Betaloc 50mg drug Astrazeneca treats hypertension, prevention of angina (3 blisters x 20 tablets)

Dosage form Box of 3 blisters x 20 tablets
Specifications Metoprolol tartrate
Ingredient Astra

Ingredient

Composition information	Content
Metoprolol tartrate	50mg

Uses

Indications

Betaloc 50 mg is indicated in the following cases:

Treatment of hypertension: Reducing blood pressure, reducing the rate of disease and reducing the risk of cardiovascular death and coronary artery disease (including sudden death). Maintain after myocardial infarction. Metoprolol has negligible membrane stability and has no internal sympathetic activity.

Metoprolol reduces or inhibits the sympathetic impact on the hearts of catecholamine (these substances are released when there is a psychological stress). This means that the increase in heart rate, cardiac supply, myocardial and blood pressure contracts due to increased concentration of catecholamine will be reduced by metoprolol. When the endogenous adrenaline concentration, Metoprolol less affects blood pressure control than unsatisfactory beta inhibitors.

When required, Metoprolol can be used in combination with a beta-2-shipping owner for patients with symptoms of obstructive pulmonary disease. When used with Beta-2, Metoprolol in the treatment dose is less acting on the bronchodilator due to the beta-2 transport owner than the unsatisfactory beta inhibitors.

Metoprolol has little effect on insulin release and carbohydrate metabolism compared to unsatisfactory beta inhibitors.

pharmacokinetic

absorption

Betaloc is completely absorbed after oral, at the dose of treatment, the concentration of drug in plasma increases linearly according to the dose. The peak concentration in plasma is achieved after about 1.5 - 2 hours. Although the concentration of plasma drugs will vary by individuals, they still demonstrate the same for each individual. Due to the first metabolic effect through the strong liver, the whole body of Metoprolol after taking the only dose is about 50%. After the dose is repeated, the bioavailability increases to about 70%. Food can increase the bioavailability of the oral dose of about 30-40%.

Distribution

Metoprolol combined with low plasma proteins, about 5-10%.

Metabolism

metoprolol metabolizes the liver with oxidation mainly by isenzyme CYP2D6. Three main metabolites have been identified and no substance has a clinical beta inhibitor activity.

Elimination

over 95% of the dose is found in urine. About 5% of the dosage excreted through urine in the form of constant, this rate increased to 30% in some cases. Metoprolol's excretion half -life is 3.5 hours (from 1 - 9 hours). Total clearance about 1 liter/minute.

Before taking Betaloc 50mg drug Astrazeneca treats hypertension, prevention of angina (3 blisters x 20 tablets)

How to use

Swallow whole tablets, take medicine with or immediately after eating, drink with meals that increase the bioavailability of the drug.

Dosage

Hypertension:

The recommended dose for hypertension patients is 100 - 200 mg/day, once in the morning or divided into 2 mornings and evening. If necessary, can increase or combine with other hypertension medications.

Treatment of long -term hypertension with betaloc at the daily dose of 100 - 200 mg has shown a decrease in the mortality rate, including death from cardiovascular complications, stroke and coronary artery events on hypertension patients.

Preventive treatment for angina:

The recommended dose is 100 - 200 mg/day, divided into two mornings and evening. If necessary, can be combined with other anti -angina drugs.

arrhythmia:

The recommended dose is 100-200 mg/day, divided into two mornings and evening. If necessary, can be combined with other anti -arrhythmic drugs.

Maintenance treatment after myocardial infarction:

Long -term oral treatment with betaloc at a dose of 200 mg/day, divided into 2 morning and evening drinks has shown to reduce the risk of death (including sudden death) and reduce the risk of myocardial infarction (including diabetes patients).

Heart dysfunction with chest drums:

The recommended dose is 100 mg/day, once a day in the morning. If necessary, the dose may increase to 200 mg.

Liver function:

No dose adjustments for liver patients because Metoprolol bonds low plasma proteins (5 - 10%). When signs of serious liver failure (for example, a patient with a shunt) should consider reducing the dose.

Renal failure:

No dose adjustment.

Elderly:

No dose adjustment.

Children:

Experience for children is limited.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when using overdose?

If appropriate, gastrointestinal and/or activated carbon.

Atropine, sympathetic nervous system stimulant or pacemaker used to treat millions of bradycardia and conduction disorders.

Intentication and mechanical ventilation should be done with very wide indications. The pacemaker is an optional therapy. If the circulation is stopped due to overdose, can be cured by resuscitation measures for a few hours.

Hypotension, acute heart failure and shock are treated by increasing the appropriate body fluid volume, glucagon injection (if necessary, then glucagon intravenous infusion), intravenously stimulating sympathetic nervous systems such as dobutamin, and supplementing α1 receptors when vasodilation occurs. Can consider using intravenous Ca 2+ ion solution.

Treatment of bronchodial spasms with bronchodilators.

What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using Betaloc 50 mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Cardiovascular system: Slow heart rate, posture disorder, cold limbs and brushing chest.

Central nervous system: fatigue, dizziness, headache

Digestive system: Nausea, abdominal pain, diarrhea, constipation.

Cardiovascular system: symptoms of transient heart failure, atrial atrial block, edema, pain in the front of the heart.

Respiratory system: bronchospasm.

Digestive system: vomiting

Cardiovascular system: myocardial dysfunction, arrhythmia. Very rare: necrosis in patients with previous peripheral peripheral disorders. Very rare: dementia/memory loss, confusion, hallucinations.

The respiratory system: rhinitis. Very rare: Hepatitis. Very rarely tinnitus, taste disorders.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Betaloc 50 mg contraindicated in the following cases:

Severe asthma and severe chronic obstructive pulmonary disease. Sinus).

Slow heart rate ( It is not recommended to use medication for breastfeeding women.

Caution when using

does not suddenly stop treating in patients with angina: Sudden stopping can cause severe arrhythmia, myocardial infarction or sudden death. The drug contains lactose. Patients with rare genetic diseases are galactose intolerance, Lapp Lactase enzyme deficiency or Glucose-Galactose should not use this drug.

It is not recommended to use this drug in combination with Diltiazem, Fingolimod and Verapamil and during breastfeeding.

Sudden stopping drugs:

Avoid sudden stopping the drug, especially in patients with ischemic heart disease. The dose should be reduced slowly for a period of one to two weeks. It is advisable to start applying alternative treatment at the same time (during the slow stopping period), if necessary, to prevent severe angina.

Asthma and chronic obstructive pulmonary disease:

Only use beta inhibitors in a mild case by choosing a selective beta-1 inhibitor with a low starting dose. Before starting treatment, it is recommended to perform respiratory function tests.

In case of malignant asthma attacks and exacerbations, chronic obstructive diseases during treatment, beta bronchial bronchodilator may be used.

heart failure:

In patients with heart failure, which is controlled by treatment and in necessary cases, Metoprolol can be used slowly with a tight medical monitoring.

Slow heart rate:

Should reduce the dose if heart rate

Atrial atrial block 1:

Be cautious to use beta inhibitors for patients with atrial block of grade 1 because of reducing the transmission speed of the atrial node.

Prinzmetal angina:

Beta blockers may increase the number of times and the time of angina in patients with prinzmetal angina. In the form of coordination and small scale, simultaneously selected beta 1 inhibitors on the heart with a vasodilator.

Peripheral artery disorders:

In patients with peripheral artery disorders (syndrome or Raynaud's disease, artery inflammation or chi venigus under the sperm) of beta inhibitors may increase these disorders. In these cases, careful use of selective beta inhibitors on the heart has a partial activity.

Patients with chromium cell tumors of the adrenal marrow:

Strictly monitor blood pressure when using beta inhibitors in the treatment of hypertension, caused by the process of treating chromium cell tumors of the adrenal marrow.

Elderly:

Absolutely comply with the drug's contraindications. Start treatment with low doses and strict control.

Liver function:

There is no data on pharmacokinetics of Metoprolol in patients with liver failure or kidney failure with chronic heart failure. Therefore, it is necessary to be absolutely careful when increasing the dose in these patients.

cirrhosis:

The bioavailability of Metoprolol has an increase due to decrease in clearance. In fact, heart rate will be controlled to reduce the dose if the heart rate is excessive (

diabetes:

Patients should self -control blood sugar to prevent and maintain at the early stages of the treatment process.

Some symptoms of hypoglycemia can be covered such as tachycardia, nervousness and sweat.

Psoriasis:

Should consider carefully when appointing drugs on these patients.

Allergic reaction:

In patients at risk of serious anaphylactic reaction, regardless of the reason, especially when using Floctafenin or during the treatment of sensitivity, treatment with beta blockers can worsen anaphylaxis and cause resistance when treated with Adrenalin at normal doses.

General anesthesia:

Beta inhibitors reduce reflective tachycardia and increase the risk of hypotension. Continuing treatment with beta inhibitors will reduce the risk of arrhythmia, myocardial ischemia and hypertension. Patients should notify the anesthetist who is using beta inhibitors.

If it is necessary to stop treatment with Metoprolol, stop taking 48 hours before anesthesia is considered enough for the re -appearance of sensitivity to Catecholamln.

Do not stop treating with beta inhibitors in the following cases:

Patients with serious coronary heart failure should continue to be treated until surgery because may appear risks when stopping sudden beta inhibitors. When anesthesia should use the cardiac inhibitor as little as possible and should compensate for the loss of blood.

Should avoid immediately starting with Metoprolol for patients who are about to have an external surgery (non -cardiac Surgery).

thyroid poisoning:

Beta inhibitors can cover some of the signs of the cardiovascular system.

Sports:

The active ingredient can cause a positive reaction to the dopping tests, so the athletes need to pay attention.

The ability to drive and operate machinery

Patients should identify their reaction for Betaloc before driving or using machines because the drug can be stunned and tired.

Pregnancy

Need to carefully monitor the mother and fetus during treatment with Metoprolol.

Breastfeeding period

only used when really necessary because the drug is excreted through breast milk.

Medicinal interaction

metoprolol is a metabolic substrate of Cytochrome P450 Isoenzyme CYP2D6. Drugs that work like enamel irritation or enzyme inhibitors can affect the plasma metoprolol levels.

Metoprolol concentration in plasma may increase when combined with metabolic substances through CYP2D6 such as anti-arrhythmia, histamine resistance, histamine-2 receptor resistance, antidepressant, sedation and COX-2 inhibitors.

plasma metoprolol levels decreases when using rifampicin and can be increased by alcohol and hydralazine.

Need to monitor when used simultaneously with sympathetic inhibitors, other beta receptor inhibitors (for example, eye drops) or enzyme inhibitors.

When stopping a therapy in combination with clonidine, beta inhibitors should be discontinued a few days before stopping clonidine.

Should monitor the effect of inhibiting heart contraction and slow heart rate when using Metoprolol combination with calcium channel blockers of the Verapamil and Diltiazem and/or anti -arrhythmic drugs. When patients are taking beta receptor inhibitors, calcium channel blockers should not be injured in the Verapamil group.

Beta inhibitors can increase the inhibitory effect of cardiomyopathy and slow passage of anti -arrhythmia (Quinidine and amiodarone).

In patients treated with beta inhibitors, airway anesthesia increases heart inhibition effect.

Treatment in combination with indomethacin and prostaglandin synthetic inhibitors can reduce the lowering effectiveness of beta inhibitors.

In some cases when using Adrenaline for patients treated with beta inhibitors, the selected beta inhibitors on the heart less affects blood pressure control than unsatisfactory beta inhibitors.

may have to adjust the dose of oral diabetes treatment in patients with beta inhibitors.

Storage

No storage at temperatures above 30 ° C.

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