Nulong MT Tablets (cilnidipine +Metoprolol )

• Composition :
  Each tablet contains Cilnidipine 10mg and Metoprolol 25mg / 50mg.
• Indications :
  It is used in the treatment of essential hypertension
• Pharmacodynamics :
  Cilnidipine is a dihydropyridine calcium-channel blocker. It inhibits cellular influx of calcium, thus causing vasodilatation. Metoprolol is a beta 1-selective (cardioselective) adrenergic receptor blocking agent. Beta-blocking activity of metoprolol is shown by: reduction in heart rate and cardiac output at rest and upon exercise, reduction of systolic blood pressure upon exercise, inhibition of isoproterenol-induced tachycardia and reduction of reflex orthostatic tachycardia.
• Dosage and administration :
  One tablet a day to be taken with food.
• Contraindications :
  Contraindicated in aortic stenosis, severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is in place) and in patients who are hypersensitive to any component of this product.
• Precautions and warnings :
  Cilnidipine- Hypotension, poor cardiac reserve, heart failure, chronic renal insufficiency and hepatic dysfunction. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration. Metoprolol-Worsening cardiac failure may occur, it may be necessary to lower the dose of metoprolol or temporarily discontinue it. Use with caution in patients with impaired hepatic function. In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent.May mask tachycardia occurring with hypoglycemia. Beta-blockers should be avoided in patients with bronchospastic disease.
• Use in pregnancy, lactation & pediatrics :
  Nulong MT should be avoided in pregnancy and lactation. Safety and effectiveness have not been established in pediatric patients.
• Drug interactions :
  Cilnidipine can interact with aldesleukin, quinidine, phenytoin, rifampicin, erythromycin, other anti-hypertensive drugs and anti-psychotic drugs.Metoprolol- Catecholamine-depleting drugs (eg, reserpine, mono amine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents.CYP2D6 Inhibitors are likely to increase metoprolol concentration. Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia.
• Adverse reactions :
  Headache, dizziness, peripheral edema, flushing rash, gingival hyperplasia, palpitations, GI disturbances, fatigue, shortness of breath, bradycardia and hypotension.
• Therapy Area :
  Anti-Hypertensives