Arbitel MT Tablets (Telmisartan + Metoprolol succinate)

• Composition :
  Each tablet contains Telmisartan 40mg+ Metoprolol Succinate 25/50mg
• Indications :
  For the treatment of essential hypertension.
• Pharmacodynamics :
  Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. MetoprololSuccinate is a beta1-selective (cardioselective) adrenergic receptor blocking agent. Itsmechanisms for antihypertensive effects are (1) competitive antagonism of catecholamines at peripheral (especially cardiac) adrenergic neuron sites, leading to decreased cardiac output; (2) a central effect leading to reduced sympathetic outflow to the periphery; and (3) suppression of renin activity.
• Dosage and administration :
  The usual starting dose of Telmisartan 40 mg Metoprolol Succinate 25/50mg combination is once daily.
• Contraindications :
  Contraindicated in patients with known hypersensitivity to active ingredients or any other component of this product. And in patients with severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is in place).
• Precautions and warnings :
  Telmisartan-Hyperkalemia,symptomatic hypotension, impaired hepatic function, impaired renal function.Metoprolol Succinate-Cardiac failure, major surgery, diabetes and hypoglycemia, hepatic impairment, bronchospastic disease, thyrotoxicosis, anaphylactic reactions and peripheral vascular disease,
• Use in pregnancy, lactation & pediatrics :
  Discontinue the tablet during pregnancy,consider possible infant exposureduring lactation. Safety and effectiveness in pediatric patients have not been established.
• Drug interactions :
  Telmisartan-Monitoring of the serum digoxin and Lithium is recommended. Its effect may be attenuated by NSAIDs including selective COX-2 inhibitor, concomitant use withACE inhibitor is not recommended. Metoprolol Succinate – Catecholamine-depleting drugs have additive effect, it is recommended to monitor CYP2D6 inhibitors, clonidine. Concomitant use of diltiazem and verapamil, with beta blockers can increase the risk of bradycardia. Abrupt withdrawal of beta-blockade may precipitate a thyroid storm.
• Adverse reactions :
  Telmisartan- back pain, sinusitis, and diarrhea. Metoprolol Succinate- tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, rash.
• Therapy Area :
  Anti-Hypertensives