Hopace MT Tablets (Ramipril + Metoprolol Succinate)

• Composition :
  Each tablet contains Ramipril 5mg and Metoprolol Succinate 50mg.
• Indications :
  For the treatment of Essential Hypertension
• Pharmacodynamics :
  Metoprolol is a beta1-selective (cardioselective) adrenergic receptor blocking agent. Beta-blocking activity of metoprolol is shown by (1) reduction in heart rate and cardiac output at rest and upon exercise, (2) reduction of systolic blood pressure upon exercise, (3) inhibition of isoproterenol-induced tachycardia and (4) reduction of reflex orthostatic tachycardia. Ramipril is an angiotensin converting enzyme inhibitor. Inhibition of ACE results in decreased plasma angiotensin II, decreased vasopressor activity and to decrease aldosterone secretion. Hence reduces stress on the heart and relaxes blood vessel so that blood flows more smoothly
• Dosage and administration :
  One tablet once daily
• Contraindications :
  In patients hypersensitive to ACE inhibitor, metoprolol, or a history of hereditary or idiopathic angioedemaor 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) with a history of angioedema, hemodynamically unstable states, severe bradycardia,and decompensated cardiac failure.
• Precautions and warnings :
  Hypotension, hyperkalemia, cholestatic jaundice, hepatic failure, neutropenia, agranulocytosis, heart failure,bronchospastic disease, pheochromocytoma,major surgery, diabetes, anaphylactic reactions, peripheral vascular disease and renal impairment.
• Use in pregnancy, lactation & pediatrics :
  Discontinue drug if pregnancy is detected, not recommended in nursing mothers.Safety and effectiveness in pediatric patients have not been established.
• Drug interactions :
  It is recommended to monitor when co-administering ramipril with Diuretics and Lithium.Metoprolol succinate administered with catecholamine depleting drugs has an additive effect - monitorfor hypotension and bradycardia. CYP2D6 Inhibitorsincreases plasma concentration. Withdrawal of clonidine can exacerbate the rebound hypertension. The concomitant use of ACE inhibitors with sacubitril/valsartan is contraindicated as this increases the risk of angioedema.
• Adverse reactions :
  The most common adverse reactions are altered taste, cough, dizziness, cold extremities, slow heart rate, numbness of extremity, increased potassium level in blood and decreased blood pressure.
• Therapy Area :
  Anti-Hypertensives