Metoprolol + Telmisartan Pharmacology
Metoprolol + Telmisartan
Metoprolol
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.
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
2.Second or third degree heart block
3.Congestive heart failure
4.Cardiogenic shock
5.Bradycardia
6.Bronchial asthma
7.Diabetes mellitus
2.Hepatic impairment
3.The drug should be gradually withdraw with caution
4.Respiratory disorders
2.Arrhythmias
3.Angina
4.Migraine
5.Prophylaxis of myocardial infarction
6.Thyrotoxicosis
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.
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.
Telmisartan
2.Headache
3.Coughing
4.Edema
5.Nausea
6.Abdominal pain
7.Diarrhoea
8.Dyspepsia
9.Pharyngitis
10.Sinusitis
11.Upper respiratory tract infections
12.Urinary tract infections
13.Elevated liver enzymes
14.Weakness
15.Chest pain
16.Myalgia
17.Back pain
18.Neutropenia
19.Fetopathic
20.Precipitate renal failure in renal artery stenosis, and in insufficient renal blood flow
21.Urticaria
22.Rashes
23.Hyperkalemia
2.Hepatic impairment
3.Heart failure
4.Aortic or mitral valve stenosis
5.Obstructive cardiomyopathy
6.Use cautiously in volume depleted and salt depleted individuals, these conditions should be corrected before starting the therapy
7.Patient should be cautiously involve in driving or operating heavy machinery during therapy
8.Avoid alcohol or use with caution during therapy
9.Use with caution in hyperkalemia and along with potassium sparing diuretics
Maintenance dose: 20 to 80mg once daily
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