Included in the formulation
АТХ:C.07.A.B.02 Metoprolol
Pharmacodynamics:Selective β1-blocker, which does not have internal sympathomimetic activity. Has antihypertensive, antiarrhythmic, antianginal action.In therapeutic doses does not affect the tone of peripheral arteries. Reduces the effect of catecholamines on the heart muscle, thereby reducing the heart rate, minute and shock volumes of blood within 24 hours.
Eliminates the effects of arrhythmogenic factors: tachycardia, arterial hypertension, increased content of cyclic AMP.
Antianginal action is due to a decrease in myocardial oxygen demand with prolonged diastole and improved perfusion of the heart muscle.
Pharmacokinetics:The maximum concentration is achieved in 2-4 hours. Metoprolol binds to plasma proteins up to 16%. Poorly penetrates the blood-brain barrier, penetrates the placenta.
The half-life of metoprolol is 3-7 hours. Partially metabolized in the liver, eliminated by the kidneys: 5% unchanged and 95% - in the form of metabolites. When hemodialysis is not excreted from the blood plasma.
Indications:
It is used for the treatment of arterial hypertension, as well as for the prevention of arrhythmia and migraine attacks.
V.F40-F48.F45 Somatoform disorders
VI.G40-G47.G43 Migraine
IX.I10-I15.I10 Essential [primary] hypertension
IX.I20-I25.I20 Angina pectoris [angina pectoris]
IX.I20-I25.I21 Acute myocardial infarction
XVIII.R00-R09.R00.0 Tachycardia, unspecified
Contraindications:Cardiogenic shock, atrioventricular blockade of II-III degree, bradycardia, chronic cardiac insufficiency, resistant to the action of cardiac glycosides, bronchial asthma, renal and hepatic insufficiency.
Individual intolerance.
Carefully:Chronic bronchitis with an asthmatic component, obliterating arterial diseases, atrioventricular blockade of the 1st degree, disturbance of the water-electrolyte balance. Stenosis of the mitral valve, acute disorders of cerebral circulation, renal and hepatic insufficiency.
Pregnancy and lactation:Recommendations for FDA - Category D without teratogenicity. Not applicable in pregnancy and lactation.
Dosing and Administration:Inside: on 100 mg / day in 1-2 reception. If necessary, the dose increases to 200 mg / day.
Intravenous injection: 2-5 mg, repeated administration is possible after 5 minutes.
The highest daily dose: inside - 400 mg; intravenously - 20 mg.
The highest single dose: inside - 200 mg; intravenously - 5 mg.
Side effects:Central nervous system: dizziness, insomnia, asthenia.
Respiratory system: shortness of breath, rarely - bronchospasm
The cardiovascular system: bradycardia, atrioventricular blockage, cold extremities.
Blood System: neutropenia, thrombocytopenia.
Sense organs: "dry eye syndrome", transient visual impairment.
Gastrointestinal tract: dyspepsia, diarrhea, or constipation.
Reproductive system: lowering the potency.
Leather: hyperhidrosis.
Allergic reactions.
Overdose:Symtomas: pronounced bradycardia, arterial hypotension.
Treatment: intravenously 1-2 mg. atropine, 2.5 μg / kg dobutamine, intravenously bolus 10 mg glucagon, intravenously drop 10-20 μg isoprenaline at a rate of not more than 5 μg / min.
Interaction:Increases the concentration of ethanol in the blood and lengthens its excretion.
Potentiates the effect of lidocaine in systemic application.
Negative dromo-, foreign, chromotropic influences are intensified with simultaneous admission with amiodarone, anesthetics, antiarrhythmics, digoxin, diltiazem, verapamil.
Increases the bioavailability of metoprololol with cimetidine.
Special instructions:Discontinue taking the drug gradually (for 8-10 days).
Before an operative intervention it is necessary to inform the anesthesiologist about taking the drug by the patient.