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Metoprolol instructions for use
Metoprolol tablets are a representative of the pharmacological group of drugs beta 1- adrenoblockers. They are used to reduce blood pressure and reduce the load on the heart for various pathologies of the cardiovascular system.
A form of issue and composition
Tablets Metoprolol have a round shape, biconvex surface, depending on the dosage they can have pinkish (50 mg) or light yellow (100 mg) color. The main active substance of the drug is metoprolol tartrate, its content in one tablet is 50 or 100 mg. It also includes auxiliary components:
- Titanium dioxide.
- Polysorbate 80.
- Crimson dye (Ponce 4R).
Metoprolol tablets are packaged in a blister of 10 and 14 pieces. Cardboard pack contains 2, 3 and 4 blisters with an appropriate number of tablets, as well as instructions for the use of the drug.
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Metoprolol tartrate, which is the main active substance of the drug, blocks b 1 -adrenoreceptors, localized in the heart and arterial vessels. It does not have an internal sympathetic effect. Therefore it has several therapeutic effects, which include:
- Hypotensive effect – reduces the level of systemic blood pressure by reducing the heart rate, cardiac output and spasm of arterial vessels (enlarging the lumen by relaxing the smooth muscles of the walls of the arteries).
- Antianginal action – is realized by reducing the heart rate and reducing the need for myocardium (cardiac muscle) in oxygen, nutrient compounds.
- Antiarrhythmic action – normalization and reduction in the frequency of cardiac contractions.
After taking metoprolol tablets inside, the active substance is quickly and almost completely absorbed into the blood from the lumen of the gastrointestinal tract. It is evenly distributed in the tissues of the body, metabolized in the liver with the formation of inactive decay products, which are excreted in the urine.
Indications of how to use
Metoprolol tablets are indicated in the complex therapy of cardiovascular pathology, accompanied by increased systemic blood pressure and increased heart burden:
- Treatment of hypertension as a monotherapy or in combination with other antihypertensive agents.
- Complex therapy of ischemic heart disease, which is characterized by a decrease in the intake of oxygen and nutrients in the myocardium.
- Therapy of various types of arrhythmia, in particular supraventricular (supraventricular) tachycardia and ventricular extrasystole.
Also, metoprolol tablets are used in the complex therapy of hyperthyroidism (increasing the level of thyroid hormones, which increases the functional activity of the heart and arteries) and migraines (attacks of a severe headache).
Contraindications for use
The use of tablets Metoprolol is contraindicated in a number of pathological and physiological conditions of the body, which include:
- Individual intolerance to metoprolol tartrate or ancillary components of the drug.
- Cardiogenic shock is severe heart failure with a critical decrease in its pumping function due to the development of multiple organ failures.
- Atrioventricular blockade of 2-3 degrees – a violation of the passage of the cardiac pulse through the nerve node, which is located between the atria and ventricles.
- Syndrome of a weakness of the sinus node, characterized by the development of a pulse in the atrial node of insufficient strength.
- A pronounced decrease in heart rate (bradycardia).
- Decompensated acute or chronic heart failure.
- Simultaneous administration of verapamil (a calcium channel inhibitor) or the use of MAO inhibitors (monoamine oxidase).
- Arterial hypotension (lowering systemic blood pressure lower than normal).
- Stenocardia of Prinzmetal is a rare form of ischemia (insufficient nutrition and oxygen supply to the heart muscle) of the myocardium, which develops at an early stage of atherosclerotic lesion of coronary (cardiac) vessels as a result of their spasm.
- Children under 18 years.
With caution, the drug is used in diabetes mellitus, chronic obstructive bronchitis , bronchial asthma (allergic inflammation of the bronchi with their periodic spasms and shortness of breath), atrioventricular blockade of 1 degree, chronic hepatic or renal insufficiency, depression, thyrotoxicosis (marked increase in thyroid hormone levels in the body) , peripheral vascular pathology with obliteration (obstruction), myasthenia gravis (muscle weakness), pheochromocytoma (hormone-producing adrenal tumor). Before starting taking metoclopramide tablets, make sure there are no contraindications.
Dosing and Administration
Metoprolol tablets are taken orally right after meals. They are not chewed and washed down with enough water. The regimen and dosage depend on the pathology:
- Arterial hypertension – the initial dosage is 50-100 mg in 1 or 2 doses during the day. With insufficient therapeutic effect, the dose can be increased to the maximum therapeutic daily dosage of 200 mg.
- Angina, arrhythmia or complex treatment of a migraine – 100-200 mg per day in 2 divided doses (morning and evening).
- Functional disorders of the heart, which are accompanied by tachycardia – 100 mg per day 2 admission (morning and evening).
- Prevention of the development of secondary myocardial infarction – 200 mg per day in 2 divided doses.
Elderly adjust the dosage is not necessary. With concomitant hepatic insufficiency, the dose is reduced depending on the severity of the functional liver failure.
Taking metoprolol tablets can lead to the development of unwanted reactions from various organs and systems:
- The digestive system – nausea, vomiting, dry mouth, abdominal pain, diarrhea or constipation, a decrease in the functional activity of the liver, a violation of taste sensations.
- Cardiovascular system – sinus bradycardia (decrease in the frequency of heart contractions), lowering of blood pressure level, palpitation, orthostatic hypotension (pronounced decrease in arterial pressure when the body changes from horizontal to vertical), worsening of symptoms of chronic heart failure, angiospasm development (pronounced reduction the walls of arterial vessels, primarily the peripheral arteries), arrhythmias, conduction disturbances of the myocardium, pain in the region of the heart.
- Nervous system – increased fatigue, headache, periodic dizziness , general weakness, depression (prolonged decline in mood), paresthesia (impaired skin sensitivity in certain areas of the body), decreased concentration and speed of psychomotor reactions, daytime drowsiness and sleeplessness at night, nightmares, confusion, memory impairment (especially short-term), weakness in skeletal muscles.
- Organs of senses – a decrease in the secretion of tear fluid, reduced visual acuity, tinnitus, dryness and soreness of the eyes, conjunctivitis (inflammation of the conjunctiva of the eyes).
- The system of breathing – nasal congestion, bronchospasm, which is characterized by difficulty in exhaling, dyspnea.
- Endocrine system – lowering of blood sugar (hypoglycemia), especially against the background of insulin, less likely to increase its level, hypothyroidism (decrease in the functional activity of the thyroid gland and the level of its hormones in the body), weight gain.
- Sexual system – there can rarely be a decrease in libido, as well as a violation of potency in men.
- Skin and subcutaneous tissue – exacerbation of psoriasis (chronic degenerative-dystrophic pathology of skin), increased sweating (hyperhidrosis), increased photosensitivity of the skin (inflammatory reaction to light, especially sunlight), reversible alopecia (hair loss).
- Allergic reactions – itchy skin and rash on it, hives (a characteristic rash, in appearance resembling a nettle burn).
- Laboratory indicators – increased activity of enzymes of hepatic transaminases in the blood (ALT, AST), which indicates damage to hepatocytes (liver cells), a decrease in the number of platelets (thrombocytopenia), leukocytes (leukopenia), hyperbilirubinemia (marked increase in bilirubin concentration in the blood).
In case of side effects, the doctor decides whether to cancel the drug, depending on their type and severity.
Before you start taking metoprolol tablets, you should carefully read the instructions for the drug. There are a few special instructions for taking the drug, which are important to pay attention to:
- Taking metoprolol tablets requires periodic monitoring of a number of indicators, namely blood pressure level, heart rate, blood glucose concentration (in patients with concomitant diabetes mellitus).
- The patient should be trained in the independent calculation of heart rate, if this figure falls below 50 beats per minute, he should consult a doctor.
- The inclusion of the drug in the treatment of heart failure is possible only after the compensation of the functional activity of the heart.
- With a sharp cancellation of the drug, the development of the “withdrawal” syndrome is possible, which is characterized by an increase in the level of arterial pressure, the appearance of angina attacks (pressing pain in the heart area associated with inadequate myocardial nutrition), the development of arrhythmia. Therefore, the withdrawal of the drug is carried out gradually, by reducing the dosage in several stages, especially in patients with concomitant ischemic heart disease.
- Metoprolol tablets can mask the symptoms of cardiovascular pathology, which is important to consider during diagnostic activities.
- If it is necessary to perform a surgical intervention against the background of taking the drug, it is important to warn the doctor of an anesthesiologist about this, who will select the appropriate drugs for anesthesia. The withdrawal of the drug during an operation is not required.
- The concomitant use of drugs that reduce the reserves of catecholamines (adrenaline and norepinephrine), in particular, reserpine, can significantly enhance the therapeutic effect of Metoprolol tablets, which is accompanied by severe arterial hypotension.
- In the presence of concomitant renal failure, periodic monitoring of laboratory indicators of the functional activity of the kidneys is recommended.
- The presence of depressive disorders at the time of taking the drug requires consultation and supervision of a psychiatrist.
- The drug is not used in children, as there is no reliable data on its effectiveness and safety.
- Persons who use contact lenses should take into account that metoprolol tablets reduce the synthesis of tear fluid and lead to dryness of the conjunctiva.
- During the use of the drug is not recommended to engage in activities that require increased concentration of attention and speed of psychomotor reactions, as it may develop dizziness and reduce the functional activity of the cerebral cortex.
In the pharmacy chain, metoprolol tablets are dispensed on prescription. It is not recommended for their independent reception without the appropriate appointment of the attending physician.
Overdose of Metoprolol
If the therapeutic recommended dose of Metoprolol tablets is significantly exceeded, a decrease in blood pressure, bradycardia, nausea, vomiting, dizziness, cyanosis of the face (bluishness of the skin and visible mucous membranes), arrhythmia, ventricular extrasystole develops. With a significant overdose develops cardiogenic shock. Treatment of exceeding the recommended dose is carried out only in a medical hospital, symptomatic therapy with atropine, dopamine, dobutamine, noradrenaline (norepinephrine) is used.
Analogs of Metoprolol tablets
Analogous for the active substance and therapeutic effect for tablets Metoprolol are preparations of Egilok, Metocard, Metodok.
Terms and conditions of storage
The shelf life of Metoprolol tablets is 5 years from the date of manufacture. The drug should be stored in a dry, dark place inaccessible to children at an air temperature of +15 to + 25 ° C.