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Basil 40 Tablets (Famotidine 40mg)Carsel 25 Tablets (Metoprolol Tartrate 25mg)

Carsel 100 Tablets (Metoprolol Tartrate 100mg)
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Carsel 100 Tablets (Metoprolol Tartrate 100mg)

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Xanthines, especially aminophylline or theophylline
Concurrent use with beta-blockers may result in mutual inhibition of therapeutic effects.


Clinical features Bradycardia premature ventricular contraction, cardiac failure, hypotension, seizure, bronchospasm, atrioventricular block, cardiogenic shock, cardiac arrest, impairnent of canciousness, coma, nausea, vomiting, cyanosis, hypoglycemia, and occasionally hyperkalemia.

Treatment of overdosage:

Treatment should include close monitoring of cardiovascular, respiratory and renal function, and blood glucose and electrolytes. Further prevention may be prevented by induction of vomiting, gastric lavage or administration of activated charcoal if ingestion is recent. Cardiovascular complications should be treated symptomatically which may require the use of sympathomimetic agents (e.g. Noradrenaline, metaraminol), atropine or inotropic agents (e.g. Dopamine, dobutamine). Temporary pacing may be required for AV block. Glucagon can reverse the effects of excessive beta-blockadge in a dose of 1-10 mg intravenously. Intravenous beta-2-simulants may be required to relieve bronchospasm. Metoprolol cannot be effectively removed by haemodialysis.

Dosage and Administration:

The tablet should be swallowed unchewed. The dosage should be adjusted 'according to individual response.
The following doses are recommended.
Adults: Angina Pectoris: Oral 50 to 100mg, 2 to 3 times a day.
Hypertension: Oral, 100mg a day, either as single or divided doses.
Increased weekly up to 400mg a day given in single or divided doses according to patients response. Maintenance Dose: 100-200 mg a day.
Cardiac arrythmias: Oral 25-50mg 2 to 3 times a day. Increase dose if necessary, up to 300mg daily in divided doses.

Myocardial Infarction:

Early: Oral, 25-50mg every 6 hours. This dosage is continued for 48 hours followed by:
Late: Oral, 100mg two times a day for at least 3 months and possible for as long as 1-3 year. Maintenance Dose: Oral, 50-100mg twice daily by mouth.
Congestive Heart Failure: Loading Dose, 12.5mg-25mg O.D for 2 weeks then 50mg O.D for 2 weeks.
Hyperthyroidism: Oral, 50mg 4 times a day.
Migraine Prophylaxis: Oral, I 00-200mg a day in divided doses.
Geriatrics: Geriatrics Patients may have increased or decreased sensitivity to the effects of the usual adult dose.
Pediatrics: Dosage has not been established.

Presentation & Composition:

  • Carsel 100 (Metoprolol Tartrate 100mg Tablets)
  • Blister Pack of 30Tablets
  • Carsel 50 (Metoprolol Tartrate 50mg Tablets)
  • Blister Pack of 30Tablets
  • Carsel 25 (Metoprolol Tartrate 25mgTablcts)
  • Blister Pack of 30Tablets

Note: This medication may be given with food to enhance bio availability.
Important: Not to miss doses, especially with schedules of one dose per day.
Missed dose: Taking as soon as possible, not taking at all lf within 4 hours of the next dose; not doubling doses.
Check with physician before discontinuing medication, gradual dosage reduction may be necessary.

Pharmaceuticals Precautions & Storage:

  • Protect from direct Light, Heat and moisture.
  • Store under controlled temperature (15° - 30°C)

Actions and Pharmacology:

Beta-adrenergic blocking agents block the agonistic effect of the sympathetic neurotransmitters by competing for receptor binding sites. Cardioselective beta-blockers block beta-l receptors in the heart at low doses and only begin to block beta-2 receptors at increased doses, Metoprolol crosses the blood-brain barrier and placenta, and is excreted in breast milk.


This medication is indicated for the treatment of

  • Angina pectoris
  • Hypertension
  • Cardiac arrhythmias
  • Myocardial infarction
  • Migraine prophylaxis
This medication is also used as an adjunct in the treatment of
  • Hyperthyroidism
  • Early management of acute myocardial infarction


Known hypersensitivity to metoprolol or when the following medical problems exist:
  • Atrioventricular block of 2nd or 3rd degree
  • Sinus bradycardia
  • Cardiac failure
  • Severe peripheral arterial circulatory disorder
  • Hypotension
  • Cardiogenic shock


  • Metoprolol may aggravate bradycardia symptoms of peripheral arterial circulatory disorders and anaphylactic shock.
  • Abrupt cessation of therapy with a beta-blocker should be avoided where possible, it should be withdrawn gradually over a period of I 0 days. During its withdrawn, the patients should be kept under close surveillance.
  • In patients with phaeochromocytoma, an alpha-blocker should be given concomitantly.
  • In patients with significant hepatic dysfunction, it may be necessary to adjust the dosage because metoprolol undergoes biotransformation in the liver.
  • It should be given cautiously to patients with metabolic acidosis.
Pregnancy - Risk of hypoglycemia. respiratory depression, bradycardia and hypotension.
Breast Feeding - Beta-blockers are excreted in breast milk.
Geriatric - Increased risk of beta-blockcr-induced hypotension.
Risk-benefit should be considered when the following medical problems exist:
History of allergy, asthma, emphysema, congestive heart failure, coronary artery disease, diabetes mellitus, hepatic function impairment, hyperthyroidism, history of mental depression, kidney disease, liver disease. heart or blood vessel disease.

Main Side / Adverse Effects:

Allergic reaction, bradycardia, breathing difficulty and chest pain, confusion, congestive heart /failure, hallucination, hepatotoxicity, leukopenia, mental depression. psoriasiform eruption, slow irregular heart beat, reduced peripheral circulation, thrombocytopenia, withdrawal reactions, dizziness or faint, nausea, vomiting, diarrhoea and abdominal discomfort, fatigue, headache, paresthesia, insomnia, decreased sexual ability, disturbance of vision, trembling and sweating.

Drug Interactions:

  • Antidiabetic Agents, Oral, or insulin Dosage adjustment of hypoglycemic medication may be necessary to avoid hypoglycemia or hyperglycemia.
  • Calcium Channel Blocking Agent, Clonidine, Diazoxide, Guanabenz Antihypotensive effect may be potentiated when these medications arc used concurrently with beta-blocker thus dosage adjustment may be necessary.
  • Cocaine: Concurrent use of beta-blockers with cocaine may increase the risk of hypertension, excessive bradycardia and possibly heart block, because beta-blockade may leave cocaine alpha-adrenergic activity unopposed.
  • Monoamine Oxidase (MAO) inhibitors, including Furazolidone, Pargyline and Procarbazine Concurrent use with beta-blockers is not recommended as possible significant hypertension may occur.
  • Sympathomimetics:
    Concurrent use of beta-blockers with sympathomimetic amines may result in mutual inhibition of therapeutic effects.