"Metoprolol": reviews, indications, instructions and analogues

Why do I need Metoprolol? Patients' comments about this drug, its release form, composition and side effects will be presented later. Also we will tell you about what contraindications and indications this medicine has, at what dose it should be taken, whether there are analogues and the like.

Composition of the preparation and its form of release

In what form is Metoprolol medication sold? The patients' testimonies say that there are three types of this drug in the pharmacy. Consider the release forms and composition in more detail.

• Pills. Contain such an active ingredient as metoprolol tartrate (100, 50 and 25 milligrams). In addition, the medicament also includes auxiliary components in the form of silicon dioxide colloidal anhydrous, microcrystalline cellulose, sodium carboxymethyl starch (type A) and magnesium stearate. The drug is sold on 50, 10, 30, 20 or 40 tablets in a package.
• Tablets having sustained-release properties ("Metoprolol succinate"), coated. They contain similar acting and auxiliary substances. In pharmacies such a medicine can be found on 30, 20 or 10 tablets in a package.
• Solution for intravenous injection in ampoules of 5 milliliters. The medicine is sold in a cardboard package of 10 ampoules.

Pharmacological properties of the medicinal product

What is the purpose of the drug Metoprolol? Indications for the use of this tool will be presented below. Now I want to tell you about the pharmacological properties of this drug.

This drug refers to cardioselective beta-adrenergic receptor blockers. It does not exhibit membrane-stabilizing properties and does not possess sympathomimetic internal activity. However, this drug is antihypertensive, antiarrhythmic and antianginal.

The medication is able to reduce the patient's heart rate, reduce the excitability and contractility of the myocardium, slow AV conduction, and also reduce the need for myocardium in oxygen.

As a rule, the hypotensive effect is observed in patients only after fourteen days after taking the drug. The drug reduces the frequency of seizures with supraventricular tachycardia, angina pectoris and atrial fibrillation. As a result, the heart rhythm of the patient is normalized.

Tablets with delayed release ("Metoprolol succinate") have a significant advantage over conventional ones. They allow to maintain a constant concentration of the active element in the blood, thus providing a good therapeutic effect throughout the day. It should also be noted that the action of "Metoprolol succinate" helps to reduce the risk of bradycardia and weakness, to a lesser extent affects the smooth muscles of the bronchi.

Pharmacokinetics (absorption, metabolism and excretion of medicament)

About the indications for the use of the drug and available in the drug "Metoprolol" analogues will be described below, but now let's talk about the pharmacokinetic features.

This agent is absorbed very quickly and almost completely (about 95%). The maximum concentration in the blood plasma is usually achieved in 50-110 minutes after ingestion.

In the first application, the bioavailability of the drug is 50%. At repeated it increases to 70%. By the way, eating food increases the bioavailability of the medication by 20-40%. It also increases if the patient has cirrhosis. The connection with proteins on average is 10%.

This drug penetrates well through the placental and blood-brain barrier. Also in small amounts, it is excreted in breast milk.

The drug is metabolized in the liver. And metabolites do not have pharmacological activity. About 5% of the remedy is excreted by the kidneys unchanged. Therapy of a patient with reduced renal function does not require a reduction or other correction of the dose of the drug. However, abnormalities in liver function can slow the metabolism of the drug. In this case, the dosage should be reduced.

Medication "Metoprolol": indications for use

There is a fairly large list of pathological conditions in which this drug is prescribed. Consider them.

• Akathisia, which was caused by neuroleptics;
• Arterial hypertension of the 1 st and 2 nd degree, arterial hypertension (possibly monotherapy, and in severe cases - together with diuretics and other antihypertensive medications);
• Thyrotoxicosis (only as part of complex treatment);
• Prevention of angina attack and angina pectoris;
• Prevention of migraine attacks;
• Violation of the rhythm of the heart (for example, with extrasystole, paroxysmal and supraventricular tachycardia, supraventricular tachycardia);
• To reduce the risk of death and morbidity in cardiovascular failure and ischemic disease;
• Secondary prevention after myocardial infarction and acute myocardial infarction;
• Prolapse of the mitral valve;
• Cardiomyopathy dilatation idiopathic;
• Cardiovascular hyperkinesis is essential, cardiac hyperkinetic syndrome, cardiac dysfunction.

Reviews about the drug

According to reviews of those who have ever taken the drug, it effectively copes with the task and positively affects the work of the heart. However, it should be noted that some patients do not say very well about the drug. As a rule, this is due to the fact that it has many contraindications and side effects. About what the patients complain about when taking this drug, we will tell below.

Contraindications to the use of medicament

So, now you know what the preparation "Metoprolol" is intended for (indications for use were described just above). However, this medication has a number of contraindications. These include:

• Individual intolerance (ie hypersensitivity to active or accessory components);
• Atrioventricular blockade of the 2 nd and 3 rd degree;
• One-time use with MAO inhibitors;
• Blockade is sinoauricular;
• Severe circulatory disturbances (peripheral);
• Bradycardia sinusovaja (if frequency of cuts of heart - less than sixty per minute);
• Hypoglycemia and labile form of diabetes mellitus;
• Syndrome of weakness of the sinus node;
• Predisposition of the patient to bronchospasm (that is, with bronchial asthma and bronchial hyperreaction);
• Metabolic acidosis;
• Arterial hypotension (less than 100 mm Hg);
• Shock cardiogenic (the drug is not recommended for patients with a diagnosis of "acute myocardial infarction" or suspected of it);
• Heart failure acute, chronic (2 nd and 3 rd stage) and uncompensated.

Limitations on the use of the drug (taking with extreme caution)

In what cases should you limit the use of the drug Metoprolol? Experts say that the dose should be reduced for hyperthyroidism, emphysema, allergic history, bronchial asthma, non-allergic bronchitis, psoriasis, pheochromocytoma, liver disorders, kidneys (sometimes), depression, myasthenia gravis and general anesthesia.

Is it possible to give children the drug Metoprolol? The use of this drug by persons under 18 is prohibited. The ban on taking the drug also applies to pregnant women who are nursing mothers. If these recommendations are not followed, there is a huge risk of developing bradycardia, hypoglycemia and hypotension in a newborn baby.

If you need to take a medication during breastfeeding, then at this time lactation should be interrupted.

Preparations "Metoprolol" and "Metoprolol succinate": instructions for use

As a rule, the drug "Metoprolol" per day is taken in the amount of 100 mg. This volume is divided into several doses. To achieve the best therapeutic effect, the reception can be increased 2 times. However, the maximum dose of the drug should not be above 400 mg.

When intravenously injected from 2 to 5 mg of the drug. In this case, the maximum dosage is 15-20 mg. In the absence of the proper effect, it is permissible to introduce the drug again (after 5 minutes).

Cancel the taking of this medication should be gradual. Usually it is done for ten days under the special supervision of a doctor.

The initial dosage of the drug "Metoprolol succinate" with supraventricular tachycardia, angina pectoris, arterial hypertension and extrasystole is about 50-100 mg once a day. With maintenance therapy for myocardial infarction, medication is taken at a dose of 200 mg.

The minimum duration of treatment with metoprolol succinate is 3 months. If the patient is diagnosed with chronic heart failure, then the dosage is selected individually. First, the drug is taken in the amount of 12.5 mg once a day for 2 weeks, and then every 14 days the dose is doubled.

With a relatively good tolerability of the drug, its maximum intake per day can reach 200 mg.

Adverse events. Patient Reviews

Can the Metoprolol medication harm the body? Reviews about this drug contain a lot of information that after receiving it there are negative consequences. What kind of phenomena are we talking about?

• On the part of the nervous system: muscle weakness, fatigue, nightmares, depression, headaches, anxiety, slowing down of motor and mental reactions, loss of attention, paresthesia in the limbs, short-term memory impairment, drowsiness or, on the contrary, insomnia.
• From the senses: a decrease in the secretion of tear fluid, decreased vision, conjunctivitis, soreness and dryness of mucous eyes, tinnitus.
• From the cardiovascular system: arrhythmia, sinus bradycardia, cardialgia, impaired myocardial conductivity, lowering of blood pressure, manifestation of angiospasm, orthostatic hypotension, decreased myocardial contractility and dizziness.
• On the part of the digestive system: dry mouth, abdominal pain, nausea, impaired liver function, constipation, vomiting, diarrhea and taste change.
• Skin: itching, reversible alopecia, hives, hyperemia, rash, increased sweating, exacerbation of psoriasis, photodermatosis, exanthema and psoriasis-like skin reactions.
• On the part of the respiratory system: dyspnea, nasal congestion, bronchospasm and difficulty exhaling.
• On the part of the endocrine system: hypothyroidism, hypoglycemia and hyperglycemia.
• Laboratory studies: thrombocytopenia, agranulocytosis, hyperbilirubinemia, leukopenia and increased activity of hepatic enzymes.
• Influence on the fetus with a pregnant woman's application: intrauterine growth retardation, bradycardia and hypoglycemia.

Among other things, after taking the drug, some patients note the occurrence of pain in the joints or back. Very rarely people show that they have slightly increased body weight, decreased libido or potency.

Specific guidance on the use of the medicinal product

Currently, in any pharmacy you can buy the drug Metoprolol. A recipe is not required. However, the patient taking the medication must have regular monitoring by the attending physician. This is especially true for those patients who have diabetes or angina.

It should be noted that when the dosage is increased (more than 200 mg per day) cardioselectivity decreases. In the presence of heart failure, therapy is started only after the stage of compensation has been reached.

People who use contact lenses should take into account that against the background of treatment with the drug "Metoprolol" the production of tear fluid decreases.

Sometimes this medicine masks some manifestations of thyrotoxicosis. At the same time, the abrupt withdrawal of the drug in patients with the said disease is contraindicated, since this contributes to increased symptoms.

If it is necessary to carry out the operation, the patient should definitely notify the anesthesiologist about the therapy with the drug.

During treatment with the drug "Metoprolol" it is necessary to wear appropriate clothing. This is due to the fact that the drug can cause allergic reactions to the skin due to sunlight.

One can not help saying that the medicament "Metoprolol" (analogues of this medicine as well) among the elderly can cause the appearance of an increasing bradycardia, a pronounced decrease in blood pressure, and an atrioventricular blockade. This is why special control is required for such patients.

In addition, during the treatment with this drug should refrain from driving the transport and stop occupying hazardous activities that require increased concentration and speed of psychomotor reactions. It is also recommended to exclude the use of ethanol.

Existing analogues of the medicinal product

What to do if the patient could not get the medicament prescribed by the doctor Metoprolol? Analogues are available in any pharmacy. Most of them contain a similar active substance, due to which they possess the same properties as the mentioned preparation. Among such medicines there are the following: Metoprolol-Acry, Metolol, Metocor Adipharm and others.

After acquiring these funds, the patient is recommended to read the attached instructions and consult with the doctor. This is due to the fact that the methods of administration may differ from the dosages of the above-mentioned agent.

What other analogues does this drug have? You can replace the medicine prescribed by the doctor with the following medicines: Bisoprolol, Metoprolol-Ratiofarm, Metocard, Corvitol, Metozok, Lidalok, Serdol, Egilok, Emzok and others.

How and how much to store a medicinal product?

Now you know what is meant for, how and in what dosage is the "Metoprolol" medication taken. Keep it in a cool place (for example, in a refrigerator) or a room where the air temperature does not exceed 25 degrees. In this case, the drug must be protected from direct sunlight.

Shelf life of the drug and most of its counterparts is five years from the date of manufacture. At the end of this period, it is prohibited to use the medicinal product for therapeutic and prophylactic purposes. It should be thrown away.