Metoprolol + Ramipril Pharmacology

Metoprolol + Ramipril

About Metoprolol + Ramipril
N/A
Mechanism of Action of Metoprolol + Ramipril
Chronic treatment with the beta-adrenoceptor antagonist metoprolol, the angiotensin converting enzyme inhibitor ramipril. After infarction, the action potential amplitude was reduced and this phenomenon was partially reversed by metoprolol- and ramipril-treatment. Prolonged repolarisation after infarction was additionally delayed after metoprolol treatment. Thus, metoprolol extends the refractory period, which may counteract tachyarrhythmia.
Pharmacokinets of Metoprolol + Ramipril
N/A
Onset of Action for Metoprolol + Ramipril
N/A
Duration of Action for Metoprolol + Ramipril
N/A
Half Life of Metoprolol + Ramipril
N/A
Side Effects of Metoprolol + Ramipril
N/A
Contra-indications of Metoprolol + Ramipril
N/A
Special Precautions while taking Metoprolol + Ramipril
N/A
Pregnancy Related Information
Contra Indicated
Old Age Related Information
N/A
Breast Feeding Related Information
Contra Indicated
Children Related Information
N/A
Indications for Metoprolol + Ramipril
N/A
Interactions for Metoprolol + Ramipril
N/A
Typical Dosage for Metoprolol + Ramipril
N/A
Schedule of Metoprolol + Ramipril
N/A
Storage Requirements for Metoprolol + Ramipril
N/A
Effects of Missed Dosage of Metoprolol + Ramipril
N/A
Effects of Overdose of Metoprolol + Ramipril
N/A

Metoprolol

About Metoprolol
A selective ?1 blocker, Anti-hypertensive.
Mechanism of Action of Metoprolol
Metoprolol is a cardio selective beta-1 adrenergic antagonist.
It have negative chronotropic and negative inotropic effects on heart. It decreases oxygen consumption; cardiac work and aortic pressure It decreases nor adrenaline and renin releases. It decreases central sympathetic out flow. In sympathetic over activity, it prolongs systole by retarding conduction. It increases oxygen supply and exercise tolerance in angina patients. The drug decreases BP in hypertensive individuals.
Antimigraine action: Metoprolol is useful in migraine due to its beta blockade action. Through beta blockade action it inhibits vasodilation and relieves migraine.
Pharmacokinets of Metoprolol
Absorption: well absorbed orally, bioavailabity is increased by administering along with food. Distribution: Widely distributed. Metabolism: Metabolized in liver by hydroxylation. Excretion: Excreted through urine.
Onset of Action for Metoprolol
15minutes
Duration of Action for Metoprolol
Up to 1 to12 hours
Half Life of Metoprolol
N/A
Side Effects of Metoprolol
1.Heart failure
2.Nightmares
3.Gastrointestinal problems
4.Nausea
5.Tiredness
6.Sinus bradycardia
7.Depression
8.Rash
9.Hypotension
10.Dizziness
11.Fatigue
12.Vomiting
13.Diarrhoea
14.Headache
15.Bronchospasm
Contra-indications of Metoprolol
1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Congestive heart failure
4.Cardiogenic shock
5.Bradycardia
6.Bronchial asthma
7.Diabetes mellitus
Special Precautions while taking Metoprolol
1.Congestive heart failure
2.Hepatic impairment
3.The drug should be gradually withdraw with caution
4.Respiratory disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Contraindicated
Indications for Metoprolol
1.Hypertension
2.Arrhythmias
3.Angina
4.Migraine
5.Prophylaxis of myocardial infarction
6.Thyrotoxicosis
Interactions for Metoprolol
Thioamines: Increased efficacy of metoprolol.
Thyroid hormones: Decreased efficacy of metoprolol.
Benzodiazepines: Increased efficacy of benzodiazepines.
Clonidine: Abrupt withdrawal of clonidine may lead to hypertensive crisis.
Ergot alkaloids: Peripheral ischaemia, possible peripheral gangrene.
Lidocaine: Increased lidocaine level may occur leading to toxicity.
Prazosin: Increased postural hypotension produced by parzosin.
Sulphonylureas: Hypoglycaemic effects may be attenuated.
Typical Dosage for Metoprolol
Oral
Adult: 50 to 450mg/day
Hypertension: Starts with 50mg to 100mg/day once daily or in divided doses and gradually increases up to 450mg/day based on patient`s response
Arrhythmias:
Oral: 100mg to 150mg/day in 2 to 3 divided doses
I.V.: Dose range: 10 to 15mg. Starts with 5mg infused within 5minutes. Then repeat the therapy with the same dose at every 5minutes interval based on patient`s response
Maximum dose: 20mg
Angina: 50mg twice daily, gradually increases based on patient`s response at one week intervals
Maximum dose: 0.4gm/day
Migraine: 0.1 to 0.2gm/day in divided doses in 12th hourly to 6th hourly.
Prophylaxis of myocardial infarction: 0.1 to 0.2gm/day in divided doses
Myocardial infarction: 15mg in 3divided doses at 2minutes interval as I.V.bolus administration. Then 200mg orally in four divided doses for 2days.

Schedule of Metoprolol
H
Storage Requirements for Metoprolol
Store at controlled room temperature between 20 to 25 degree C in a well closed container

Effects of Missed Dosage of Metoprolol
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Metoprolol
Treatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal. Treat Bradycardia with atropine 0.5 to 1mg.If required administer isoproterinol with caution. Treat hypotension with glucagons and vasopressors like epinephrine. Treat cardiac failure with diuretics and cardiac glycosides. Treat bronchospasm with isoproterinol and aminophylline

Ramipril

About Ramipril
Angiotensin - converting enzyme inhibitor, Antihypertensive.
Mechanism of Action of Ramipril
It is a prodrug and converted in to active Ramiprilat; which is an angiotensin converting enzyme inhibitor prevents the conversion of angiotensin-1 to angiotensin-2 and abolishes the pressor actions of angiotensin. It decreases aldosterone secretion, sodium and water retention, and total peripheral resistance, leads to fall in BP. The arterioles dilate and the compliance of larger arteries is increased. Both systolic and diastolic BP is lowered. The drug does not compromise renal, cerebral, and coronary blood flow. The drug also increases plasma kinin levels and potentiate the hypotensive action of exogenously administered bradykinin. It is used for treatment of systolic heart failure, because it improves symptoms, decrease mortality and reduce ventricular hypertrophy. It reduces both preload and after load and thus increasing cardiac out put in patients with heart failure.
Pharmacokinets of Ramipril
Absorption: Absorbed orally up to 60%, Distribution: Widely distributed in the tissues, Metabolism: Metabolized in the body in to active metabolite, Ramiprilat. Excretion: Excreted mainly through urine and also excreted through faeces.
Onset of Action for Ramipril
1 to 2 hours
Duration of Action for Ramipril
24 hours
Half Life of Ramipril
8 to 48 hours
Side Effects of Ramipril
1.Cough
2.Angioedema
3.Hypotension
4.Chest pain
5.Hyperkalemia
6.Rashes
7.Urticaria
8.Swelling of lips, mouth, nose, and larynx
9.Fetopathic in later half of pregnancy
10.Headache
11.Diarrhoea
12.Fatigue
13.Dizziness
14.Nausea
15.Neutropenia
16.Thrombocytopenia
17.Acute renal failure is precipitated in renal artery stenosis


Contra-indications of Ramipril
1.Hypersensitivity to the drug
2.Renal artery stenosis
3.Aortic stenosis
4.Coarctation of aorta

Special Precautions while taking Ramipril
1.Renal impairment
2.Hepatic impairment
3.Use cautiously in patient at high risk of cardiogenic shock, severe heart failure etc
4.Anaesthesia and surgery

Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Ramipril
1.Hypertension
2.Heart failure

Interactions for Ramipril
Antacids: May decrease bioavailability of ramipril.
Phenothiazines: Pharmacologic effects enhanced by phenothiazines.
Allupurinol: Higher risk of hypersensitivity reactions.
Digoxin: Increases plasma digoxin levels.
Potassium preparations & Potassium sparing diuretics: Hyperkalaemia and increased risk of renal failure.
Lithium: Toxicity due to increased serum concentration of lithium.
Typical Dosage for Ramipril
Starts with 1.25mg once daily. Increases the dose to 2.5 to 5mg once daily; depending on patient`s response.
Maximum dose: 10mg once daily.
In CHF patients starts the dosage with 1.5mg once daily dosage and gradually increases at 2 to3 weeks` intervals to usual dosage.

Schedule of Ramipril
H
Storage Requirements for Ramipril
Store at a temperature range of 15 to 30 degree C. in a well closed container and protect from moisture.






Effects of Missed Dosage of Ramipril
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Ramipril
Treatment is supportive and symptomatic. To remove drug from the body perform induced emesis and gastric lavage. Administer activated charcoal to reduce absorption. In severe cases haemodialysis is considered if required. Treatment includes I.V. infusion of normal saline solution.

Home Delivery for Metoprolol + Ramipril in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including metoprolol + ramipril.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for metoprolol + ramipril and other medicines and health products. Home delivery services for metoprolol + ramipril may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take metoprolol + ramipril only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for metoprolol + ramipril before they complete the sale. You can get this information while placing the order for metoprolol + ramipril with the pharmacy.

Metoprolol + Ramipril is a generic medicine name and there are several brands available for it. Some of the brands for metoprolol + ramipril might be better known than metoprolol + ramipril itself. If the pharmacy that's willing to deliver medicines to your home doesn't have metoprolol + ramipril in stock, you can ask for one of the branded alternatives for metoprolol + ramipril.