Metolar XR 25 Mg Tablets

Description

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Metolar XR 25 Mg Tablets

Metolar XR 25 Mg Tablets contain metoprolol succinate 25 mg in an extended-release (XR) formulation. This is the lower-strength starting dose of the cardioselective beta-1 blocker metoprolol succinate, particularly used for initiation in stable chronic heart failure and in patients who require more cautious up-titration. Once-daily dosing maintains stable plasma levels and supports long-term cardiovascular management.

Composition

About the Manufacturer

Metolar XR is manufactured by Cipla Limited, one of India’s foremost pharmaceutical companies headquartered in Mumbai. Cipla has an extensive cardiology and specialty medicines portfolio and distributes medicines to regulated markets worldwide.

Mechanism of Action

Metoprolol selectively antagonises beta-1 adrenergic receptors in the heart. This reduces heart rate, myocardial contractility, and blood pressure, decreasing cardiac workload and oxygen demand. In heart failure, long-term beta-blockade counteracts the sustained sympathetic nervous system activation that accelerates ventricular remodelling, improving ejection fraction and reducing mortality over time. At the 25 mg dose, beta-2 receptor effects on bronchi and peripheral vasculature are minimal.

Indications

• Initiation and titration in stable chronic heart failure (NYHA Class II–IV)
• Hypertension (mild to moderate, as low-dose starting therapy)
• Angina pectoris
• Post-myocardial infarction cardioprotection

Dosage & Administration

• Swallow tablets whole; do not crush, chew, or split
• Take once daily, at the same time each day, with or without food
• Heart failure initiation: 12.5–25 mg once daily; double dose every 2 weeks as tolerated, targeting up to 200 mg daily
• Hypertension: 25–50 mg once daily as a starting dose; may be increased to 100–200 mg
• Never stop abruptly; taper gradually over 1–2 weeks under medical supervision

Special Populations

• Severe hepatic impairment: May require dose reduction
• Renal impairment: No dose adjustment generally required
• Elderly: Standard dose; monitor for bradycardia and hypotension
• Children: Use under specialist supervision; limited paediatric data
• Pregnancy: May be used when clinically necessary; monitor neonate for bradycardia and hypoglycaemia

Precautions

• Monitor heart rate and blood pressure during dose titration
• Use with caution in patients with reactive airways disease (asthma, COPD) — cardioselective but may worsen airflow at higher doses
• May mask tachycardia in hypoglycaemic episodes; use with care in insulin-dependent diabetes
• Avoid abrupt withdrawal in patients with ischaemic heart disease to prevent rebound angina or MI
• Use with caution in peripheral vascular disease and Raynaud’s phenomenon

Contraindications

• Hypersensitivity to metoprolol, any other beta-blocker, or any excipient
• Cardiogenic shock or decompensated heart failure requiring IV inotropes
• Symptomatic bradycardia (heart rate <45–50 bpm)
• Sick sinus syndrome, second- or third-degree AV block (without pacemaker)
• Severe hypotension
• Phaeochromocytoma (unless given with alpha-blocker)

Side Effects

• Very common: Fatigue, bradycardia
• Common: Dizziness, headache, cold extremities, nausea, dyspnoea on exertion
• Less common: Depression, sleep disturbances, impotence
• Rare: Bronchospasm, AV block, hypoglycaemia in diabetics, dry eyes

Drug Interactions

• Verapamil / diltiazem: Combined IV use may cause severe bradycardia or AV block; avoid co-administration
• Amiodarone, digoxin: Additive risk of bradycardia and conduction disturbances
• Antihypertensives and diuretics: Enhanced blood-pressure reduction
• Insulin and oral hypoglycaemics: Beta-blockers may mask tachycardia of hypoglycaemia; monitor blood glucose closely
• NSAIDs: May reduce antihypertensive efficacy

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children. Do not use after the expiry date printed on the pack.

Related Products

• Metolar XR 50 Mg Tablets – higher-strength dose for maintenance therapy
• Cardivas 3.125 Mg Tablets – carvedilol initiation dose for heart failure
• Corbis 5 Mg Tablets – bisoprolol for hypertension and heart failure

Frequently Asked Questions

Why is the 25 Mg dose used for heart failure?

In heart failure, beta-blockers must be started at the lowest possible dose and increased very slowly, because starting too high can worsen fluid retention or cause hypotension. Metolar XR 25 Mg is the standard initiation dose, doubled every two weeks as tolerated toward the target maintenance dose.

Can I take Metolar XR 25 Mg with food?

Yes. Metolar XR 25 Mg can be taken with or without food. Taking it at the same time each day helps maintain consistent drug levels in the blood.

What should I do if my heart rate becomes too slow on Metolar XR?

A resting heart rate below 50–55 bpm or symptoms such as dizziness, fainting, or unusual breathlessness should be reported to your doctor promptly. Do not adjust the dose yourself; your doctor may lower the dose or reassess treatment.

Is Metolar XR 25 Mg safe for patients with diabetes?

Metoprolol can be used in diabetic patients, but it may mask the increased heart rate that often signals a low blood sugar episode. Blood glucose monitoring should be more frequent, and patients should discuss dose adjustments with their doctor if hypoglycaemia is a concern.

How is Metolar XR 25 Mg different from immediate-release metoprolol?

Immediate-release metoprolol tartrate is taken 2–3 times daily and produces peaks and troughs in plasma levels. Metolar XR 25 Mg uses the succinate salt in an extended-release matrix that delivers a consistent drug level over 24 hours, allowing once-daily dosing with less heart-rate variability.

References

1. NHS – Metoprolol
2. MedlinePlus – Metoprolol
3. FDA – Metoprolol Succinate Extended-Release Prescribing Information
4. EMA – Metoprolol-Containing Medicinal Products Assessment

Disclaimer: This page is for informational purposes only and does not constitute medical advice. Metolar XR 25 Mg Tablets must be prescribed by a qualified cardiologist or physician and must not be stopped without medical guidance.

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