Diseases of the heart and blood vessels worry a lot of people. To eliminate these ailments, appoint “Metozok”. Instructions for use strongly recommends that you consult a doctor before using these tablets and do not take the drug on your own, as it has serious contraindications. The medicine helps with diseases of angina pectoris, severe heart failure, tachycardia, migraine and similar ailments.
Structure
Only the prescription Metozok is released. Instructions for use in detail describes the composition of the tablets.
A medicine with a dosage of 25 mg contains 23.83 mg of the active substance metoprolol tartrate, 50 mg contains about 47.66 mg of the active ingredient, and 100.32 contains 95.32 mg.
Excipients in the composition of the drug are: hypromellose, ludipress LCE, povidone, colloidal silicon dioxide, magnesium stearate.
The dragee shell consists of the finished substance "Opadry II", which is painted in orange. It includes such components as polyvinyl alcohol, talc, macrogol, titanium dioxide, iron dye oxide yellow, black and red, as well as indigo carmine.
Tablets are a long-acting medicine, they are covered with a light green shell. They are round in shape, convex on both sides.
Dragees in the amount of 30 pieces are packed in plastic bottles and 10 pieces in aluminum blisters. In a cardboard box there are three blisters.
The manufacturer of Metozok is the Russian company Akrikhin OJSC.
Pharmacological action and pharmacodynamics
They belong to cardioselective beta1-blockers Metozok tablets. Instructions for use fully describe the pharmacological effect of the drug. The medicine does not have membrane stabilizing properties and sympathomimetic activity. It is characterized by antihypertensive, antianginal and antiarrhythmic action.
In small amounts, it inhibits β1-adrenergic receptors of the heart, reduces the activation of cAMP by ATP from catecholamines, minimizes the current inside calcium ions, and forms a negative chrono-, batmo-, dromo- and inotropic effect. At the very beginning of the use of the drug, the overall resistance of the vessels increases. This is due to the stimulation of α-adrenergic receptors and the blocking of β2-adrenergic receptors. After a few days (1-3), the patient's condition returns to its original state, and with prolonged therapy, OPSS decreases.
The antihypertensive effect occurs by reducing the minute amount of blood flow and renin compounds due to the inhibition of the renin-angiotensin-aldosterone function and central nervous system, as well as the revival of the susceptibility of baroreceptors of the aortic arch, and finally peripheral sympathetic indices decrease. High blood pressure falls at rest. The decrease in pressure occurs with physical activity and psychological stress. The antihypertensive effect lasts more than a day.
The antianginal property is manifested by a decrease in myocardial oxygen demand, which ultimately reduces the heart rate and muscle susceptibility to the effect of sympathetic innervation. The number of attacks with angina is reduced and their duration is reduced. The physiological activity of man is increasing. Due to the increase in finishing diastolic pressure in the left ventricle and the elasticity of the muscles of both ventricles, oxygen demand in people suffering from heart failure increases.
The antiarrhythmic result is achieved by suppressing arrhythmogenic manifestations, which are expressed in the form of tachycardia, arterial hypertension, etc. There is a decrease in the unexpected excitation of sinus and ectopic rhythm and inhibition of AV conduction.
In the presence of supraventricular and sinus tachycardia , the detection of atrial fibrillation, thyrotoxicosis and other functional diseases of the heart apparatus, the heart rate decreases, which in some cases leads to restoration of the sinus rhythm.
The drug is an excellent prophylactic against migraine.
Used in medium therapeutic doses, it does not have a pronounced effect on organs with β2-adrenergic receptors and does not affect the metabolic processes of carbon in the body. Its effect is similar to that of Propranolol.
When taking the drug for several years, the amount of cholesterol in the blood can significantly decrease. When taking daily doses from 100 mg, the drug simultaneously affects all subtypes of β-adrenergic receptors.
"Metozok" (instructions for use is complete with tablets) is absorbed by the body by 95%. It is moderately soluble in fats. It is involved in the presystemic metabolism, and its bioavailability is 50% at the initial use of the drug and 70% at the following doses. The maximum concentration of a substance in the blood is observed after 6-12 hours after taking the pill. With ongoing therapy, bioavailability is gradually increasing. Food increases bioavailability by up to 40%.
The active substance 10% combines with blood proteins. It is quickly absorbed by the tissues and penetrates the blood-brain barrier, the placenta. A certain part of it passes into breast milk.
It is metabolized in the liver, and the two main metabolites are characterized by beta-blocking activity. In the metabolism of the drug, the CYP2D6 isoenzyme is involved.
The elimination half-life is on average 3.5-7 hours. The drug is not excreted by the body during hemodialysis.
In the plural, metabolites are present in patients with CC 5 ml / min., And in this case, its beta-adrenergic blocking activity does not increase.
Bioavailability increases with cirrhosis. Here, the overall clearance decreases.
"Metozok": indications for use
Patient reviews say that this drug relieves tachycardia, reduces heart pain and stabilizes well-being. The indication for taking the tablets is arterial hypertension, as well as chronic heart failure, which is in the process of compensation. In the latter case, the drug is recommended to be used along with other complex drugs.
In case of cardiac ischemia, the medicine “Metozok” is prescribed. Indications for use occur with angina attacks (in a stable form), a decrease in mortality and a decrease in the likelihood of a recurrent heart attack, after an acute stage of the disease.
The drug is recommended for cardiac organ rhythm failures, when supraventricular tachycardia is present, to reduce the frequency of contraction of both ventricles with atrial fibrillation and ventricular extrasystoles.
The drug is effective for functional disorders of the heart, which are accompanied by severe tachycardia. It is often used to prevent migraines. These were indications for use recommended for taking the Mesotok preparation. Next, we will talk about contraindications.
Contraindications
In any cases, it is forbidden to take the medicine yourself, without a doctor's prescription. Tablets are not prescribed for cardiogenic shock and AV block II-III severity. Do not use the drug for sinoatrial blockade and sick sinus syndrome. A prohibition is the use of severe bradycardia (50 beats / min), heart failure in acute, chronic form and stage of decompensation. “Metozok” is contraindicated (the instruction describes in more detail all the features of the drug use) for arterial hypotension, acute myocardial infarction, severe bronchial asthma, pheochromocyte, peripheral circulation disorders. Strongly do not recommend combining the pill with MAO inhibitors and intravenous injection of Verapamil.
Do not use the medicine for children under the age of eighteen, while breastfeeding, for people with lactose deficiency and intolerance, as well as for malabsorption syndrome, hypersensitivity to beta-blockers, including metoprolol.
With caution, a drug is prescribed for diabetes mellitus, I degree of AV block and Prinzmetal angina. Alertness should cause metabolic acidosis, a disease of bronchial asthma, as well as diseases of the pulmonary, hepatic and renal systems. Almost no medicine is prescribed for myasthenia gravis, pheochromocytes, thyrotoxicosis, depression, psoriasis, malfunctions in the peripheral circulation, during pregnancy and the elderly.
Clinical studies on the effect of the drug on pregnant women have not been conducted. There is also no data on the degree of penetration of the drug into breast milk. Therefore, during the period of bearing a child and with lactation, before using tablets, you need to consult a doctor.
"Metozok": instructions for use
Reviews of some patients note that the drug can cause a side effect in the form of rapid fatigue. Therefore, it is important to follow the rules of administration and the recommended dose. If the doctor did not select the treatment individually, then you should drink according to the classical scheme of the Metozok tablet. Instructions for use recommend taking the drug once a day in the morning, regardless of the meal. Dragees are not chewed and washed down with a small amount of water. So that bradycardia does not occur, the dose of the drug is increased gradually.
In the presence of angina pectoris and arterial hypertension, treatment begins with 50 mg per day. If the effect has not been achieved, then the daily dose is increased to 100-200 mg / day, and with arterial hypertension, in some cases, the therapy is supplemented with another antihypertensive drug.
For people with chronic heart failure of class II, according to the NYHA classification, without stages of exacerbation for six months and without significant changes in complex treatment over the past fourteen days, an initial dose of 25 mg once a day is prescribed. After two weeks, if necessary, the daily dose is increased to 50 mg, and then, after another two weeks, to 100 mg and after the same period (14 days) is increased to 200 mg.
In the III-IV class of chronic heart failure, treatment begins with 12.5 mg once a day and only after two weeks this amount is increased to 25 mg and so on until the maximum daily dose of 200 mg is reached. With this diagnosis, the patient with an increase in the therapeutic dose should be under close supervision of a doctor, as in some patients the condition may worsen.
The medicine is used for repeated prophylaxis of myocardial infarction and heart rhythm failures at a therapeutic daily dose of 100 mg.
Patients with functional disorders of the heart, in which tachycardia is also observed, are prescribed 50 mg per day. If necessary, increase the daily dose to 200 mg.
To prevent migraine, the drug is recommended to drink 100-200 mg per day.
The therapeutic dose is not adjusted for the elderly and patients with renal failure undergoing hemodialysis.
Liver diseases affect the excretion of metoprolol from the body, therefore, in this case, during treatment, the therapeutic dose is adjusted regardless of the patient's condition.
Overdose
It is necessary to take Metozok tablets with caution and only as directed by a doctor. The instruction describes contraindications in which taking this medicine is not possible. Experts emphasize that if doses and reception rules are not followed, an overdose of the drug may occur, which is accompanied by ventricular extrasystole and tachycardia, a feeling of heaviness in the head, arms and legs, as well as a significant increase in blood pressure.
The treatment is carried out by intravenous injection of alpha-blockers and beta-blockers.
Side effects
As already mentioned, in some cases, when taking the drug "Mesotok" side effects can be observed. According to patients, this can be an increase in blood pressure, an acceleration of the heart rhythm, cardiac ventricular fibrillation, arrhythmia, cardialgia and bradycardia.
On the part of the central nervous system, dizziness, an unconscious feeling of fear, anxiety, sleep disturbance, headache, muscle cramps, tremors, cerebral hemorrhage, paresthesia can be observed.
Other adverse ailments, judging by the reviews of doctors and their patients, include symptoms such as pallor of the skin, ischemia of the skin in the injection area, allergies, necrosis, scab on the surface of the tissue after the introduction of subcutaneous injections.
In case of side effects, it is advised to cancel the Metozok preparation; instructions for use. Analogs to this medicine will help to choose the attending physician.
special instructions
Indications for use are of great importance when prescribing the drug "Metozok". Analogs are used to treat such diseases is not so rare. They are selected by a specialist, carefully assessing the condition of the patient, in the event that the Mesotok for some reason did not fit.
Throughout the treatment, it is necessary to carefully monitor the cardiogram, blood pressure, blood circulation in the arms and legs, as well as the minute volume of blood.
In patients suffering from hypertension with acute heart failure, systolic blood pressure should be maintained at a level of 30-40 mm RT. Art.
With an increase in blood pressure, accompanied by symptoms of tachycardia or bradycardia, heart rhythm malfunctions are sometimes observed. In such a situation, treatment with Metozok (the instruction warns of possible side effects) should be discontinued. To prevent a secondary decrease in blood pressure after drug withdrawal, the dose is gradually reduced, especially if there was a prolonged infusion, and droppers are continued to be given to the patient if the pressure drops to 70-80 mmHg. Art.
In older people, the number of adrenergic receptors particularly susceptible to phenylephrine is reduced. In turn, monoamine oxidase inhibitors, increasing the compressive effect of sympathomimetics, provoke pain in the head, arrhythmia, vomiting reflex, hypertensive crisis. As a result, patients using monoamine oxidase inhibitors reduce the number of sympathomimetics in 2-3 days.
During the course of therapy, doctors do not recommend performing dangerous activities, which are based on the speed of the reaction - both mental and physiological.
With extreme caution should drink tablets for people with kidney disease and the elderly. The drug should not be taken for children under eighteen years of age due to insufficient knowledge of its effect.
The medicine is dispensed from pharmacies strictly by prescription.
Drug Analogs
What to do if for some reason the Metozok doesn’t fit? Analogs can always be found in the pharmacy. They have exactly the same active substance and in a similar way affect the body. These drugs include:
- Betalok.
- "Serdol."
- "Egilok C".
- "Vasocardine Retard."
- "Metoprolol."
- "Corvitol 50."
- "Metocard."
- Emzok.
- Atenalol.
- Lidalk.
These and other substitutes for Metozok are successfully used in the treatment of cardiovascular diseases. All funds require a serious approach, and they can not be taken on their own, without a doctor’s prescription.
Patient Reviews
The drug "Metozok" reviews is mostly positive. People note that it is convenient to drink (the recommended dose is one tablet per day). They talk about its effective action. Many patients claim that after taking the remedy they forgot about heart pains.
Specialists in the field of medicine also praise Metozok tablets in every possible way. Reviews of doctors indicate that this medicine is effective and safe, so cardiologists often prescribe it to their patients. Experts argue that during treatment, the main thing is to choose the right dose, otherwise side effects may occur in the form of fatigue, nausea, vomiting and diarrhea.