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Betaloc - instructions for use, reviews, analogs and formulations (tablets 100 mg, sustained-release ZOK 25 mg, 50 mg and 100 mg, injections in injections) of the drug for the treatment of arrhythmias in adults, children and pregnancy

Betaloc - instructions for use, reviews, analogs and formulations (tablets 100 mg, sustained-release ZOK 25 mg, 50 mg and 100 mg, injections in injections) of the drug for the treatment of arrhythmias in adults, children and pregnancy

In this article, you can read the instructions for using the drug Betalock. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of experts on using Betalok in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Betaloc with available structural analogues. Use to treat heart rhythm disturbances (arrhythmias) in adults, children, as well as during pregnancy and lactation. Interaction of the drug with alcohol.

 

Betalock - beta1-adrenoblocker blocking beta-1 receptors at doses significantly lower than the doses required to block beta2 receptors. Metoprolol has an insignificant membrane-stabilizing effect and does not exhibit the activity of a partial agonist. Metoprolol reduces or inhibits the agonistic effect that catecholamines exerted on nervous activity by nervous and physical stresses on cardiac activity. This means that metoprolol has the ability to interfere with the increase in heart rate, minute volume and increased cardiac contractility, as well as increased blood pressure caused by a sharp release of catecholamines.

 

Patients with symptoms of obstructive pulmonary disease, if necessary, can be prescribed metoprolol in combination with beta2-adrenomimetics. When used together with beta2-adrenomimetics, Betaloc at therapeutic doses has less effect on the bronchodilation induced by beta2-adrenomimetics than non-selective beta-blockers. Metoprolol to a lesser extent than non-selective beta-blockers affects insulin production and carbohydrate metabolism.The effect of Betaloc on the response of the cardiovascular system in conditions of hypoglycemia is much less pronounced in comparison with nonselective p-adrenergic blockers.

 

Clinical studies have shown that Betaloc can cause a slight increase in triglyceride levels and a decrease in free fatty acids in the blood. In some cases there was a slight decrease in the fraction of high-density lipoprotein (HDL), which is less pronounced than with non-selective P-blockers. However, one of the clinical studies showed a significant reduction in total serum cholesterol in the treatment of metoprolol for several years.

 

The quality of life during the treatment with Betaloc does not worsen or improve. Improvement of the quality of life in the treatment with Betaloc was observed in patients after myocardial infarction.

 

Composition

 

Metoprolol tartrate + excipients.

 

Pharmacokinetics

 

Betalok almost completely absorbed after ingestion. When taking the drug within therapeutic doses, the concentration of the drug in the blood plasma is linear depending on the dose taken.

 

After oral administration of the first dose of metoprolol systemic circulation reaches about 50% of the dose. At repeated receptions the indicator of system bioavailability increases up to 70%. Taking the drug along with food can increase systemic bioavailability by 30-40%. The connection with plasma proteins is low, about 5-10%.

 

Metoprolol undergoes oxidative metabolism in the liver with the formation of 3 major metabolites, none of which has a clinically significant beta-blocking effect.

 

About 5% of the accepted dose is excreted unchanged in urine, in some cases this figure can reach 30%.

 

Indications

  • arterial hypertension: lowering blood pressure and reducing the risk of cardiovascular and coronary death (including sudden death);
  • angina pectoris;
  • heart rhythm disturbances, including supraventricular tachycardia;
  • in complex therapy after myocardial infarction;
  • functional disorders of cardiac activity accompanied by tachycardia;
  • prevention of migraine attacks;
  • hyperthyroidism (complex therapy);
  • supraventricular tachycardia (for injections).

 

Forms of release

 

Tablets of 100 mg.

 

Solution for intravenous administration (injections in ampoules for injection).

 

Tablets with sustained release, coated with 25 mg, 50 mg and 100 mg (Betaloc ZOK).

 

Instructions for use and dosing regimen

 

Pills

 

Tablets can be taken with or without food as well as on an empty stomach.

 

Arterial hypertension

 

100-200 mg of Betaloc once in the morning or in two divided doses; in the morning and in the evening. If necessary, the dose can be increased or added to another antihypertensive agent.

 

Prolonged antihypertensive therapy of 100-200 mg of the drug Betalok per day can reduce overall mortality, including sudden death, as well as the incidence of cerebral strokes and coronary circulation disorders in patients with arterial hypertension.

 

Angina pectoris

 

100-200 mg per day in two divided doses; in the morning and in the evening. If necessary, another antianginal drug may be added to the therapy.

 

Heart rhythm disturbances

 

100-200 mg per day in two divided doses; in the morning and in the evening. If necessary, another antiarrhythmic drug may be added to the therapy.

 

Supportive therapy after myocardial infarction.

 

The maintenance dose is 200 mg per day in two divided doses; in the morning and in the evening.The appointment of Betalok at a dose of 200 mg per day can reduce mortality in patients with myocardial infarction and reduce the risk of recurrent myocardial infarction (including in patients with diabetes mellitus).

 

Functional disorders of cardiac activity, accompanied by tachycardia

 

100 mg of the drug Betaloc once a day, it is recommended to take a pill in the morning. If necessary, the dose may be increased.

 

Preventing migraine attacks

 

100-200 mg per day in two divided doses; in the morning and in the evening.

 

Hyperthyroidism

 

150-200 mg per day in 3-4 divided doses.

 

Ampoules

 

Nadzheludochkovaya tachycardia.

 

Begin the introduction with 5 mg (5 ml) of the preparation Betalok at a rate of 1-2 mg / min. You can repeat the introduction with a 5-minute interval until the therapeutic effect is achieved. Usually the total dose is 10-15 mg (10-15 ml). The recommended maximum dose for intravenous administration is 20 mg (20 ml).

 

Prophylaxis and treatment of myocardial ischemia, tachycardia and pain in case of myocardial infarction or suspected of it.

 

Intravenous 5 mg (5 ml) of the drug. You can repeat the introduction with a 2 minute interval, the maximum dose is 15 mg (15 ml). 15 minutes after the last injection, metoprolol was administered for oral administration at a dose of 50 mg (Betaloc) every 6 hours for 48 hours.

 

Betalok ZOK

 

When choosing a dose, it is necessary to avoid the development of a bradycardia.

 

With arterial hypertension, the dose is 50-100 mg once a day. If necessary, the dose can be increased to a dose of 100 mg 1 time per day, or use ZOK Betalok in combination with other antihypertensive drugs (preferably diuretic and calcium channel blocker dihydropyridine derivative).

 

With angina, the dose is 100-200 mg once a day. If necessary, Betaloc ZOK can be used in combination with another antianginal drug.

 

With stable symptomatic chronic heart failure with a violation of the systolic function of the left ventricle, Betaloc ZOK can be administered to patients who had no episodes of exacerbation during the last 6 weeks and there has been no change in the main therapy within the last 2 weeks. The therapy of heart failure with beta-blockers can sometimes lead to a temporary worsening of the symptomatic pattern. In some cases, it is possible to continue therapy or reduce the dose, and in some cases it may be necessary to cancel the drug.

 

With stable chronic heart failure, functional class 2, the recommended initial dose for the first 2 weeks is 25 mg once a day.After 2 weeks, the dose can be increased to 50 mg once a day and can then be doubled every 2 weeks. The maintenance dose for long-term treatment is 200 mg once a day.

 

With stable chronic heart failure 3 and 4 functional classes, the recommended initial dose for the first 2 weeks is 12.5 mg once a day. The dose is selected individually. During the period of increasing the dose, the patient should be under observation, since In some patients, symptoms of heart failure may worsen. After 1-2 weeks the dose can be increased to 25 mg once a day, then after 2 weeks - up to 50 mg once a day. With good tolerability, you can double the dose every 2 weeks until you reach the maximum dose of 200 mg once a day.

 

In the case of arterial hypotension and / or bradycardia, a reduction in concomitant therapy or a decrease in the dose of Betaloc ZOK may be necessary. Arterial hypotension at the beginning of therapy does not necessarily indicate that this dose of Betaloc ZOK will not be tolerated with further long-term treatment. However, doses should not be increased until the condition stabilizes.It may also be necessary to monitor kidney function.

 

With violations of the heart rhythm, the drug is prescribed in a dose of 100-200 mg once a day.

 

For maintenance treatment after myocardial infarction, the drug is prescribed in a dose of 200 mg once a day.

 

In functional disorders of cardiac activity accompanied by tachycardia, the dose is 100 mg once a day, if necessary, the dose can be increased to 200 mg per day.

 

For the prevention of migraine attacks are prescribed in a dose of 100-200 mg once a day.

 

Betalok ZOK is designed for daily administration once a day (preferably in the morning). The tablet of the Betaloc ZOK preparation should be swallowed with a liquid. Tablets can be divided in half, but should not be chewed or crumbled. Eating does not affect the bioavailability of the drug.

 

In patients with impaired renal function, as well as in elderly patients, there is no need to adjust the dose of the drug.

 

In patients with impaired hepatic function, dose adjustment is usually not required because of the low degree of binding of metoprolol to plasma proteins. However, with a severe impairment of liver function (in patients with severe cirrhosis or porto-caval anastomosis), a dose reduction may be required.

 

Side effect

  • bradycardia;
  • postural disorders (very rarely accompanied by syncope);
  • coldness of limbs;
  • palpitation;
  • temporary increase in symptoms of heart failure;
  • AV blockade of 1 degree;
  • Cardiogenic shock in patients with acute myocardial infarction;
  • other cardiac conduction abnormalities;
  • arrhythmias;
  • gangrene in patients with previous severe impairment of peripheral circulation;
  • increased fatigue;
  • dizziness;
  • headache;
  • increased nervous excitability;
  • anxiety;
  • impotence / sexual dysfunction;
  • paresthesia;
  • convulsions;
  • depression;
  • weakening of attention;
  • drowsiness or insomnia;
  • nightmares;
  • amnesia / memory impairment;
  • depression;
  • hallucinations;
  • nausea, vomiting;
  • abdominal pain;
  • diarrhea;
  • constipation;
  • dry mouth;
  • impaired liver function;
  • rash (in the form of urticaria);
  • increased sweating;
  • hair loss;
  • photosensitization;
  • exacerbation of psoriasis;
  • shortness of breath with physical effort;
  • bronchospasm;
  • rhinitis;
  • impaired vision;
  • dryness and / or eye irritation;
  • conjunctivitis;
  • tinnitus;
  • violation of taste;
  • arthralgia;
  • increase in body weight;
  • thrombocytopenia.

 

Contraindications

  • atrioventricular block 2 and 3 degrees;
  • heart failure in the stage of decompensation;
  • patients receiving long-term or intermittent therapy with inotropic agents and acting on beta-adrenergic receptors;
  • clinically significant sinus bradycardia;
  • syndrome of weakness of the sinus node;
  • cardiogenic shock;
  • severe peripheral circulatory disturbances;
  • arterial hypotension;
  • Betalok is contraindicated in patients with acute myocardial infarction at a heart rate of less than 45 beats per minute, a PQ interval of more than 0.24 seconds, or a systolic blood pressure of less than 100 mm Hg;
  • with serious peripheral vascular diseases with a threat of gangrene;
  • patients receiving beta-blockers are contraindicated intravenous administration of blockers of "slow" calcium channels such as verapamil;
  • age under 18 years (effectiveness and safety not established);
  • known hypersensitivity to metoprolol and its components or to other beta-blockers.

 

Application in pregnancy and lactation

 

Like most Betaloc drugs, you should not prescribe during pregnancy and during breastfeeding, except when the expected benefit to the mother exceeds the potential risk to the fetus and / or the baby.Like other antihypertensive drugs, beta-blockers can cause side effects, for example, bradycardia in the fetus, newborns or breastfed babies.

 

The amount of metoprolol released into breast milk and the beta-blocking effect of a baby breastfed (when metoprolol is taken by the mother at therapeutic doses) are minor.

 

Application in elderly patients

 

There is no need to adjust the dose in elderly patients.

 

Use in children

 

Contraindicated in children under 18 years.

 

special instructions

 

Patients taking beta-blockers should not be administered intravenously blockers of "slow" calcium channels such as verapamil. Patients with obstructive pulmonary disease should not be prescribed beta-blockers. In the case of poor tolerability of other antihypertensive agents or their ineffectiveness, metoprolol can be prescribed, since it is a selective drug. It is necessary to prescribe a minimally effective dose, if necessary, the appointment of beta2-adrenomimetic.

 

With the use of beta1-adrenoblockers, the risk of their effect on carbohydrate metabolism or the possibility of masking the symptoms of hypoglycemia is significantly less than with the use of nonselective beta-blockers.

 

In patients with chronic heart failure in the stage of decompensation, it is necessary to achieve a compensation stage both before and during treatment with the drug.

 

Patients suffering from Prinzmetal angina pectoris are not recommended to prescribe non-selective beta-blockers.

 

Very rarely in patients with AV conduction disorder, deterioration may occur (the possible outcome is AV blockade). If bradycardia develops on the background of treatment, the dose of Betalok should be reduced or the drug should be gradually withdrawn.

 

Metoprolol may worsen the symptoms of peripheral circulatory disorders mainly due to lowering blood pressure. Caution should be exercised in prescribing patients suffering from severe renal failure, metabolic acidosis, co-administration with cardiac glycosides. Patients suffering from pheochromocytoma, in parallel with the preparation Betaloc should be prescribed alpha-blocker.

 

In patients with cirrhosis of the liver, the bioavailability of metoprolol is increased. In case of surgery, the anesthetist should be informed that the patient is taking a beta-blocker.

 

Avoid abrupt discontinuation of the drug. If it is necessary to cancel the drug, the cancellation should be done gradually. In most patients, the drug can be withdrawn in 14 days. The dose of the drug is reduced gradually, in several steps, until the final dose of 25 mg once a day. Patients with ischemic heart disease should be under close supervision of the doctor during the withdrawal of the drug. In patients taking beta-adrenoblockers, anaphylactic shock occurs in a more severe form.

 

Impact on the ability to drive vehicles and manage mechanisms

 

When using the drug, episodes of dizziness or general weakness are possible, in connection with which it is necessary to refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

 

Drug Interactions

 

It should be avoided co-administration of the drug Betaloc with the following drugs:

 

Derivatives of barbituric acid: barbiturates (the study was conducted with phenobarbital) slightly increase metabolism of metoprolol, due to the induction of enzymes.

 

Propafenone: when administering propafenone, four patients treated with metoprolol experienced an increase in plasma concentrations of metoprolol by a factor of 2-5, while two patients experienced side effects typical of metoprolol. This interaction was confirmed during the study on 8 volunteers. Probably, the interaction is due to the inhibition of propafenone, like quinidine, metabolism of metoprolol through the cytochrome P4502D6 system. Considering the fact that propafenone has the properties of a beta-blocker, the joint administration of metoprolol and propafenone is not advisable.

 

Verapamil: a combination of beta adrenoblockers (atenolol, Propranolol and pindolol) and Verapamil can cause bradycardia and lead to a decrease in blood pressure. Verapamil and beta-adrenoblockers have a complementary inhibitory effect on atrioventricular conduction and sinus node function.

 

The combination of Betaloc with the following drugs may require dose adjustment:

 

Class 1 antiarrhythmics: Class 1 antiarrhythmics and beta-blockers can lead to a summation of the negative inotropic effect, which can lead to serious hemodynamic side effects in patients with impaired left ventricular function. Also, this combination should be avoided in patients with sinus node weakness syndrome and AV conduction disorder. The interaction is described by the example of disopyramide.

 

Amiodarone: Joint use of Amiodarone and metoprolol may lead to severe sinus bradycardia. Taking into account the extremely long half-life of amiodarone (50 days), possible interaction should be considered after a long time after amiodarone withdrawal.

 

Diltiazem: Diltiazem and beta adrenoblockers mutually enhance the inhibitory effect on AV conduction and sinus node function. In the combination of metoprolol with diltiazem, cases of severe bradycardia were noted.

 

Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs weaken the antihypertensive effect of beta-blockers.This interaction is most documented for indomethacin. There was no marked interaction for sulindac. In the studies with diclofenac, the described reaction was not noted.

 

Diphenhydramine: Diphenhydramine reduces the clearance of metoprolol to alpha gidroksimetoprolola 2.5 times. At the same time there is an increase in the effect of metoprolol.

 

Epinephrine (adrenaline) has been reported 10 cases of severe hypertension and bradycardia in patients treated with non-selective beta-adrenergic blockers (including pindolol and propranolol) and treated with epinephrine (adrenaline). Interaction is noted in the group of healthy volunteers. It is assumed that similar reactions may occur and the application of epinephrine with local anesthetic together with a random contact with the bloodstream. It is assumed that this risk is much lower with the use of cardioselective beta-blockers.

 

Phenylpropanolamine: Phenylpropanolamine (norephedrine) in a single dose of 50 mg may cause an increase in diastolic blood pressure to pathological values ​​in healthy volunteers. Propranolol basically prevents the increase in blood pressure, caused by phenylpropanolamine.However, beta-blockers can cause reactions of paradoxical arterial hypertension in patients receiving high doses of phenylpropanolamine. Several cases of hypertensive crisis have been reported against phenylpropanolamine.

 

Quinidine: Quinidine inhibits the metabolism of metoprolol in a particular group of patients with rapid hydroxylation (in Sweden about 90% of the population), mainly causing a significant increase in plasma concentrations of metoprolol and augmentation of the beta blockade. It is believed that this interaction is characteristic for other p-adrenoblockers in the metabolism of which cytochrome P4502D6 participates.

 

Concomitant use of alcohol, antihypertensive drugs, quinidine or barbiturates can worsen the patient's condition.

 

Clonidine: Hypertensive reactions with a sharp abolition of clonidine can be enhanced by the joint administration of beta-blockers. When combined, in the case of withdrawal of clonidine, discontinuation of beta-blockers should begin several days before the withdrawal of clonidine.

 

Rifampicin: Rifampicin can enhance metabolism of metoprolol, decreasing the plasma concentration of metoprolol.

 

The concentration of metoprolol in the blood plasma can be increased when combined with cimetidine, hydralazine, selective serotonin inhibitors, such as paroxetine, Fluoxetine and sertraline. Patients who simultaneously take metoprolol and other p-blockers (eye drops) or monoamine oxidase (MAO) inhibitors should be closely monitored. Against the background of taking beta-blockers, inhalational anesthetics increase cardiodepressive action. Against the background of taking beta-blockers, patients receiving oral hypoglycemic agents may need to adjust the dose of the latter.

 

Cardiac glycosides when combined with beta-blockers can increase the time of atrioventricular conduction and cause bradycardia.

 

Analogs of Betaloc

 

Structural analogs for the active substance:

  • Betalok ZOK;
  • Vasocardine;
  • Corvitol 100;
  • Corvitol 50;
  • Metodok;
  • Metocard;
  • Metocor Adipharm;
  • Methanol;
  • Metoprolol;
  • Egilok;
  • Egilok Retard;
  • Egilok S;
  • Emzok.

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Reviews (9):
Guests
lads
With what preparations it is possible to accept betalkov? We accept in combination with valz, the pressure after 1 hour to 190.
Administrators
admin
ladsDepending on the indications and contraindications, the following groups of drugs can be used in a specific patient with the Betaloc drug: ACE inhibitors (Enalapril, Lysinopril and many other drugs), diuretics or diuretics (Indapamide, Veroshpiron and others), calcium channel blockers (Nifedipine, Amlodipine , Verapamil, Lercanidipine and others), plus individual antihypertensives (Moxonidine, Doxazosin and others). A representative of another group of angiotensin 2 receptor antagonists you already take (Vals) and this scheme is ineffective from your words. Steady effect of antihypertensive therapy is manifested after 2 weeks of regular and correct intake of drugs.Address to the attending physician, it is better if it will be the cardiologist, for selection of the optimum scheme or plan of therapy.
Visitors
Aimee
Good afternoon. I have hypertension 2 tbsp. (51g). Saw three years Concor 2.5 and Prestarium 5. Recently, the doctor changed the treatment: betok Zok 100 and lorist 25. Although there were no complaints. She drank 10 days. I noticed that the pressure jumps to 140/90, and the pulse to 120. Strongly the head is turned, weakness and began to sleep badly. I read in the instructions of Betalok Zok that he influences driving, and I felt it. And more weight gain. Do I have to leave the first appointment? The second question: there were severe pains in the Achilles tendons, the doctors put ailobursitis, I am treated for 2 years. Nothing helps. Concor can not give such complications? Thanks for answers.
Administrators
admin
AimeeIf a person well tolerates the initial treatment regimen and the indicators (pressure, pulse) are in the normal range of values, then I do not see any reason to change the treatment, so if the pressure and pulse dance, you can return to the previous treatment regimen, but it's interesting to know why the doctor has replaced it with you and whether there were objective reasons for this.Concor does not affect the processes occurring in the tendons, so inflammation of the tendons separately, and taking the medication separately. Especially since you have changed the treatment, and no noticeable improvement or reduction of pain in the tendons.
Administrators
admin
Feedback from the site visitor love moved to the required section:
I take Betaloc zoc after a massive heart attack. The drug works well.
Visitors
VSVSvetlana
Good afternoon. I accept betalk in the morning, in the evening. Ringing in the right ear. The body is hot, and the extremities are cold. Warm socks do not help. Is it a pity? Is it temporary?
Administrators
admin
VSVSvetlanaIt's more like a vascular disorder and they are treated for a long time and not always successfully. So warm socks with you for a long time. We can assume a bust with the dosage of the drugs mentioned in the question, but it is already the task of the attending physician who prescribes this complex of medicines.
Visitors
Nikodim
Hello.Ringing in the ears appeared after 1.5 weeks of taking Betaloc ZOK daily from 25 mg to 37.5 (increased when tachycardia was growing). I accept from a tachycardia, EGC in norm or rate. Can I change to Concor right away or do I need to take 12.5 mg for a while? Thank you.
Administrators
admin
Nikodim, You can replace with another medicine immediately, the day after the abolition of Betaloc ZOK.

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