Acino Pharma AG


Ceutical Trading
Chong Ruan Trading
Full Prescribing Info
Metoprolol succinate.
Each METRACIN tablet contains metoprolol succinate 23.75mg, 47.5mg, 95mg or 190 mg as the active ingredient.
Excipients/Inactive Ingredients: sugar spheres, macrogol 6000, polyacrylate dispersion, talc, povidone, microcrystalline cellulose, magnesium stearate, colloidal anhydrous silica, hypromellose, titanium dioxide (E171).
METRACIN belongs to a group of medicines called beta-blockers.
METRACIN tablets are used to treat heart failure. It is used in combination with other medicines to treat the patient's condition.
It works by affecting the body's response to some nerve impulses, especially in the heart. As a result, it decreases the heart's need for blood and oxygen and therefore reduces the amount of work the heart has to do. It also helps the heart to beat more regularly.
METRACIN tablets are used to treat heart failure. It is used in combination with other medicines to treat the patient's condition.
Dosage/Direction for Use
All directions given to the patient by the doctor or pharmacist should be followed carefully.
How much METRACIN to take: The usual starting dose is half a 25 mg or a whole 25 mg tablet once a day for one to two weeks. The dose is then usually doubled every second week up to a maximum dose of 200 mg once daily or to the highest tolerated dose.
METRACIN tablets may be broken in half or swallowed whole with a glass of water as directed by the doctor. METRACIN tablets should not be chewed or crushed.
If the patient is taking other medicines the doctor may need to change the dose of them to obtain the best results.
When to take METRACIN: Take the medicine at about the same time each day, preferably together with the morning meal.
Taking it at the same time each day will have the best effect. It will also help the patient remember when to take it.
How long to take METRACIN: Continue taking the medicine as long as prescribed by the doctor. The medicine helps to control the patient's condition, but does not cure it.
It is important to keep taking the medicine even if the patient feels well.
Do not stop taking METRACIN tablets suddenly.
The dose needs to be reduced slowly over 7 to 14 days to avoid worsening of patient's condition. The doctor will instruct the patient how to gradually reduce the dose before stopping completely.
If the patient had forgotten to take METRACIN: If the patient misses a dose of METRACIN and the next dose is more than 12 hours away, the missed dose must be taken right away.
If the next dose is less than 12 hours away, take only half the dose, the next dose must be taken when meant to.
Do not take a double dose to make up for the dose missed.
If the patient is not sure what to do, ask the doctor or pharmacist.
If patient has trouble remembering when to take the medicine, ask the pharmacist for some hints.
If METRACIN has been taken too much, the doctor must be notified or go to casualty at the nearest hospital immediately. This must be done even if there are no signs of discomfort or poisoning. Urgent medical attention may be needed.
Taking too many METRACIN tablets may cause the blood pressure drop too far. Fainting may be felt, and heart rate will also slow down. Nausea, vomiting and shortness of breath may also be experienced. In extreme cases, serious heart and lung problems may occur.
METRACIN tablets should not be taken if: The patient has any allergies to metoprolol succinate, the active ingredient in METRACIN tablets, or any of the ingredients listed in Description, or any other beta-blocker medicine.
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin or fainting may be felt.
The patient has or have had asthma difficulty in breathing, wheezing, bronchitis or other lung problems in the past.
The patient has a history of allergic problems, including hayfever.
The patient has low blood pressure.
The patient has a very slow heartbeat (less than 45-50 beats/minute).
The patient has certain other heart conditions.
The patient has phaeochromocytoma (a rare tumour of the adrenal gland) which is not being treated already with other medicines.
The patient has a severe blood vessel disorder causing poor circulation in the arms and legs.
The patient is receiving/having emergency treatment for shock or severely low blood pressure.
Special Precautions
Before taking METRACIN, the doctor must be informed if the patient has any allergies to: Metoprolol succinate or any of the ingredients listed in Description.
Any other medicine including other beta-blocker medicines.
Any other substances, such as foods, preservatives or dyes.
The doctor must be informed if the patient has, or have had, any medical conditions, especially the following: Asthma or other lung problems, even if the patient have had them in the past; allergic problems, including hayfever; diabetes; very slow heart beat (less than 45-50 beats/minute); severe blood vessel disorder causing poor circulation in the arms and legs; liver problems; kidney problems; certain types of angina; any other heart problems; phaeochromocytoma, a rare tumour of the adrenal gland; hyperthyroidism (an overactive thyroid gland).
Effects on the Ability to Drive and Operate Machinery: Care must be taken when driving or operating machinery until the patient becomes aware of the effects of METRACIN.
As with other beta-blocker medicines, METRACIN may cause dizziness, light-headedness, tiredness, or drowsiness in some people. The patient should be sure that he/she knows how to react to METRACIN before he/she drives a car, operates machinery, or do anything else that could be dangerous if dizziness or light-headedness is encountered.
Use in Children: Do not give METRACIN to children.
The safety and effectiveness of METRACIN in children has not been established.
Use In Pregnancy & Lactation
The doctor must be informed if the patient is pregnant or intends to become pregnant..
Like most beta-blocker medicines, METRACIN is not recommended for use during pregnancy.
The doctor must be informed if the patient is breast-feeding or plans to breast-feed.
The active ingredient in METRACIN passes into breast milk and therefore there is a possibility that the breast-fed baby may be affected.
The doctor must be informed about any of these things before taking METRACIN.
Adverse Reactions
The doctor or pharmacist must be notified as soon as possible if the patient does not feel well while taking METRACIN.
If the patient gets any side effects, he/she should not stop taking METRACIN without first talking to his/her doctor.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. Medical treatment may be needed if the patient gets some of these side effects.
If the patient is over 65 years of age there is an increased chance of getting side effects.
Should the patient have any questions, ask the doctor or pharmacist.
The doctor must be notified of the following and if they are worrisome to the patient: Headache, tiredness, drowsiness, weakness, or lack of energy.
Aches and pains, painful joints.
Nausea (feeling sick), vomiting.
Stomach upset, diarrhoea or constipation, weight gain.
Dry mouth, changes in taste sensation.
Difficulty sleeping, nightmares.
Mood changes.
Confusion, short-term memory loss, inability to concentrate.
Increased sweating, runny or blocked nose.
Hair loss.
These side effects are usually mild.
The doctor or pharmacist must be notified immediately if the patient notices any of the following: Dizziness, light headedness or fainting especially on standing up, which may be a sign of low blood pressure.
Tingling or "pins and needles".
Coldness, burning, numbness or pain in the arms and/or legs.
Skin rash or worsening of psoriasis.
Sunburn happening more quickly than usual.
Abnormal thinking or hallucinations.
Buzzing or ringing in the ears, deafness.
Irritated eyes or blurred vision.
Problems with sexual function.
Constant "flu-like" symptoms with tiredness or lack of energy.
Unusual bleeding or bruising.
These are serious side effects. Urgent medical attention may be needed. Serious side effects are rare.
If any of the following happen, the patient must notify his/her doctor or go to Accident and Emergency at the nearest hospital immediately: Shortness of breath, being less able to exercise.
Swelling of the ankles, feet or legs.
Chest tightness, wheezing, noisy breathing, difficulty breathing.
Chest pain, changes in heart rate or palpitations.
Swelling of the face, lips, tongue or throat which may cause difficulty in swallowing or breathing, which may be signs of a serious allergic reaction.
Yellowing of the skin or eyes (jaundice), generally feeling unwell.
These are very serious side effects. Urgent medical attention or hospitalisation may be needed. These side effects are rare.
Other side effects not listed here may occur in some patients. If anything makes the patient feels unwell, this must be reported to his/her doctor or pharmacist.
Do not be alarmed by this list of possible side effects.
The patient may not experience any of them.
Drug Interactions
Tell the doctor or pharmacist if the patient is taking any other medicines, including medicines acquired without a prescription from the pharmacy, supermarket or health food shop.
Some medicines and METRACIN may interfere with each other. These include: Other beta-blocker medicines, including beta-blocker eye drops.
Calcium channel blockers or calcium antagonists, medicines used to treat high blood pressure and angina, for example verapamil and diltiazem.
Medicines used to treat high blood pressure, for example clonidine, hydralazine, and prazosin.
Medicines used to treat abnormal or irregular heartbeat, for example amiodarone, disopyramide and quinidine.
Medicines used to treat arthritis, pain, or inflammation, for example indomethacin and ibuprofen.
Digoxin, a medicine used to treat heart failure.
Medicines used to treat diabetes.
Medicines used to treat bacterial infections, for example rifampicin.
Cimetidine, a medicine used to treat stomach ulcers.
Medicines used to treat depression.
Warfarin, a medicine used to prevent blood clots.
Monoamine-oxidase inhibitors (MAOIs).
These medicines may be affected by METRACIN or may affect how well it works. Different doses of the medicine, or different medicines may need to be taken. The doctor will advise the patient.
The doctor and pharmacist have more information on medicines to be careful with or avoid while taking METRACIN.
The patient should tell the doctor about any of these before taking METRACIN.
Caution For Usage
Disposal: Ask the pharmacist what to do with the tablets left over if the doctor tells him/her to stop taking them, or if he/she finds that the expiry date has passed.
Keep the tablets in the blister pack until it is time to take them.
Do not store METRACIN above 25°C.
Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills.
Heat and dampness can destroy some medicines.
Keep it where young children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Patient Counseling Information
While you are using METRACIN: Things you must do: Be sure to keep all of your doctor's appointments so that your progress can be checked.
If you become pregnant while taking METRACIN, tell your doctor immediately.
If you have a severe allergic reaction to foods, medicines or insect stings, tell your doctor immediately.
If you have a history of allergies, there is a chance that METRACIN may cause allergic reactions to be worse and harder to treat.
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly.
You may feel light-headed or dizzy when you begin to take METRACIN. This is because your blood pressure has fallen suddenly. Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure. If this problem gets worse or continues, talk to your doctor.
If you feel a worsening of your condition in the early stages of taking METRACIN, tell your doctor immediately.
Some people may experience an apparent worsening of their condition in the early stages of treatment with METRACIN. It is important to tell your doctor if this happens to you, although it is usually temporary. If your condition continues to worsen, you should see your doctor as soon as possible.
Make sure you drink enough water during exercise and hot weather when you are taking METRACIN, especially if you sweat a lot.
If you do not drink enough water while taking METRACIN, you may feel faint or light-headed or sick. This is because your blood pressure is dropping too much. If you continue to feel unwell, tell your doctor.
If you are being treated for diabetes, make sure you check your blood sugar level regularly and report any changes to your doctor.
METRACIN may change how well your diabetes is controlled. It may also cover up some of the symptoms of low blood sugar (hypoglycaemia). METRACIN may increase the time your body takes to recover from low blood sugar. Your doses of diabetic medicines, including insulin, may need to change.
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking METRACIN.
Tell any doctors, dentists, and pharmacists who are treating you that you are taking METRACIN.
If you plan to have surgery (even at the dentist) that needs an anaesthetic, tell your doctor or dentist that you are taking METRACIN.
If you have to have any medical tests while you are taking METRACIN, tell your doctor.
METRACIN may affect the results of some tests.
Things you must not do: Do not stop taking METRACIN without checking with your doctor.
Your doctor may want you to gradually reduce the amount of METRACIN you are taking before stopping completely. This may help reduce the possibility of your condition worsening or other heart complications occurring.
Do not give METRACIN to anyone else even if they have the same condition as you.
Do not use METRACIN to treat any other complaints unless your doctor tells you to.
Things to be careful of: Be careful drinking alcohol while you are taking METRACIN. If you drink alcohol, dizziness or light-headedness may be worse.
Dress warmly during cold weather, especially if you will be outside for a long time (for example when playing winter sports).
METRACIN, like other beta-blocker medicines, tends to decrease blood circulation in the skin, fingers and toes. It may make you more sensitive to cold weather, especially if you have circulation problems.
MIMS Class
ATC Classification
C07AB02 - metoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
PR tab (white to off-white, oblong, biconvex, film-coated, scored) 25 mg x 30's, 100's. 50 mg x 30's, 100's. 100 mg x 30's, 100's. 200 mg x 30's.
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