Expiration date: 01/2025
Structure and Composition:
One tablet contains metoprolol tartrate 50 or 100 mg
Excipients: lactose, magnesium stearate, PVP CMC rice starch
in blisters of 10 pieces. in a stack of cardboard 3 packaging.
Pharmachologic effect:
Selectively blocking beta1-adrenergic receptors, it inhibits the action of endogenous catecholamines, inhibits the activity of the renin-angiotensin system.
Pharmacokinetics:
Quickly and almost completely absorbed from the gastrointestinal tract. Cmax and Tmax Metocard when receiving 100 mg or retard Metocard constitute 99,4 ± 33 ng / ml and 1.58 ± 0.55 hours, or 152.9 ± 72.8 ng / ml and 2.75 ± 0.87 hours . protein binding - 11-12%. It is metabolized in the liver, T1 / 2 -. 3.5 hours Excreted in the kidney (95%). It passes through the placenta.
Description of the pharmacological actions:
It reduces cardiac output and heart. It depresses the central sympathetic impulses. It has no membrane stabilizing action, and has no intrinsic sympathomimetic activity.
Testimony:
Hypertension, angina pectoris (prevention of attacks), cardiac arrhythmias, including supraventricular tachycardia, arrythmia (except Metocard retard).
Contraindications:
Hypersensitivity, AV block II and III degree, congestive heart failure, sinus block, bradycardia, hypotension, congestive heart failure IIB-III stage, cardiogenic shock, late stage and severe peripheral circulatory disorders, co-administration of MAO inhibitors, intravenous calcium channel blockers (verapamil, diltiazem) or others. antiarrhythmics (disopyramide), breast-feeding.
Application of pregnancy and breastfeeding:
Perhaps during pregnancy if the expected effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.
Side effect:
From the nervous system and sensory organs: headache, dizziness, nightmares, insomnia, depression, short-term amnesia, disorientation, paresthesia blurred vision, dry eyes, tinnitus.
Cardio-vascular system and blood (blood, hemostasis): bradycardia, palpitations, hypotension, disturbance of AV conduction, circulatory failure, thrombocytopenia, agranulocytosis.
From the respiratory system: bronchospasm, dyspnea.
From the digestive tract: dry mouth, heartburn, bloating, stomach pain, vomiting, constipation / diarrhea.
Allergic reactions: itching, rash, psoriatic skin changes.
Other: Peyronie's disease, myalgia, alopecia.
Drug Interactions:
Enhances hypoglycemic effect of insulin and oral antidiabetic drugs, cardiodepressivny effect of anesthetic and antiarrhythmic agents, deprimiruyuschie - alcohol. Cimetidine increases the concentration in the blood, rifampicin - lowers. Cardiac glycosides increase the likelihood of bradycardia, reserpine, verapamil and other calcium antagonists, -. Cardiac arrhythmias and hypotension, ergotamine derivatives - disorders of the peripheral circulation.
Dosage and administration:
The inside is not liquid, squeezed small amounts of liquid.
Hypertension - 50 mg 2 times a day in a week, if necessary to increase the dose of 200 mg / day (2 tablets at 100 mg.). In the absence of a positive therapeutic result may use the drug in combination with other antihypertensive or diuretic agents.
Angina - 50-100 mg 2-3 times a day, if necessary, may increase the dose to 400 mg / day.
When arrhythmias - 50 mg 2-3 times a day.
In the treatment of elderly patients should be cautious (basically dose adjustment is not required).
The maximum dose - 400 mg / day.
Overdose:
Symptoms: increased severity of side effects.
Treatment: symptomatic therapy if necessary atropine sulfate (1.2 mg / in), isoprenaline sulphate (in / slow).
Precautionary measures:
To use caution in diabetes, peripheral circulatory disorders, including Raynaud's syndrome, pheochromocytoma, severe violations of the kidneys and liver, bronchial asthma, obstructive bronchitis, hyperthyroidism, prolonged fasting, acidosis, patients in the elderly. It should refrain from the use Metocard retard in pediatric patients (safety and effectiveness are not determined). It is necessary to cancel 48-72 hours before delivery (development of bradycardia and hypotension in the newborn). Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention.
