Egilok 25mg Egis Pharma medicine for hypertension, angina (60 tablets)

In patients with hypertension. The long -term use will lead to a decrease in statistically significance of left ventricular volume and improvement of the activity of left ventricular ventricular in the diastolic period.

In male patients with severe to severe hypertension, Metoprolol reduces cardiovascular death (especially the rate of sudden death, infarction that causes death and does not cause death).

Like other beta blockers, Metoprolol reduces the need for heart oxygen due to reducing systemic artery blood pressure, heart rate and heart muscle contraction, by slowing heart rate and thereby prolonging diastolic time, Metoprolol improves irrigation and oxygen supply to myocardial areas reduced blood supply. Therefore, in angina, the drug reduces the number of times, time and severity of pain as well as ischemic anemia silently improving the patient's mobility.

In myocardial ischemia, Metoprolol reduces death by reducing the risk of sudden death. This effect is mainly to prevent ventricular vibrations. The effect of reducing death is also seen the same when the Metoprolol is given in the early or later stages and is also evident in patients at high risk and patients with diabetes. Use after myocardial infarction, the drug reduces the relapse of non -dead infarction.

In the tachycardia on ventricular, atrial fibrillation and ventricular external ventricular, Metoprolol reduces the frequency of ventricular and the number of heartbeat beats out.

With the treatment doses, the effect of peripheral vessels and bronchospasm, Metoprolol is not as strong as the non -selective beta blockers. Compared to the unsatisfactory beta blockers, metoprolol affects less impact on insulin production and carbohydrate metabolism. The drug does not significantly change the reaction of the heart for low blood sugar or prolong the time of hypoglycemia.

In short -term clinical trials, metoprolol gently increases the concentration of triglycerides in the serum and reduces the concentration of free fatty acids in serum. In some cases, there is a mitigation of HDL cholesterol levels, but this decrease is less than using beta blockers that have an unstable effect. However, long -term clinical trial results show a significant decrease in the whole serum cholesterol after many years of using Metoprolol.

pharmacokinetic

absorption

Metoprolol is absorbed quickly and completely from the digestive system. The pharmacokinetics of the drug have linear signs according to the treatment dose, the peak concentration in plasma appears 1.5 - 2 hours after treatment. Although the plasma concentration changes a lot among individuals, in an individual, it changes little. After being absorbed Metoprolol is strongly metabolized. The bioavailability of Metoprolol is about 50% after the single dose and about 70% after repeated dose.

Take medicine with food can increase the bioavailability of Metoprolol to 30-40%.

Distribution

Metoprolol is less attached to plasma proteins, about 5-10%. Metoprolol is widely distributed in the tissue, and has a large distribution volume (5.6 l/kg).

Metabolism

Metoprolol is metabolized in the liver by cytochrome P450 enzymes. The metabolites are not clinically important.

Elimination

The average selling time is 3.5 hours (changes in the range of 1 to 9 hours), excreting the whole body from about 1 l/min. More than 95% of the treatment dose found in urine, 5% are discharged in the form of Metoprolol unchanged. The later rate has increased by 30% in some chiefs.

Metoprolol pharmacokinetics are not much different in elderly patients.

renal failure does not change the bioavailability, in the body and the elimination of Metoprolol. However, there is a reduction in metabolites in these cases.

There is a significant accumulation of metabolites in patients with severe disease in the kidneys (Filter of 5 ml/minute glomerulon). However, the accumulation of metabolites does not increase the level of beta blockers. Hepatic failure only mildly impact on the pharmacokinetics of Metoprolol. However, when severe cirrhosis and after the surgery of the across the portal vein - the owner can increase, the total clearance from the body has a decrease in the body.

In patients with the northern -vein surgery - the owner, the total clearance can be reduced to about 0.3 l/min and the area under the concentration curve - the time increases by 6 times compared to healthy people.

Very rare: ADR

Must stop Egilok 25 mg Egis 60V if the above side effects occur in severity and the cause is not clearly defined. Notify the doctor when having unwanted side effects.

Be cautious when using

Anaphylaxis can occur more worse in patients using Metoprolol.

Very rarely moderate disorders that lead atrial transmission will become worse and can cause atrial - ventricular block.

If a slow heart rate occurs, it must be treated at a lower dosage or to stop the drug.

Metoprolol can make the symptoms of peripheral circulatory disorders worse.

Discontinue Egilok 25 mg Egis 60V by reducing the dose step by step in about 14 days. Suddenly stopping the drug can make symptoms of angina worse and increase the risk of coronary artery disease. Patients with coronary artery disease must be specially monitored when they have to stop the drug.

Although beta blockers with selective effects in the heart have a weaker effect on respiratory function compared to unsatisfactory condddosipants, but they should still avoid using them as much as possible if the patient has respiratory disease blockage. If Metoprolol must be used for patients with asthma, it may be necessary to coordinate the stimulating drugs 2 (tablets and/or aerospm) or adjust the dosage to stimulate beta 2 before.

While the beta blockers with a selective effect affects the metabolism of carbohydrates, or covering some symptoms of high blood sugar, if you have to use Egilok 25 mg Egis 60V for diabetics, you must check the metabolism of carbohydrates more often and if necessary, you have to adjust insulin dose and oral diabetes medications.

When treating patients with chromium cell tumors, Metoprolol must be combined with alpha blockers.

Must notify the anesthetist before going to surgical intervention if there is Metoprolol, but should not stop Egilok 25 mg Egis 60V.

The ability to drive and operate machinery

Metoprolol affects the ability to drive and do jobs at risk of accidents, especially when the beginning of treatment and patients have alcohol (sometimes tired dizziness), so the dosage allows driving and doing dangerous jobs must be determined in one case.

Pregnancy

When treatment must consider gain/harm. If the medication is required, the fetus and the newborn must be monitored very carefully for many days (48 - 72 hours) after birth, because the circulation of the uterus - the placenta can affect the development of the fetus and the drug in the circulation of the fetus can cause the heart rate, respiratory failure, hypotension and hypoglycemia.

The breastfeeding period

Although used at the dose of treatment, Metoprolol is less discharged into breast milk, so it is not possible to cause conddarical blockage for children, but it still needs to monitor children more carefully (may occur slowly).

Medicinal interaction

The effect of lowering drugs and other antihypertensive drugs with each other, so to avoid low blood pressure, be cautious when coordinating with each other. However, the nature of the force of antihypertensive drugs can help control blood pressure more effectively when needed. Use Metoprolol at the same time with Verapamil and/or other diltiazem calcium channel blockers that will increase the negative and rhythmic effects. Non -venous drugs should be used for Verapamil -type calcium channel blockers when the patient is treated with beta blockers.

Precautions when coordinating with