure and cardiogenic shock.
Ischemic Heart Disease: Do not abruptly discontinue Metoprolol therapy in patients
with coronary artery disease. Severe exacerbation of angina, myocardial infarction
and ventricular arrhythmias have been reported in patients with coronary artery
disease following the abrupt discontinuation of therapy with beta-blockers.
When discontinuing chronically administered metoprolol, particularly in patients
with coronary artery disease, the dosage should be gradually reduced over a period
of 1 to 2 weeks and the patient should be carefully monitored. If angina markedly
worsens or acute coronary insufficiency develops, metoprolol administration should
be reinstated promptly, at least temporarily, and other measures appropriate for the
management of unstable angina should be taken.

16. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Warnings
Use During Major Surgery: Chronically administered beta-blocking therapy should
not be routinely withdrawn prior to major surgery; however, the impaired ability of
the heart to respond to reflex adrenergic stimuli may augment the risks of general
anesthesia and surgical procedures.
Bradycardia: Bradycardia, including sinus pause, heart block, and cardiac arrest have
occurred with the use of Metoprolol. Patients with first-degree atrioventricular block
sinus node dysfunction or conduction disorders may be at increased risk. Monitor
heart rate and rhythm in patients receiving Metoprolol. If severe bradycardia
develops, reduce or stop Metoprolol.
Exacerbation of Bronchospastic Disease: Patients with bronchospastic disease,
should, in general, not receive beta-blockers, including Metoprolol.

17. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Warnings
Diabetes and Hypoglycemia: Beta-blockers may mask tachycardia occurring with
hypoglycemia, but other manifestations such as dizziness and sweating may not be
significantly affected.
Pheochromocytoma: If Metoprolol is used in the setting of pheochromocytoma, it
should be given in combination with an alpha-blocker, and only after the alpha-
blocker has been initiated. Administration of beta-blockers alone in the setting of
pheochromocytoma has been associated with a paradoxical increase in blood
pressure due to the attenuation of beta-mediated vasodilatation in skeletal muscle.
Thyrotoxicosis: Metoprolol may mask certain clinical signs (e.g., tachycardia) of
hyperthyroidism. Avoid abrupt withdrawal of beta-blockade, which might precipitate
a thyroid storm.

18. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Possible Side Effects
The most common Metoprolol Tartarate (Metolar
tablets) side effects reported are exertional tiredness,
gastrointestinal disorders, and disturbances of sleep
patterns.
The most serious side effects reported are congestive
heart failure, bronchospasm and hypotension.

19. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Possible Side Effects
The following side effects occurred during clinical trials and are listed according to according
to Organ Systems:
Cardiovascular: Secondary effects of decreased cardiac output which include: syncope, vertigo,
light-headedness and postural hypotension; second and third degree AV block; congestive
heart failure; severe bradycardia; lengthening of PR interval, sinus arrest; cardiac arrhythmias;
palpitations; chest pains; hot flushes; edema; cold extremities; Raynaud's phenomenon;
claudication; gangrene in patients with pre-existing severe peripheral circulatory disorders;
precordial pain
Central Nervous System: Headache; dizziness; mental depression; light-headedness; vivid
dreams / nightmares; vertigo; anxiety; alertness decreased ; weakness; fatigue; sedation;
somnolence or insomnia; hallucination; paresthesia; personality disorder.
Gastrointestinal: Diarrhea; constipation; flatulence; nausea and vomiting ; abdominal pain;
heartburn; dry mouth ; hepatitis.

20. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Possible Side Effects
Respiratory: Shortness of breath; bronchospasm; status asthmaticus; exertional
dyspnea; wheezing; rhinitis; worsening of psoriasis.
Allergic/Dermatological: Skin rash (exanthema, urticaria, psoriasiform and dystrophic
skin lesions) hyperhydrosis; ; pruritus; photosensitivity.
Ear, Eye, Nose and Throat (EENT): Tinnitus; dry and/or eye irritation; conjunctivitis;
hearing disorders (e.g. hypoacusis or deafness) when doses exceed those
recommended; blurred vision and non-specific visual disturbances.
Miscellaneous: Muscle cramps; exertional tiredness; weight increase; alopecia;
decreased libido; Peyronie's disease; arthritis; retroperitoneal fibrosis
Clinical Laboratory: The following laboratory parameters have been elevated on rare
occasions: transaminases, BUN, alkaline phosphatase and bilirubin.
Hematology: Isolated cases of thrombocytopenia and leucopenia

21. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Metolar Tablets Overdosage
The most common signs to be expected with overdosage of a beta-
adrenoreceptor agent like Metoprolol Tartarate (Metolar tablets) are
hypotension, bradycardia, congestive heartfailure, bronchospasm and
hypoglycemia. Atrioventricular block, cardiogenic shock and cardiac arrest
may develop. In addition, impairment of consciousness (or even coma),
nausea, vomiting and cyanosis may occur.
Concomitant ingestion of alcohol, antihypertensives, quinidine, or
barbiturates aggravate the signs and symptoms.
The first manifestations of overdosage set in 20 minutes to 2 hours after drug
administration.

22. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Treatment of Metolar Overdosage
If overdosage occurs, in all cases therapy with Metoprolol Tartrate should be
discontinued, the patient hospitalized and observed closely. Remove any drug
remaining in the stomach by induction of emesis or gastric lavage.
In addition, if required, the following therapeutic measures are suggested:
Bradycardia and Hypotension: Initially 1to 2 mg of Atropine Sulfate should be given
intravenously. If a satisfactory effect is not achieved, Norepinephrine or Dopamine
may be administered after preceding treatment with Atropine.
In case of hypoglycemia glucagon (1 mg to 10 mg) can be administered.
Heart Block (second- or third- degree): Isoproterenol or transvenous cardiac
pacemaker.1.Congestive Heart Failure:Conventional therapy. 2.Bronchospasm:
Intravenous aminophylline or a beta2-agonist. 3.Hypoglycemia: Intravenous glucose

23. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Metoprolol Tartarate During Pregnancy
Metoprolol Tartarate (Metolar tablets) has been classified by the US FDA
as Pregnancy Category C.
Metoprolol Tartarate (Metolar tablets) has been shown to increase
postimplantation loss and decrease neonatal survival in rats at doses up to
55.5 times the maximum daily human dose of 450 mg. Distribution studies
in mice confirm exposure of the fetus when Metoprolol Tartarate is
administered to the pregnant animal. These studies have revealed no
evidence of impaired fertility or teratogenicity. There are no adequate and
well-controlled studies in pregnant women. Because animal reproduction
studies are not always predictive of human response, Metolar tablets
should be used during pregnancy only if clearly needed.

24. Metolar (Generic Metoprolol Tartarate Tablets)
© The Swiss Pharmacy
Metolar Tablets are manufactured by Cipla
Limited, India.
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