Kapspargo Sprinkle ER 25mg Capsules

Metoprolol is a cardioselective beta-1 adrenergic receptor blocker. It competitively blocks beta-1 adrenergic receptors, primarily in the heart, leading to decreased heart rate, myocardial contractility, and cardiac output. This results in reduced blood pressure and myocardial oxygen demand. At higher doses, it can also block beta-2 adrenergic receptors.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of low blood sugar, including:
+ Dizziness
+ Headache
+ Feeling sleepy
+ Feeling weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
Depression
Severe dizziness or fainting
New or worsening chest pain
New or worsening abnormal heartbeat
Slow heartbeat
Shortness of breath, significant weight gain, or swelling in the arms or legs

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Feeling dizzy, tired, or weak
Diarrhea
Upset stomach
Vomiting

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before taking this medication, it is essential to inform your doctor about the following:

Any allergies you have, including allergies to this drug, its components, or other substances. Be sure to describe the allergic reaction you experienced, including the symptoms that occurred.
Certain heart-related conditions, such as:
+ Heart block or sick-sinus syndrome (types of abnormal heartbeats)
+ Heart failure (a weak heart)
+ Low blood pressure
+ Poor blood flow to the arms or legs
+ Shock caused by heart problems
+ A slow heartbeat
Respiratory conditions, including:
+ Asthma
+ Other breathing problems, such as COPD (chronic obstructive pulmonary disease)

This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor. Please inform your doctor and pharmacist about:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
Any health problems you have

It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Do not initiate, stop, or modify the dose of any medication without first consulting your doctor.

Important Warnings and Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Caution with Daily Activities
Until you understand how this medication affects you, avoid driving and other tasks that require alertness. To minimize the risk of dizziness or fainting, rise slowly from a sitting or lying position, and be cautious when climbing stairs.

Monitoring Your Condition
Follow your doctor's instructions for checking your blood pressure and heart rate. Additionally, have your blood work and other laboratory tests done as directed by your doctor.

Interference with Lab Tests
This medication may affect certain laboratory tests. Be sure to inform all your healthcare providers and laboratory personnel that you are taking this medication.

Risk of Low Blood Sugar
This medication may mask symptoms of low blood sugar, such as a rapid heartbeat, which can increase the risk of severe or prolonged low blood sugar. This is particularly concerning for individuals with diabetes, children, and those who are fasting, undergoing surgery, or experiencing nausea and vomiting. If you have questions or concerns, discuss them with your doctor.

Managing Diabetes
If you have high blood sugar (diabetes), it is crucial to closely monitor your blood sugar levels while taking this medication.

Interactions with Other Medications
If you have high blood pressure and are taking this medication, consult your doctor before using over-the-counter products that may increase blood pressure, such as cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Stopping the Medication
Do not stop taking this medication abruptly, as this may lead to worsened chest pain or even a heart attack, especially if you have certain types of heart disease. To avoid side effects, your doctor will instruct you on how to gradually stop taking this medication. If you experience new or worsening chest pain or other heart problems, contact your doctor immediately.

Thyroid Conditions
This medication may make it more challenging to recognize symptoms of an overactive thyroid, such as a rapid heartbeat. If you have an overactive thyroid and stop taking this medication suddenly, your condition may worsen and become life-threatening. Discuss this with your doctor.

Allergic Reactions
If you have a history of severe allergic reactions, inform your doctor. You may be at risk of an even more severe reaction if you are exposed to the allergen again. If you use epinephrine to treat severe allergic reactions, consult your doctor, as epinephrine may be less effective while taking this medication.

Alcohol Consumption
Avoid drinking alcohol while taking this medication.

Pregnancy and Breastfeeding
If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor.

• MAO inhibitors (non-selective, due to potential for hypertensive crisis if used with indirect-acting sympathomimetics)
• Strong CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine, bupropion) - concomitant use should be avoided or require significant dose reduction of metoprolol due to increased metoprolol exposure and risk of bradycardia/hypotension.

• Calcium channel blockers (non-dihydropyridine, e.g., verapamil, diltiazem): Increased risk of bradycardia, AV block, and hypotension. Avoid concomitant IV administration.
• Clonidine: May potentiate rebound hypertension upon clonidine withdrawal. Discontinue metoprolol several days before gradual withdrawal of clonidine.
• Digoxin: Additive bradycardia.
• Other beta-blockers (including ophthalmic): Additive systemic effects.
• Reserpine, Guanethidine, Alpha-methyldopa: Additive hypotensive and bradycardic effects.
• Prazosin, Terazosin, Doxazosin (alpha-1 blockers): Increased risk of first-dose hypotension.

• NSAIDs (e.g., ibuprofen, naproxen): May reduce the antihypertensive effect of metoprolol.
• Rifampin: May decrease metoprolol plasma concentrations (CYP2D6 induction).
• Cimetidine: May increase metoprolol plasma concentrations (CYP2D6 inhibition).
• Oral contraceptives: May increase metoprolol plasma concentrations.
• Alcohol: May increase metoprolol plasma concentrations and enhance hypotensive effects.
• Insulin and oral hypoglycemics: Beta-blockers may mask symptoms of hypoglycemia (e.g., tachycardia) and prolong hypoglycemic episodes.
• Lidocaine: Metoprolol may reduce lidocaine clearance, increasing lidocaine levels and toxicity risk.

• Not specifically listed as minor, but general caution with other drugs affecting heart rate or blood pressure.

• Bradycardia (slow heart rate)
• Hypotension (dizziness, lightheadedness, fainting)
• Fatigue, lethargy
• Shortness of breath, wheezing (especially in patients with reactive airway disease)
• Peripheral edema, weight gain (signs of worsening heart failure)
• Cold extremities
• Depression, sleep disturbances
• Masked symptoms of hypoglycemia (e.g., sweating, hunger, confusion may still be present, but tachycardia may be absent)

Metoprolol is Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Beta-blockers may cause bradycardia, hypoglycemia, and respiratory depression in the neonate. Monitor neonates for these effects.

Metoprolol is excreted in breast milk. The amount is small, and adverse effects in breastfed infants are unlikely but possible. Monitor the infant for signs of beta-blockade (e.g., bradycardia, lethargy, poor feeding). L3 (Moderately Safe).

Safety and effectiveness in pediatric patients have not been established for hypertension or angina. For heart failure, limited data exist, and it is generally not recommended as first-line therapy. Use in children should be under specialist supervision.

No overall differences in effectiveness or safety have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Start with lower doses and titrate slowly, monitoring closely for adverse effects such as bradycardia and hypotension.

• Kapspargo Sprinkle ER capsules can be opened and the beads sprinkled on a spoonful of soft food (e.g., applesauce, pudding, yogurt) and swallowed immediately without chewing. Do not crush or chew the beads.
• Always take metoprolol succinate extended-release consistently with food or on an empty stomach, but ideally with food to enhance absorption and reduce GI upset.
• This is an extended-release formulation, designed for once-daily dosing. Do not substitute with immediate-release metoprolol tartrate on a milligram-for-milligram basis.
• Patients with asthma or COPD should use metoprolol with extreme caution, as even beta-1 selective agents can cause bronchospasm at higher doses or in susceptible individuals.
• Diabetic patients should be advised that beta-blockers can mask symptoms of hypoglycemia, particularly tachycardia. Other symptoms like sweating may still be present.
• Patients should be educated on the importance of not abruptly discontinuing the medication due to the risk of rebound hypertension, angina exacerbation, or myocardial infarction.

• Other Beta-blockers (e.g., Carvedilol, Bisoprolol, Atenolol, Nebivolol)
• ACE Inhibitors (e.g., Lisinopril, Enalapril)
• Angiotensin Receptor Blockers (ARBs) (e.g., Valsartan, Losartan)
• Calcium Channel Blockers (e.g., Amlodipine, Felodipine, Diltiazem, Verapamil)
• Diuretics (e.g., Hydrochlorothiazide, Furosemide)
• Alpha-1 Blockers (e.g., Prazosin, Terazosin)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.