Betaloc ZOK 50mg #30

Instruction for Betaloc ZOK

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Composition

The drug contains metoprolol succinate, as well as auxiliary substances such as ethyl cellulose, hypromellose, paraffin, silicon dioxide, titanium dioxide, giprolase, MCC, macrogol, sodium stearyl fumarate.

Form of issue

The drug is available in round, biconvex tablets, covered with a white shell. On one side is a notch, on the other side - engraving "A / ms" in the form of a fraction. In one package there may be 25, 50 and 100 mg of the drug.

pharmachologic effect

Betaloc 30K is a cardioselective blocker of beta1-adrenergic receptors, has antiarrhythmic, anti-anginal and hypotensive effects.

Pharmacodynamics and pharmacokinetics

Active active substance Betaloca reduces or eliminates the stimulating effect of catecholamines in stress and physical exertion, reduces myocardial contractility and cardiac output, reduces high blood pressure and heart rate. In addition, metoprolol reduces the need for myocardium in oxygen and prolongs the period of diastole.
The drug may slightly increase the level of TG, as well as slightly reduce the fraction of HDL and free fatty acids in blood plasma.
Tablets are characterized by sustained release of the active substance, so the concentration of the drug in the blood plasma remains unchanged, which provides a stable clinical effect for a day or more. The drug is better tolerated than its counterparts, the risk of unwanted side effects is markedly reduced.
Betaloc ZOK is absorbed completely. Absorption does not depend on the time of ingestion. The degree of connection with blood plasma proteins is 5-10%. The active substance is metabolized in the liver with the formation of three metabolites without beta-adrenoblocking activity.
About 95% of the drug is excreted in the urine, the remaining quantity is unchanged. The half-life period is 3-4 hours on average.

Indications for use

From what tablets Betaloc ZOK? First of all, they are prescribed for patients with:
    arterial hypertension;
    a violation of the heart rhythm;
    angina pectoris;
    functional disorders of the heart, which are accompanied by tachycardia.
As an element of therapy, the drug is used for chronic heart failure. In addition, Betaloc ZOK is used to reduce mortality and the likelihood of recurrent myocardial infarction after an acute phase of myocardial infarction, and also as a prophylactic against migraine attacks.

Contraindications

This drug is contraindicated in case of atrioventricular blockade of II-III degree, inotropic therapy for activation of beta-adrenergic receptors, weakness of sinus node, peripheral arterial circulation disorders, heart failure in decompensation phase, clinically significant sinus bradycardia, cardiogenic shock, and also with hypersensitivity to beta-adrenoreceptor blockers and any component of the drug.
In addition, Betaloc ZOK is not suitable for patients with acute myocardial infarction at a heart rate of less than 45 per minute, a systolic blood pressure less than 100 mm Hg. Art. or the duration of the P-Q interval on the ECG is more than 0.24 s.

Side effects

As a rule, with proper use, the medicine is well tolerated by patients who are prescribed it. Side effects are minor or easily reversible.
Cardiovascular system: bradycardia, cold extremities, increased manifestations of heart failure, orthostatic hypotension, cardiogenic shock, edema, pain in the heart, fainting, palpitation, atrioventricular blockade of the 1st degree, arrhythmia.
Gastrointestinal tract: nausea, diarrhea, vomiting, abdominal pain, constipation.
Skin: a rash, increased sweating.
Metabolism: an increase in body fat.
CNS: increased fatigue, headache, seizures, problems with concentration, insomnia, dizziness, paresthesia, depression, drowsiness, nightmares.
Respiratory organs: shortness of breath, bronchospasm.
In rare cases, when taking the drug are possible:
    gangrene;
    increased nervous excitability;
    memory impairment;
    hallucinations;
    anxiety;
    depression;
    dryness of the oral mucosa;
    hepatitis;
    hair loss;
    exacerbation of psoriasis;
    impaired liver function;
    photosensitization;
    rhinitis;
    visual impairment;
    conjunctivitis;
    violation of taste;
    irritation and / or dry eyes;
    tinnitus;
    arthralgia;
    thrombocytopenia;
    impotence, sexual dysfunction.

Instructions for use Betaloc ZOK (Method and dosage)

Instructions for use Betaloc ZOK provides for taking the drug every 1 time, regardless of meals (preferably in the morning). Tablets can not be crushed or chewed. During the selection of the dosage, the heart rate should be monitored.
Arterial hypertension: 50 mg per day (if the therapeutic effect is not achieved, the dose can be gradually increased to 100-200 mg per day, while Betaloc ZOK tablets instructions for use allow you to combine with other antihypertensive drugs).
Stable chronic cardiac insufficiency III-IV of the functional class: a dosage of 12.5 mg per day is prescribed for the beginning (1/2 tablet in 25 mg). If necessary, the dose gradually rises, but this must be done strictly under the supervision of the doctor. After 14 days, the initial dosage is increased to 25 mg per day, after another 2 weeks, 50 mg per day can be prescribed. Thus, every 14 days the dose can be increased 2 times to reach a maximum dosage of 200 mg. However, the dose can not be increased until there is clear information about the patient's stable state. It is necessary to control the work of the kidneys.
Stable chronic heart failure of functional class II: in the beginning, a dose of 25 mg is prescribed. In the first 2 weeks, it can be increased to 50 mg per day, and then doubled every 14 days until a therapeutic effect is achieved. The maximum dosage is 200 mg per day.
Prevention of migraine: appointed 100-200 mg per day.
Angina pectoris: 100-200 mg per day is prescribed (it can be combined with other agents for the treatment of angina pectoris).
Arrhythmia: it is prescribed 100-200 mg per day.
Impaired cardiac activity with palpitation: 100 mg per day (if necessary, dosage can be adjusted to 200 mg).

Overdose

There are cases when at a dosage of 7.5 g the drug caused severe intoxication with a lethal outcome in an adult. At doses of 1.4 and 2.5 g, respectively, there was moderate and severe intoxication.
Overdose of this drug can lead to respiratory depression, atrioventricular blockade of I-III degree, lowering of arterial pressure, heart failure, bradycardia, asystole, weak peripheral perfusion, cardiogenic shock, apnea. In addition, Betaloc ZOK in elevated doses can cause impaired consciousness, tremor, excessive sweating and fatigue, bronchospasm, vomiting, hypoglycemia or hyperglycemia, impaired renal function, loss of consciousness, seizures, paresthesia, nausea, and esophageal spasm and hyperkalemia.
Initial signs of drug overdose will be noticeable in 20-120 minutes after administration.
As treatment, activated charcoal is prescribed, as well as gastric lavage if necessary.
Depending on the manifestations of an overdose, symptomatic treatment is performed. This may require intubation and adequate ventilation of the lungs, ECG monitoring, replenishment of bcc and glucose infusion. If necessary, enter atropine (before washing the stomach) intravenously 1-2 mg. When depression of the myocardium is administered dobutamine or dopamine. It is possible to use glucagon intravenously in a dosage of 50-150 μg per 1 kg of body weight. In some cases, adrenaline, terbutaline (for cupping bronchospasm), as well as an artificial pacemaker, helps. At an arrhythmia and an extensive ventricular complex the sodium solution is entered. Resuscitative measures may be necessary.

Interaction

With the simultaneous use of the drug Betaloc ZOK and other beta-adrenoreceptor blockers, as well as MAO inhibitors and ganglion blockers, strict medical supervision is required.
Do not combine the drug with Propafenone, Verapamil. When taking Diltiazem and / or antiarrhythmic drugs may develop a negative foreign and chronotropic effect. With the use of inhalational anesthetics, the cardiodepressant effect is enhanced.
Possible influence of inducers or inhibitors of microsomal liver enzymes on the content of the active substance Betaloc ZOK in blood plasma. Its concentration decreases when combined with taking rifampicin or increases with the simultaneous administration of cimetidine, hydralazine, phenytoin, as well as serotonin reuptake inhibitors.
With the withdrawal of clonidine Betaloc ZOK must be canceled a few days before.
In combination with COX inhibitors, the antihypertensive effect of the drug may decrease. Also, it may be necessary to correct the dosage of oral antidiabetic agents while receiving.

Storage conditions

The medicine should be stored at a temperature of up to 30 ° C.

Shelf life

If all storage conditions are met, 3 years.

Betaloc ZOK and alcohol

The combination, including Betaloc ZOK and alcohol, can lead to the fact that the patient's condition worsens. The concentration of active substance in the blood plasma at the same time decreases.

Reviews about Betaloc ZOK

Reviews about Betaloc ZOK indicate that often after its use, there are undesirable symptoms. So often patients report cases of rhinitis. Some also complain about the inconsistency of the pulse and the instability of blood pressure. Because of this, experts prescribe additional drugs that are designed to remove these side effects. Nevertheless, it should be noted that most people still tolerate taking this medication easily.
In addition, reviews of Betaloc ZOOC draw attention to the fact that the selection of dosage should be approached with special care. The patient's condition must be constantly monitored and the danger of deterioration eliminated in time.