home Diseases Metoprolol - instructions for use. To achieve the best effect: rules for taking antihypertensive tablets Metoprolol

Metoprolol - instructions for use. To achieve the best effect: rules for taking antihypertensive tablets Metoprolol

To reduce blood pressure and reducing the load on the heart muscle, doctors often prescribe the drug Metoprolol to their patients.

This effective medicine helps improve the condition of a person with various pathologies of cardio-vascular system, but like any potent drugs, has its contraindications.

Before starting treatment, hypertensive patients need to learn about the dosage of Metoprolol and understand how to take this medicine without consequences for their health.

The drug Metoprolol belongs to the group of beta-blockers. The main active ingredient of this medicine is metoprolol tartrate. The accompanying components of the drug include substances such as talc, silicon dioxide, titanium dioxide, cellulose, magnesium stearate, dye, etc.

Metoprolol tablets

Metoprolol is available in tablet form in dosages of 25, 50 and 100 milligrams. This drug helps block b-adrenergic receptors present in the heart muscle and blood vessels.

Metoprolol has the following effects on the body:

lowers blood pressure;
reduces heart rate;
dilates blood vessels, relieving vascular spasms;
eliminates increased stress on the heart;
reduces myocardial excitability;
reduces the heart muscle's need for nutrients and oxygen.

After hitting gastrointestinal tract active substance of the drug in as soon as possible absorbed into the blood and evenly distributed in tissues, beginning active therapeutic effect. Metoprolol is metabolized in the liver and after some time is excreted in the urine.

How long to take Metoprolol? As a rule, to achieve a stable hypotensive effect, it is necessary to take the tablets for at least two weeks.

Indications for use

Metoprolol is allowed to be used for the following indications:

hypertensive syndrome;
cardiac ischemia;
various heart rhythm disturbances (tachycardia, extrasystole, etc.);
myocardial infarction.

In addition, tablets with antihypertensive effects are used in complex therapy for the treatment of migraines and hyperthyroidism, as well as for the prevention of angina pectoris.

Metoprolol is a potent medicines, therefore, only a doctor can prescribe it, if self-treatment This medication increases the risk of complications and side effects.

How to take Metoprolol?

Metoprolol must be taken in accordance with the instructions that are usually included with the drug. In addition, a hypertensive patient must take into account all the recommendations of the treating doctor.

In order not to harm your health, the patient must take this drug as follows:

tablets should be taken immediately after meals, without chewing, with plenty of water;
when treating hypertension with Metoprolol, the dose consumed per day should be at least 50-100 milligrams;
if the expected hypotensive effect does not occur at the minimum dosage, daily dosage can be increased to 200 milligrams;
for arrhythmia and migraines, the daily dose of the drug should be 100-200 milligrams;
for tachycardia, it is necessary to take 100 milligrams of medication per day;
for the prevention of heart attack with Metoprolol, the dosage is 200 milligrams per day;
recommended daily dose medications should be divided into two doses - morning and evening;
the exact dosage and duration of treatment should be selected by the attending physician;
when taking antihypertensive medicine the patient needs to control not only his blood pressure, but also his heart rate, as well as blood sugar levels;
When treated with Metoprolol, the patient must refuse to perform work associated with increased concentration of attention, because this drug slows down the speed of psychomotor reactions;
Abrupt withdrawal of the drug can provoke severe complications from the cardiovascular system, therefore, when stopping treatment, the dosage of the drug should be reduced gradually.

Contraindications

The drug Metoprolol has many contraindications.

Accept antihypertensive pills It is prohibited for diseases and conditions such as:

cardiogenic shock;
bradycardia;
acute and chronic heart failure;
low blood pressure (hypotension);
atrioventricular block 2 or 3 degrees;
severe circulatory disorders;
decreased blood pH and blood bicarbonate levels;
dysfunction syndrome sinus node;
sinoatrial block.

People with diseases such as:

The drug should not be used by children and adolescents under 18 years of age and by pregnant women. Young mothers who are breastfeeding should stop lactation while taking the pills.

Side effects

In case of misuse or overdose:

Gastrointestinal tract: attacks of vomiting, nausea, dry mouth, stomach pain, constipation, diarrhea, change taste sensations, liver dysfunction;
nervous system: headaches, dizziness, insomnia, nervous disorders, depressive states, general weakness, memory impairment, clouding of consciousness;
heart and blood vessels: bradycardia, sharp decrease in pressure, arrhythmia, heart pain, vasospasm;
endocrine system: decreased hormone levels thyroid gland, decreased or increased blood glucose levels, weight gain;
respiratory system: runny nose, bronchospasm, shortness of breath, difficulty breathing;
sense organs: dry eye mucosa, decreased visual acuity, inflammation of the conjunctiva, tinnitus;
skin: psoriasis, increased sweating, baldness, photophobia;
genitourinary system: weakened libido, erectile dysfunction;
allergic reactions: pruritus, urticaria;
changes in blood parameters: decrease in leukocytes and platelets, increase in bilirubin, increase in ALT and AST levels.

Video on the topic

How and when to take antihypertensive drugs correctly:

Metoprolol tablets have a pronounced hypotensive effect and help people fight hypertension. However, this drug should not be taken unsupervised. Self-medication and incorrectly selected dosage of medication can only worsen the patient’s condition and lead to the development serious complications, affecting the state of the cardiovascular system.

Metoprolol on pharmaceutical market It has been in operation for quite a long time and has managed to prove itself quite well.

This drug is prescribed for hypertension, heart failure, and also in some cases for prevention, including ischemic disease hearts.

In this case, the question often arises regarding not only the action, but also the side effects of this medicine. Therefore, the article will describe in more detail all necessary information about Metoprolol.

Metoprolol is a cardioselective beta1-blocker agent whose main task is a membrane-stabilizing effect.

In addition, the drug has antiarrhythmic, antianginal, and hypotensive effects.

Metoprolol tablets

With regular use of the drug over several weeks, a stable decrease in blood pressure is observed. The drug can also prevent the development of migraines.

Due to the blocking of beta1-adrenergic receptors of the hearts, the drug reduces the frequency of heart contractions, reduces myocardial contractility. In addition, even with physical exertion and stress, blood pressure, which is considered high, decreases and returns to normal. This effect is also observed at rest.

Metoprolol drug mechanism of action is aimed at achieving the following effects:

decreased renin synthesis;
suppression of central nervous system activity;
decrease in blood volume per minute;
reduction of sympathetic peripheral influences;
restoration of the sensitivity of the baroreceptors of the aortic arch.

The antianginal effect is observed in the form of a decrease in the need for oxygen for the myocardium, as well as a decrease in its sensitivity to the influence of sympathetic innervation.

The antiarrhythmic effect of metoprolol is the slowing down of atrioventricular conduction and the elimination of arrhythmogenic factors.

Composition and release form

This tool is available in tablets, the film shell of which has a white or yellowish color.

They round shape, and in the middle they have a strip that allows you to split a Metoprolol tablet in half. The active substance of the drug is metoprolol tartrate in a volume of 100 mg in one tablet.

TO excipients include: colloidal anhydrous silicon dioxide, microcrystalline cellulose, magnesium stearate, sodium carboxymethyl starch.

The shell consists of talc, polysorbate 80, titanium dioxide, hypromellose. These tablets are packaged in blisters of 10 pieces. In turn, they are folded into cardboard packages of 3 pieces. This drug is also available in pinkish tablets. Their composition is identical, only the shell additionally contains crimson dye.

One tablet contains less active substance, namely 50 mg. 14 tablets are packed in one blister, and 2 or 4 blisters are put into the package itself.

Indications for use

Metoprolol is prescribed for both treatment and prevention.

The use of the drug is possible in the following cases:

coronary heart disease, also including myocardial infarction, angina pectoris;
hyperthyroidism;
ventricular extrasystole;
arterial hypertension, tachycardia;
migraine prevention;
heart rhythm disturbance.

The drug should be taken only as prescribed by a doctor due to the presence of contraindications. This is especially true for preventive measures so as not to worsen your health.

Contraindications

The drug has a number of contraindications:

severe bradycardia;
hypersensitivity to components;
sinoatrial block;
Prinzmetal's angina;
arterial hypotension;
breast-feeding;
cardiogenic shock;
AV block II-III degree;
chronic heart failure;
peripheral circulatory disorders;
taking together with Verapamil or monoamine oxidase inhibitors
age up to 18 years.

There are a number of cases in which Metoprolol should be taken with caution. First of all, it is pregnancy and elderly age. This also includes depression, obliterating peripheral vascular disease, myasthenia gravis, diabetes mellitus, psoriasis, thyrotoxicosis, bronchial asthma, renal failure, metabolic acidosis, obstructive pulmonary disease, AV block I degree.

Side effects

Together with contraindications, this drug can cause many side effects, which once again indicates its careful use as prescribed by a doctor.

So, when taking Metoprolol tablets, the following side effects are possible:

work of the cardiovascular system: dizziness, arrhythmia, decreased blood pressure, shortness of breath, loss of consciousness, palpitations, myocardial contractility, cardialgia, edema, manifestation of vasospasm;
nervous system: weakness, slow reaction, insomnia, headache, muscle weakness, nightmares, memory impairment, increased fatigue, decreased attention, depression;
digestive system: abdominal pain, vomiting, dry mouth, liver disorder, constipation, change in taste, nausea, diarrhea;
sense organs: decreased vision, tinnitus, conjunctivitis, eye pain;
skin problems: rash, itching, photodermatosis, increased sweating, exanthema, exacerbation of psoriasis;
respiratory system: difficulty in exiting, nasal congestion, shortness of breath;
endocrine system: hypoglycemia, hypothyroidism;
changes in laboratory parameters: agranulocytosis, thrombocytopenia, leukopenia.

Instructions for use

Metaprolol is administered entirely orally. There is no need to chew it; you should drink it with a glass of water.

at arterial hypertension First, 50-100 mg of the drug is taken once or twice a day. Next, the dose is increased to a maximum of 200 mg per day. Additionally, other antihypertensive drugs may be prescribed for complex therapy;
in case of myocardial infarction, in order to avoid it again, use 200 mg of the drug in two doses for prevention;
in case of tachycardia, use 100 mg tablets twice a day;
for migraine, arrhythmia or angina pectoris, you need to drink 100-200 mg of the drug in two doses.

The dosage should be prescribed strictly by a doctor after necessary examinations based on the diagnosis and extent of the disease. In case of an overdose, the side effects of Metoprolol can be noticed within 20 minutes. In this case, it is necessary to rinse the stomach and then take an absorbent agent. If there is no effect, you may need additional measures. It is better to immediately contact a specialist or call an ambulance.

Drug interactions

It is extremely important to introduce the reception this drug use caution if other medications are used together with it.

It is prohibited to use Metoprolol with MAO inhibitors. This will lead to increased hypotensive effect.

Between doses you need to take a break of at least two weeks. If Verapamil is administered intravenously at the same time as taking this drug, then cardiac arrest is quite likely.

Ethanol and Nifedepine together with Metoprolol reduce blood pressure. The hypotensive effect can be weakened by simultaneous administration of Theophylline, Indomethocin and other anti-inflammatory drugs. non-steroidal drugs. Arterial hypotension occurs when taking additional carbon derivatives.

Capsules Indomethacin Retard

Antidepressants, ethanol, sleeping pills contribute to depression nervous system. When taking ergot alkaloids, peripheral circulatory disorders are likely to occur. A sharp decrease in blood pressure is provoked by diuretics, antihypertensive drugs, and nitroglycerin.

Drugs such as Verapamil, Diltiazem, Methyldopa, drugs for general anesthesia, cardiac glucosides, Guanfacine together with Metoprolol reduce heart rate and inhibit AV conduction. Insulin and hypoglycemic agents reduce overall efficiency reception.

Is it possible to take Metoprolol and alcohol at the same time? The compatibility of this “mix” is not allowed. When Metoprolol is combined with alcohol, patients experience an increased inhibitory effect on the central nervous system.

The drug metoprolol was first released in 1969, and since 1980 it has been widely used throughout the world.

Medicine Metoprolol should be used when various diseases cardiovascular system, andat what pressurewill this drug work?

Properties of influence on the body

Metoprolol belongs to the drugs that can block beta-adrenergic receptors. Such receptors are found in various tissues of the body: smooth muscles, cardiac muscle, kidneys, arteries.

They respond to stress, in particular to the action of adrenaline. Once in the human body, substances that block the action of beta-adrenergic receptors prevent the action of hormones on receptors and reduce stress.

Beta-blockers have a cardiac effect - they reduce the strength and frequency of contractions of the heart muscle, reduce its need for oxygen, reduce cardiac conduction, and prevent heart stimulation during physical and emotional stress.

Metoprolol has these qualities. It has antihypertensive, antiarrhythmic effects and eliminates symptoms of ischemia.

The antihypertensive result occurs gradually and is achieved after taking the medicine for two weeks. Metoprolol normalizes the heart rhythm during tachycardia and atrial fibrillation, reduces the risk of arrhythmia, thereby limiting the area of infarction and the possibility of its recurrence. When consumed in small doses, it has less effect on the muscles of the bronchi and distant arteries.

Dosage forms

Metoprolol is produced in two medicinal types: tartrate and succinate.Both tartrate and succinate appear as white crystalline powders. Both types are highly soluble in water. Tartrate is highly soluble in alcohol, trichloromethane and methylene chloride, less soluble in acetone, and not at all soluble in ether. Succinate dissolves in methyl alcohol, worse - in ethyl, slightly soluble in isopropyl and dichloromethane, insoluble in ethers and acetone.

The substance Metoprolol succinate in the body is poorly released from microgranules and acts longer than tartrate.

The therapeutic effect of succinate lasts about a day, and tartrate lasts no more than 12 hours. Metoprolol tartrate is less effective and has many side effects.

Metoprolol is metabolized in the liver and excreted through the urinary system.

Form of manufacture and shelf life

They release tablets 25, 50, 100 and 200 mg, packaged in 14, 30, 50, 60, 100 and 200 pcs. For intravenous use— 1% solution in ampoules of 0.05 g, packed in 10 pcs.

Trade names: Betalok, Betalok ZOK, Egilok, Egilok S, Egilok Retard, Metoprolol Ratiopharm, Metoprolol Acri, Corvitol, Vasocardin and others.

Stored at temperatures up to +25 C for 3 years.

When should Metoprolol be used?

Metoprolol can be prescribed by a doctor for pathologies:

At the same time, metoprolol is effective in different types arrhythmias: sinus, ventricular, atrial, supraventicular, paroxysmal tachycardia, atrial fibrillation.

For the treatment of hypertension it can be used either alone or in a complex form. Metoprolol can be used to prevent migraines and general therapy hyperthyroidism.

How to use Metoprolol

Pills Metoprolol can be taken immediately after meals. But consuming them directly with meals increases the bioavailability of the active substance by 35-40%. Pills swallow without chewing, but with water. It is not advisable to break a long-acting drug in half; such medicine must be purchased required dosage. The dosage of the drug is selected by the doctor according to the patient’s indications.

For adults and children over 18 years of age, Metoprolol is recommended to be used in doses:

for hypertension - 100 - 150 mg per day in 1 or 2 doses, maximum 200 mg;
for the prevention of recurrent infarction - 0.2 g per day in 2 divided doses;
for the prevention of migraine - 0.1-0.2 g per day, divided into 2-4 times;
for hyperkinetic cardiac syndrome, including treatment of hyperthyroidism - 50 mg 1-2 times a day;
for arrhythmia - 0.05 g 2-3 times over 24 hours.

To localize supraventricular tachycardia and in acute stage heart attack, the drug is administered intravenously in a hospital setting. For tachycardia, Metoprolol is administered in single doses of 2-5 mg at 5-minute intervals until desired effect, but not more than 15 mg. The drug is administered at a rate of 1-2 mg per minute. The dose of 15 mg is not exceeded, because it does not lead to results. After localizing the arrhythmic attack, the patient takes the medicine orally 0.05 g 4 times a day. The first dose of tablet medication should arrive within 15 minutes after intravenous administration.

For a heart attack, Metoprolol is administered three times, 5 mg every 2 minutes. Next, patients take the drug orally at 25-50 mg every 6 hours. Pills begin to take 15 minutes after intravenous administration.

If a person does not tolerate intravenous administration well, at first the oral dose is reduced by half. For older patients, it is better to start taking this medicine at lowest dose- 0.05 g per day.

Duration of treatment with metoprolol

The therapeutic effect occurs when long-term use this remedy. To prevent recurrence of a heart attack, Metoprolol is taken for up to 3 years.Metoprolol is not suitable for immediately relieving an attack of hypertension.

When treating with this drug, you must strictly adhere to the dosage and time of administration indicated by the doctor.You cannot stop taking the medicine yourself or take longer breaks between doses.

third party action

In addition to effective positive effect, Metoprolol has many side effects, which at the beginning of the intake period can be expressed as follows:

dizziness;
weakness;
fatigue;
headache;
muscle cramps;
feeling of coldness in the legs and arms;
dry mouth;
constipation or diarrhea;
conjunctivitis;
rhinitis;
skin rash or itching.

You must inform your doctor about the occurrence of such indications so that he can prescribe other pills . Long lasting This medicine, in case of negative reactions, can lead to the development of:

hypotension;
bradycardia;
sleep disorders;
depression;
hypoglycemia (in people with diabetes);
reducing the secretion of tear secretion;
bronchial obstruction(in people predisposed to it).

When is its use dangerous?

This beta-blocker is contraindicated in patients with sick sinus syndrome, persistent sinus bradycardia when the pulse is below 60 beats/min, arterial hypotension(with systolic pressure below 100 mm Hg), hypersensitivity, sinotrial blockade, heart failure in the stage of decompensation, atrioventricular block of the II and III degrees, cardiogenic shock, severe disturbances in the process of blood movement in the circulatory system.

During pregnancy and breastfeeding The attending physician can prescribe this medication only when the woman's risk of illness is higher than the risk of possible side effects on the fetus or child.

In case of renal failure, Metoprolol can be used.

For liver pathologies, this medicine It is better to replace it with another beta-blocker that is metabolized outside the liver.People with diabetes mellitus and Raynaud's disease are prescribed the medicine with caution.People who use contact lenses, it must be taken into account that Metoprolol can reduce the production of tear secretion.

Interaction with other substances

When treated with Metoprolol and simultaneous use other medicines, it should be remembered that its effect may increase or decrease, or even have the opposite effect.

Substances causing allergies, increase in effect and can cause an allergic reaction. Contraceptives taken orally and antacids increase the concentration of Metoprolol in the blood, and Rifampicin reduces it.

Digitalis-based cardiac medications in combination with Metoprolol reduce atrioventricular conduction. Nonsteroidal anti-inflammatory drugs reduce the antihypertensive effect. The possibility of hypotension and bradycardia can be caused by painkillers and antiarrhythmic drugs.

Other blood pressure medications may cause hypotension. Drinking alcohol during treatment with Metoprolol will result in increased depression of the central nervous system.

Metoprolol reduces the potency of lidocaine, changes the effectiveness of insulin-containing drugs and increases the possibility of developing hypoglycemia.

Overdose

At simultaneous reception doses of Metoprolol exceeding daily norm, within 2 hours nausea, vomiting appears, breathing is impaired, consciousness is confused. Bronchospasm, convulsions, cardiogenic shock, and atrioventricular block may occur. Acute heart failure, hypotension, bradycardia develop, and cardiac arrest may occur.

To avoid severe consequences, after taking a large dose of Metoprolol you need to rinse your stomach big amount clean water and call ambulance. Then, in a hospital setting, symptomatic treatment is carried out:

for bradycardia and decreased atrioventicular conduction, Atropine is administered intravenously;
when the contraction of the heart muscle decreases, Glucagon and Dobutamine are used;
for arterial hypotension - use adrenergic agonists;
to eliminate seizures, Diazepam is administered slowly intravenously;
to suppress bronchospasm, inhalations with beta-agonists are carried out or Eufillin is administered intravenously;
Pacemakers are used to avoid cardiac arrest.

For a lasting effect of Metoprolol, it is used for a long time. Discontinuation of its use should occur gradually, over 10 days, under medical supervision.

If surgery is to be performed, the patient should stop taking Metoprolol several days before using the painkiller. The anesthetic drug in this case should have the least effect on the force of heart contractions.

Take Metoprolol only as prescribed by your doctor and strictly follow his recommendations. Before taking, be sure to read the instructions for the medicine. Taking medications for healthy way life is the key to treating hypertension.

Metoprolol is a drug with pharmacological group beta blockers. By appearance they are film-coated tablets. The shape of the tablets is round, convex on both sides, on one of which there is a pattern.

Composition and release form

Active substance The medication is metropolol tartrate. Its content in one tablet reaches 100 mg. Excipients include:

Silicon dioxide;
Crystalline cellulose;
Magnesium stearate.

Components used to make the outer shell:

Hypromellose;
Polysorbate 80;
Talc.

Release form of the medicine

The medicine is sold in packs of ten pieces in blisters. Tablets with lower concentrations of the main substance are available for sale. They also have a round, convex shape on both sides. The metoprolol content in them reaches 50 mg.

They are also sold in blisters of fourteen pieces. According to its action, Metoprolol is classified as a cardioselective blocker. They don't have internal activity or membrane stabilizing properties.

pharmachologic effect

Actions of this drug:

Hypotensive;
Antiaginal;
Antiarrhythmic.

Medication Metoprolol in small doses:

Blocks cardiac adrenergic receptors.
Reduces the formation of cAMP from ATP.
Reduces intracellular calcium current.
Produces a negative inotropic (chrono-, batmo-) effect.

Peripheral resistance at the beginning of the course of using the drug Metoprolol (in the initial twenty-four hours after oral administration) increases. This is due to a reciprocal increase in the activity of adrenergic receptors. After a few days it returns to optimal shape. With a long course of treatment it decreases. The presence of antihypotensive action in acute form causes a decrease in cardiovascular output. The antihypertensive effect develops during the first three weeks, which is caused by a drop in renin synthesis, as well as inhibition of the angiotensin system. Highest value this characteristic has for sick patients with initial increased secretion of renin. The drug allows you to reduce elevated level blood pressure at rest, during physical stress, and also in depression.

Indications for use of Metoprolol

Arterial hypertension - the medicine can be used as a single agent or in combination with other drugs), can be prescribed for tachycardia.
Ischemic heart disease as preventative measure attacks of angina.
Heart rhythm disturbance.
Hyperthyroidism (the drug can only be used in complex therapy);
Preventative measure for migraine attacks.

Contraindications

Cardiogenic shock.
Baricardia.
Lactation period.
Under eighteen years of age because the effectiveness or safety of the drug has not been established.
High sensitivity to Metropolol, individual intolerance to other components included in the composition.

Use with caution in patients suffering from:

Diabetes mellitus;
Bronchial asthma;
Psoriasis;
During pregnancy;
Advanced age.

Side effects

All side effects depend on the sensitivity of the patient. As a rule, all effects are insignificant and disappear as soon as use of the drug is stopped:

Nervous system:

Fast fatiguability;
Appearance of weakness;
Frequent headaches, less often dizziness;
The speed of psychomotor reactions slows down;
Depressive and restless state;
Drowsiness;
The appearance of insomnia;
Nightmares;
Consciousness is confused;
Memory is impaired.

Sense organs:

Vision decreases;
The secretion of tear fluid decreases;
Dry eyes;
Noise in ears.

The cardiovascular system:

Heart rate increases;
Blood pressure decreases;
Dizziness, in some situations loss of consciousness;
Exacerbation of chronic heart failure (swelling, shortness of breath);
The lower extremities are cold.

Digestive system:

Nausea and vomiting;
Pain in the abdominal area;
Dry mouth;
Diarrhea;
Constant constipation;
The functioning of the liver is impaired;
The taste changes after taking the product.

Skin:

The appearance of urticaria;
Skin itching;
Psoriasis;
Exanthema;
Sweating increases.

Respiratory system:

Nose is stuffed;
Inhalation and exhalation become difficult;
Dyspnea.

Endocrine system:

Hypoglycemia (develops in patients receiving insulin);
Hyperglycemia;
Hypothyroidism.

The effect of Metoprolol on the condition of the fetus:

Growth is stunted;
Bradycardia.

Other side effects:

Appearance pain in the back and joints;
Increase in body weight;
Decreased potency.

Instructions for use

According to the instructions, Metoprolol tablets must be taken orally with food or after meals. They do not need to be chewed, just drink plenty of liquid. For arterial hypertension, the daily dosage is 100 mg in two doses (morning and evening). If provided therapeutic effect application is not sufficient, the dosage must be increased to 200 mg of Metoprolol. This amount of medication is the maximum daily dose.

Method and dosage

For angina pectoris, arrhythmia – 100-150 mg/daily (two doses);
As a preventive measure for migraine attacks - 100-150 mg/daily;
Metoprolol as a preventive measure for myocardial infarction – 100 mg/daily (two doses);
At functional disorders activity of the cardiovascular system – 100 mg/daily (two doses).

The dosage is not affected by the patient’s age and the condition of his renal system. In case of disruption of activity hepatic system it is necessary to reduce the dose of the drug. Many cases of overdose have been identified.

Reception scheme

When heart failure is diagnosed, treatment should begin only after the compensation stage has been reached.
An increase in the severity of reactions with increased sensitivity cannot be ruled out.
After taking Metoprolol, signs of arterial blood flow disturbances may increase. In this case, you need to stop using the drug, gradually reducing the dosage to ten days.
If the course of therapy is abruptly stopped, withdrawal syndrome cannot be ruled out (pressure increases, angina attacks intensify).
If patients wear contact lenses, then it must be taken into account that the work of the lacrimal gland may be reduced.
If it is needed surgical intervention, then you need to notify the anesthesiologist about this. However, the use of the medication does not stop.
If Metoprolol is taken by patients diagnosed with severe renal failure, then it is necessary to monitor the kidneys.

It is worth considering that at the beginning of the therapeutic course you may experience fatigue and dizziness. In this case, it is worth giving up control vehicles movement and activities dangerous types activities that require high concentration attention.

Metoprolol for heart treatment

The antianginal effect can be achieved by reducing the myocardial need for oxygen molecules due to a decrease in the heart rate. Thanks to the use of the drug, the sensitivity of the myocardium to the action of innervation decreases, the number of angina attacks decreases, and the exercise stress. Blood pressure drops fifteen minutes after administration and continues for the next six hours. Diastolic blood pressure decreases much more slowly. A stable decrease is established only a few weeks after regular use Metoprolol products.

The antiarrhythmic effect can be achieved by eliminating arrhythmogenic factors, which include:

Tachycardia;
High activity of the nervous system;
Increased cAMP content;
Arterial hypertension.

The antiarrhythmic effect is also expressed in a decrease in the rate of spontaneous excitation and helps prevent the occurrence of migraine. If you take Metoprolol in average dosage, then the effect on the organs is not so pronounced. Metoprolol is almost instantly absorbed into the gastrointestinal tract in full (95%). Maximum concentration The drug reaches the blood level two hours after taking the drug orally. The period of withdrawal of the drug from the body is 3.5 hours.

The level of bioavailability is fifty percent when the drug is first used. It rises to seventy percent with repeated doses. If Metoprolol is taken with food, the bioavailability increases by 30%. It also increases with liver cirrhosis. The medicine crosses the placenta, but breast milk enters only in small quantities.

One of the properties of Metoprolol is the ability to be metabolized in the liver. Metabolites do not differ in activity. About five percent of the drug in unchanged form is excreted through renal system. Treatment of patients suffering from reduced kidney function does not require dosage adjustments. If the functioning of the liver is impaired, then the metabolism of the drug slows down. If liver function is insufficient, the dosage of the drug is reduced.

Metoprolol for children

No, application this tool V childhood Not recommended. This is due to the insufficient number of clinical trials. To avoid side effects or undesirable consequences, it is better to avoid using the drug in childhood.

During pregnancy and lactation

According to the instructions, it is not recommended to prescribe medication during pregnancy. This can only happen in situations accompanied by strict indications and taking into account the benefit-risk ratio. Taking Metoprolol can adversely affect the child:

Development of bradycardia;
Appearance arterial hypotension;
Hypoglycemia.

After birth, if the mother used Metoprolol, it is necessary to monitor the newborn for the first three days.

Overdose

Dizziness;
Nausea appears, accompanied by vomiting;
Drop in blood pressure;
Arrhythmia;
The patient loses consciousness and may fall into a coma;
Cardialgia.

The first symptoms indicating an overdose of Metoprolol appear within the first two hours after administration. To eliminate these signs, you need to rinse the stomach and take adsorbents.

special instructions

The instructions note that the duration of treatment varies from three months to three years. With a long course of treatment, it is necessary to refuse high dosages, as this can lead to side effects or overdose. If the course of treatment with Metoprolol lasts three months, then after some time it can be re-prescribed by the doctor. Often this is necessary in order to consolidate the already obtained result.

Interaction with other drugs

According to the instructions, Metoprolol is not recommended to be used simultaneously with MAO inhibitors, as this will lead to an increase in the hypotensive effect. Between taking MAO inhibitors and Metoprolol, there must be a break, the minimum duration of which is fourteen days.

If verapamil is administered, the heart may stop;
With simultaneous use of nifedipine, blood pressure drops significantly;
If you take Metoprolol together with drugs intended for inhalation anesthesia, then the likelihood of inhibition of the functioning of the myocardium increases;
If combined with ethanol, there is an increase in the inhibitory effect. Affects the central nervous system;
The cardiodepressive effect increases if Metoprolol is taken with drugs for anesthesia;
When used simultaneously with hypoglycemic drugs for internal use their effectiveness may decrease;
When taking insulin, the likelihood of developing hypocemia increases or its symptoms appear (tachycardia, increased sweating, increased blood pressure);
When using the drug together with antihypertensive medications(diuretics or nitroglycerin), a decrease in blood pressure is observed, the severity of the decrease in heart rate increases;
In cases of taking Metoprolol simultaneously with clonidine, they must be discontinued at intervals of several days. Otherwise, withdrawal syndrome may occur.

Domestic and foreign analogues

Metoprolol analogues include:

Price in pharmacies

The price of metoprolol in different pharmacies can vary significantly. This is due to the use of cheaper components and pricing policy pharmacy network.

Read the official information about the drug Metoprolol, the instructions for use of which include general information and treatment plan. The text is provided for informational purposes only and cannot serve as a substitute for medical advice.

Metoprolol- This is a drug that has a selective type of action. It affects the beta-adrenergic receptors of the heart muscle. This medicine has enough wide range actions: stops or prevents angina pectoris, lowers blood pressure and brings the heart rhythm back to normal. The drug inhibits the automation of the sinus node, also has a depressive effect on the heart rate, reduces atrioventricular conduction, stops the function of the heart to contract and conduct an excitation impulse throughout the myocardium, reduces blood volume cardiac output and the amount of oxygen required by the myocardium. It has the property of stimulating the inhibition of catecholamines located in the heart muscle during physical and emotional stress. With angina pectoris, Metoprolol reduces the frequency and strength of attacks, normalizes the heart rate with supraventricular tachycardia and atrial fibrillation. Metoprolol in people with myocardial infarction causes a decrease in the area of necrosis, a subsequent risk of the onset of fatal arrhythmias, a decrease in mortality and the risk of recurrent infarcts. When taken average therapeutic doses increased selective effect on the smooth muscles of the bronchial tree and peripherally lying blood vessels than non-selective beta-blockers.

Indications for use

A drug Metoprolol used for the treatment of diseases: moderate and moderate arterial hypertension moderate severity(monotherapy or in combination with other antihypertensive drugs), ischemic heart disease, hyperkinetic cardiac syndrome, cardiac arrhythmia ( sinus tachycardia, ventricular and supraventricular arrhythmia, including paroxysmal tachycardia, supraventricular tachycardia, extrasystole, atrial flutter and fibrillation, atrial tachycardia), hypertrophic cardiomyopathy, mitral valve prolapse, myocardial infarction (prevention and treatment), migraine (prevention), thyrotoxicosis ( complex therapy); treatment of akathisia caused by neuroleptics.

Mode of application

Metoprolol taken orally, with food or immediately after a meal, tablets can be divided in half, but not chewed and washed down with liquid; for long-acting dosage forms - swallow whole, do not crush, do not break (except for metoprolol succinate and tartrate), do not chew. For arterial hypertension average dose- 100-150 mg/day in 1-2 doses, if necessary - 200 mg/day. For angina pectoris - 50 mg 2-3 times a day. For hyperkinetic cardiac syndrome (including thyrotoxicosis) - 50 mg 1-2 times a day. For tachyarrhythmia - 50 mg 2-3 times a day, if necessary - 200-300 mg/day. Secondary prevention myocardial infarction - 200 mg / day. Prevention of migraine - 100-200 mg / day in 2-4 doses. To relieve paroxysmal supraventricular tachycardia, it is administered parenterally in a hospital setting. Enter slowly, a dose of 2-5 mg (1-2 mg / min). If there is no effect, the administration can be repeated after 5 minutes. Increasing the dose above 15 mg usually does not lead to a greater severity of action. After stopping the attack of arrhythmia, patients are transferred to oral administration at a dose of 50 mg 4 times a day, with the first dose taken 15 minutes after stopping the IV administration. In the acute stage of myocardial infarction, immediately after hospitalization of the patient (with constant monitoring of hemodynamics: ECG, heart rate, AV conduction, blood pressure), a bolus of 5 mg should be administered intravenously, the administration should be repeated every 2 minutes until a total dose of 15 mg is reached. With good tolerance after 15 minutes - inside, 25-50 mg every 6 hours, for 2 days. In patients who have not tolerated the full intravenous dose, oral administration should be initiated starting with half the dose. Maintenance therapy continues at doses of 200 mg / day (for 2 doses), for 3 months-3 years. Elderly patients are recommended to start treatment with 50 mg/day. Kidney failure does not require dose adjustment. At liver failure it is advisable to prescribe other beta-blockers that are not metabolized in the liver.

Side effects

At the beginning of therapy, side effects from the use of the drug Metoprolol Possible weakness, fatigue, dizziness, headache, muscle cramps, feeling of cold and paresthesia in the extremities. Bradycardia, arterial hypotension, impaired atrioventricular conduction, the appearance of symptoms of heart failure with peripheral edema, decreased secretion of tear fluid, conjunctivitis, rhinitis, depression, sleep disturbance, nightmares, dry mouth, hypoglycemic conditions in patients with diabetes mellitus, vomiting, diarrhea are also possible , constipation. Predisposed patients may experience symptoms of bronchial obstruction. There have been isolated cases of liver dysfunction, thrombocytopenia, allergic reactions - skin rash, itching.

Contraindications

A drug Metoprolol contraindicated in case of hypersensitivity, AV block II and III degree, sinoatrial block, acute or chronic (in the stage of decompensation) heart failure, sick sinus syndrome, severe sinus bradycardia (heart rate less than 60 beats/min), cardiogenic shock, arterial hypotension (sBP) less than 100 mm Hg.

Art.), severe peripheral circulatory disorders, pregnancy, breastfeeding.

Interaction with other drugs

Hypotension is potentiated by sympatholytics, nifedipine, nitroglycerin, diuretics, hydralazine and other antihypertensive drugs. Antiarrhythmic and anesthetic drugs increase the risk of bradycardia, arrhythmia, and hypotension. Digitalis preparations potentiate the slowing of AV conduction. Simultaneous intravenous administration of verapamil and diltiazem can provoke cardiac arrest. Beta-agonists, aminophylline, cocaine, estrogens, indomethacin and other NSAIDs weaken the antihypertensive effect. Strengthens and prolongs the effect of antidepolarizing muscle relaxants. Combination with alcohol leads to a mutual strengthening of the inhibitory effect on the central nervous system. Allergens increase the risk of severe systemic allergic reactions or anaphylaxis. Changes the effectiveness of insulin and oral antidiabetic agents and increases the risk of hypoglycemia. Antacids, oral contraception, cimetidine, ranitidine, phenothiazines - increase the level of metoprolol in the blood, rifampicin - decreases. Reduces the clearance of lidocaine, the effectiveness of beta2-adrenergic agonists (it is necessary to increase the dose of the latter). Incompatible with MAO type A inhibitors.

Overdose

Symptoms of drug overdose Metoprolol: arterial hypotension, acute heart failure, bradycardia, cardiac arrest, AV block, cardiogenic shock, bronchospasm, impaired breathing and consciousness/coma, nausea, vomiting, generalized convulsions, cyanosis (manifest 20 minutes - 2 hours after administration).
Treatment: gastric lavage, symptomatic therapy: administration of atropine sulfate (0.5–2 mg intravenously quickly) - for bradycardia and impaired AV conduction; glucagon (1–10 mg IV, then IV drip 2–2.5 mg/h) and dobutamine - in case of decreased myocardial contractility; adrenomimetics (norepinephrine, adrenaline, etc.) - for arterial hypotension; diazepam (iv slowly) - to eliminate seizures; inhalation of beta-adrenergic agonists or intravenous injection of aminophylline to relieve bronchospastic reactions; cardiac stimulation.

Storage conditions

List B. At a temperature not higher than +25°C.

Release form

Tablets of 50 and 100 mg in a package of 30; 100 and 200 pieces; retard tablets 200 mg in a package of 14 pieces; 1% solution in ampoules of 5 ml in a package of 10 pieces.

Compound

(±)-1--3-[(1-methylethyl)amino]-2-propanol (as tartrate or succinate).
Metoprolol tartrate: white, practically odorless crystalline powder, highly soluble in water, methylene chloride, chloroform and alcohol, slightly soluble in acetone, insoluble in ether. Metoprolol succinate: white crystalline powder, readily soluble in water, soluble in methanol, sparingly soluble in ethanol, slightly soluble in dichloromethane and 2-propanol, practically insoluble in ethyl acetate, acetone, diethyl ether and heptanes.

Synonyms

Betaloc, Blocksan, Specikor, Belok, Lopressor, Neoblock, Opresol, Selopral, Vasocardin, Corvitol, Methohexal, Metolol

Additionally

Prescribe with caution when diabetes mellitus(especially with a labile course), Raynaud's disease and patients with impaired peripheral circulation, pheochromocetoma, severe renal and liver dysfunction (when prescribing Metoprolol-Acri to this category of patients, constant monitoring of the dynamics is necessary functional state liver and/or kidneys). Patients who use contact lenses should take into account that during treatment with Metoprolol-Acri it is possible that the production of tear fluid may decrease. Termination of the course should occur gradually (at least 10 days) under the supervision of a physician. A few days before anesthesia with chloroform or ether, you must stop taking the drug. If taking the drug before surgery, the patient should choose a narcotic drug with minimal negative inotropic effect.

Main settings

Name:	METOPROLOL
ATX code:	C07AB02 -