Metoprolol - a drug belonging to the selective beta-blockers without intrinsic sympathomimetic activity, hypotensive effect.
The active ingredient metoprolol has a hypotensive, antiarrhythmic and antianginal effects.
The drug reduces heart rate, reduces the excitability of myocardial contractility and slows AV-conduction, reducing myocardial oxygen demand. Typically hypotensive effect stabilized after two weeks of preparation.
Metoprolol reduces the frequency of seizures in angina, with supraventricular tachycardia and atrial fibrillation - heart rate normalizes.
The dosage form of metoprolol succinate sustained release has the advantage compared to the normal form of the drug, allowing to maintain a constant concentration of the active substance in the blood than a therapeutic effect throughout the day. Metoprolol succinate also reduces the risk of weakness and bradycardia and affects to a lesser extent on the smooth muscles of the bronchi.
Metoprolol is produced in the form of:
- Tablets containing 25, 50 and 100 mg of active substance. 10, 20, 30, 40 or 50 pieces in a package;
- Tablets, coated tablets, sustained release (metoprolol succinate), containing 25, 50, 100 mg of the active ingredient. In 10, 20 or 30 pieces in a package;
- Solution for intravenous administration of 5 mg in 5 ml ampoules. 10 ampoules per pack.
According to the instructions of metoprolol applied:
- When hypertension including hyperkinetic type of tachycardia, and as monotherapy or in combination with other antihypertensive agents;
- For the prevention of migraine attacks;
- When arrhythmias, including supraventricular tachycardia and ventricular arrhythmia;
- In ischemic heart disease - myocardial infarction, as well as for the prevention of strokes;
- In hyperthyroidism, in the complex therapy.
Metoprolol is contraindicated according to the instructions to apply at:
- Sinoatrial block;
- Metabolic acidosis;
- AV-block II and III;
- Sick sinus syndrome;
- Cardiogenic shock;
- Sinoatrial block;
- Expressed disturbances of peripheral circulation;
- Congestive heart failure;
- Chronic heart failure IIB-III stage;
- Hypersensitivity to metoprolol.
Metoprolol during pregnancy is not recommended due to the potential risk of a newborn hypoglycemia, bradycardia and hypotension.
If necessary, metoprolol during lactation breastfeeding is recommended to interrupt. It is also not recommended for metoprolol and 18 years due to lack of the necessary clinical trials.
Use caution when Metoprolol:
- Raynaud's disease and obliterative peripheral arterial disease;
- Chronic obstructive airways disease;
- Severe disorders of the kidneys and liver.
When metoprolol can decrease production of tear fluid production, which should be considered in patients with contact lenses.
Instructions for use of metoprolol
Generally, when administered daily take 100 mg of metoprolol, divided into several stages.
To achieve therapeutic effect, the dose can be increased twice. The maximum dose should not exceed 400 mg.
When intravenously administered to one-time 2 to 5 mg metoprolol maximum - 15-20 mg. Repeatedly in the absence of the effect of metoprolol can enter instructions in 5 minutes. Cancelling Metoprolol should gradually, within 10 days under the supervision of a physician.
The initial dose of metoprolol succinate in hypertension, supraventricular tachycardia, arrhythmia and angina is 50-100 mg once a day, with maintenance treatment of myocardial infarction - 200 mg. Typically, the minimum treatment metoprolol succinate is three months. In chronic heart failure, the dose is adjusted individually, starting with 12, 5 mg once a day for two weeks, then once every two weeks dose can be increased twice. With good endurance metoprolol succinate maximum dose - 200 mg once a day.
Metoprolol on responses can cause various side effects:
- Aetiology, symptoms of heart failure, hypotension and AV-conduction disturbances;
- Conjunctivitis, reduced secretion of tear fluid, depression, rhinitis, nightmares and sleep disturbances;
- Skin rash and itching.
At the beginning of therapy Metoprolol reviews often causes:
- Dry mouth;
- Muscle cramps;
In diabetes Review Metoprolol can cause hypoglycemic condition.
With simultaneous use of metoprolol:
- Diuretics, antihypertensive agents, nitrates, antiarrhythmics - there is a risk of bradycardia, marked hypotension, AV-blockade;
- Opioid analgesics - can mutually enhance cardiodepressivny effect;
- With peripheral muscle relaxants - may increase neuromuscular blockade;
- With amiodarone - possible bradycardia, hypotension, asystole, ventricular fibrillation;
- Lidocaine - may impair excretion of the drug;
- With barbiturates - reduces the effectiveness of metoprolol;
- With hypoglycemic agents - may increase the action of these drugs;
- With means for inhalation anesthesia - may increase the risk of hypotension and depression of the myocardium;
- Since reserpine, methyldopa, guanfacine, clonidine - can develop bradycardia.
The drug is sold by prescription. Shelf life of metoprolol - 5 years.