Cardiovascular disease is the most common. In order to quickly reduce pressure, reduce the number of heart contractions, alleviate the condition with angina pectoris, migraines, take the drug "Corvitol". Analogs are also assigned quite often for one reason or another. The drug has contraindications, therefore, before using it, you must consult your doctor.
Form of release and composition of the drug
The drug belongs to beta-blockers. It is produced in the form of white tablets, which have a cylindrical round shape, chamfer and one-sided risk. Available in two dosages:
- "Corvitol 100". Contains 100 mg of the active ingredient metoprolol tartrate.
- "Corvitol 50." It contains 50 mg of the active component of metoprolol tartrate.
Additional ingredients for both forms of release are the same and are represented by lactose monohydrate, magnesium stearate, povidone K30, croscarmellose sodium, silicon dioxide, colloidal talc.
The tablets are packed in aluminum blisters of 10 pieces. The package can contain from 3 to 10 blisters. The medicine is accompanied by instructions for use.
Pharmacology and pharmacodynamics
Corvitol is a cardioselective beta-blocker that does not exhibit sympathomimetic activity and does not have membrane-stabilizing qualities. It has antihypertensive, antiarrhythmic, antianginal properties.
It inhibits a small amount of β1-adrenergic receptors of the heart, reduces the formation of cAMP activated by catecholamines from ATP, weakens the intracellular current of calcium ions. It has a negative batmo-, chrono-, dromo- and inotropic effects.
OPSS at the start of the use of beta-blockers increases, and after a few days of taking the drug, it returns to its original level, with prolonged use it decreases.
The antihypertensive property is due to a decrease in cardiac output and renin synthesis, inhibition of the activity of the renin-angiotensin and central nervous systems, restoration of the sensitivity of the baroreceptors of the aortic arch and, as a result, a decrease in peripheral sympathetic influences. Lowers blood pressure at rest and during physical, neuropsychic stress.
Antihypertensive result is achieved in minutes. So, systolic blood pressure decreases after fifteen minutes, a maximum of two hours. The effect lasts for six hours. Diastolic blood pressure changes more slowly. Its stabilization can be achieved only after several weeks of taking the drug.
The antianginal properties of the drug are determined by a decrease in myocardial oxygen demand due to a decrease in heart rate. Myocardial susceptibility to the influence of sympathetic innervation, the number and severity of angina attacks are reduced. Physical stamina is increasing.
Antiarrhythmic properties are manifested in the removal of arrhythmogenic manifestations, a decrease in the excitation of sinus and ectopic rhythm, as well as inhibition of AV conduction. With manifestations of supraventricular tachycardia, the occurrence of atrial fibrillation and the detection of sinus tachycardia associated with heart diseases and with hyperthyroidism, the drug reduces the heart rate. Sometimes restores sinus rhythm. It alleviates the condition of migraine and prevents its occurrence in the future.
When used in medium therapeutic doses, unlike non-selective beta-blockers, it has a less pronounced effect on organs containing β2-adrenergic receptors and on carbohydrate metabolism. When used in large doses (more than 100 mg per day), it has a blocking effect on both subtypes of β-adrenergic receptors.
Metoprolol is 95% absorbed from the stomach and intestines. The maximum plasma concentration is observed after 1-2 hours. Due to active metabolism, the first bioavailability of the drug is 50%. With the subsequent use of the drug, it increases to 70%. Eating food each time increases bioavailability by 20-40%.
Corvitol combines with blood proteins by 10%, Vd - 5.5 l / kg. It passes through the BBB and the planetary barrier. It is excreted in breast milk in small doses.
The drug is almost all metabolized in the liver. Two of the three main metabolites are characterized by a beta-blocking property. The isoenzyme of cytochrome P450 (CYP 2D6) takes part in the metabolism of the drug. Excretion lasts about 3.5 hours. The medicine is excreted in the urine, and 5% comes out unchanged.
Kidney diseases inhibit the metabolism of metoprolol. Significantly increased bioavailability in cirrhosis. The active substance is not excreted from the body during hemodialysis.
Indications for use of medicine
"Corvitol" should be used strictly as prescribed by the doctor for arterial hypertension. It is used as monotherapy or in combination with other antihypertensive agents. Indications for use are tachycardia, coronary heart disease, myocardial infarction. Often use "Corvitol 100", analogues to prevent angina attacks and heart rhythm disturbance, for the prevention of migraine.
Contraindications
"Corvitol 50", as well as a drug in a dosage of 100 mg should not be taken with cardiogenic shock. Contraindication is AV blockade of the II and III degrees, as well as sinoatrial block. Do not take the drug for weak sinus node syndrome, severe bradycardia. The prohibition is peripheral circulatory failure and heart failure. Tablets do not drink with angina pectoris, acute myocardial infarction and arterial hypotension.
It is impossible to combine taking the medicine “Corvitol 50” (if necessary, the attending physician will help to choose analogues) with the use of monoamine oxidase inhibitors and with the intravenous injection of “Verapamil”.
The drug is not prescribed during breastfeeding, to persons under the age of eighteen, and people with hypersensitivity to metoprolol, additional substances in the composition of the product.
With special care, take a medication for diabetes mellitus, bronchial asthma, emphysema, metabolic acidosis, chronic bronchitis in obstructive form. Only under the supervision of a doctor should people take medicine with peripheral vascular disease, renal and hepatic insufficiency. Caution when using Corvitol tablets should be patients with myasthenia gravis, AV blockade of the 1st degree, as well as with pheochromocytoma, depression and thyrotoxicosis. With caution, it is prescribed for psoriasis and the elderly.
During pregnancy, Corvitol tablets are prescribed only in cases of urgent need, when the fetus has bradycardia, arterial hypotension, hypoglycemia. In this case, the treatment process should take place under the close supervision of a doctor. In the future, they constantly monitor the newborn for 48-72 hours after delivery.
The effect of metoprolol on the child in the first days of life has not been studied, therefore, ladies who use the drug are advised to stop breastfeeding.
"Corvitol": recommended doses
The therapeutic course for each patient is determined by the doctor and depends on the course of the disease. Only a specialist should prescribe a dose and a dosage of Corvitol. Instructions for use (analogues of drugs from Russian manufacturers are much cheaper) describes only the classical regimen for certain diseases.
So, with arterial hypertension and angina pectoris, the drug is taken orally 100 mg once a day or 50 mg twice a day. If necessary, the amount of the drug is increased to 100 mg, taken twice a day. The maximum possible daily dose is 200 mg.
With functional disorders in the work of the heart, provoking the occurrence of tachycardia, the initial dose is prescribed in an amount of 50-100 mg per day. This volume can be divided in two. As needed, the daily dose is increased to 200 mg.
To prevent migraines, the drug is prescribed 100 mg once a day or 50 ml in the morning and evening. When the therapeutic effect is achieved, the dose must be reduced. This process should occur slowly and under close medical supervision.
In older people with kidney disease and for hemodialysis, the daily dose is not reduced. In case of a malfunction in the liver, the daily amount of the drug is reduced, focusing on the patient's condition.
In all of the above cases, Corvidol is taken orally, after meals, and washed down with a small amount of water. Tablets should be swallowed without chewing. If the drug is drunk once a day, then it should be taken in the morning. With double use, tablets are taken in the morning and in the evening.
Overdose
The medicine "Corvitol" in case of overdose immediately stop taking. Symptoms of drug abuse include sinus bradycardia, nausea, dizziness, decreased blood pressure, gag reflex, cyanosis, arrhythmia, bronchospasm, fainting, ventricular extrasystole.
An acute overdose of Corvitol (analogues in Russia can be bought at any pharmacy from 30 rubles and above) is manifested in the form of cardiogenic shock, coma, AV blockade, loss of consciousness, cardialgia. As a rule, the first signs of excessive use of the drug occur after 20 minutes - 2 hours after administration.
First of all, the patient is washed the stomach and prescribed absorbent drugs. If there was a sharp decrease in blood pressure, then the person is laid in the Trendelenburg position. If the pressure drops to a critical level and there is heart failure, bradycardia, then beta-adrenostimulants are administered intravenously with an interval of 2-5 minutes. The procedure is carried out until a positive result. Injections of 0.5–2 mg Atropine Sulfate may be given intravenously.
If the desired effect is not achieved, then drugs such as Dopamine, Norepinephrine, Norepinephrine, or Dobutamine are used. Sometimes 1-10 mg of Glucagon is prescribed or a transvenous intracardial electrostimulator is prescribed. When bronchospasm occurs, beta-adrenostimulants are injected into the vein. If convulsions occur, they slowly inject Diazepam into a vein. Hemodialysis in this case does not give a result.
Side effects
Continuous use of the drug “Corvitol” (tablets) can provoke a headache, muscle weakness, excessive fatigue, dizziness from the side of the central nervous system, cause inhibition of mental and physiological reactions, paresthesia of the arms and legs. A depressive state, a feeling of anxiety and fear are manifested, attention is disturbed. Concerned about drowsiness, negative dreams, insomnia, confusion of thoughts, short-term memory loss. Asthenic syndrome may occur.
Corvitol and its analogues can cause visual impairment, dry eyes and soreness, and a decrease in tear fluid production. In rare cases, conjunctivitis, rhinitis appears. There is tinnitus.
The drug can cause disruption of the cardiovascular system in the form of sinus type bradycardia, increased heart rate, a sharp decrease in pressure, orthostatic hypotension . In rare cases, there is a decrease in myocardial contractions, aggravation of heart failure, arrhythmia, angiospasm. Myocardial patency is impaired. Cardialgia occurs.
With regular use of the drug, gastrointestinal tract dysfunctions were observed, which manifested themselves in the form of nausea, vomiting, pain in the abdomen, diarrhea, and dry mouth. Some patients noted a change in taste preferences, an increase in the activity of liver enzymes. In rare cases, hyperbilirubinemia was manifested.
As a result of therapy, dermatological reactions were also observed. This is psoriasis and its exacerbation, hyperemia, exanthema. Excessive sweating, reversible-type alopecia and photodermatosis have been noted.
Side effects of the respiratory system were found in the form of shortness of breath and nasal congestion. Some patients suffered from shortness of breath.
Sometimes there was hypoglycemia and a hypothyroid state. Thrombocytopenia, leukopenia and agranulocytosis worried patients. There was an allergy in the form of itching, urticaria and rash. Pain in the back (joints), weight gain, loss of libido, potency were noted.
special instructions
When using the drug, special control should be exercised over the heart rate, blood pressure and glucose level, especially in patients with diabetes mellitus. In the latter case, the dose of the drug is selected in accordance with the picture of the disease.
The patient should be trained in the method of calculating heart rate and instructed on the need to consult a doctor with a heart rate of less than 50 beats / min.
If high doses are prescribed (from 200 mg per day), then cardioselectivity is reduced. In patients with heart failure, therapy is carried out during the compensation period.
It is possible to increase the severity of hypersensitivity reactions (against the background of a burdened allergic history) and the lack of effect from the introduction of the usual doses of Epinephrine.
Against the background of taking the drug, symptoms of peripheral arterial circulation disturbance may intensify.
Cancellation of treatment is carried out gradually, reducing the dose to a minimum for ten days. You can not abruptly stop taking the drug, since an angina attack may occur and blood pressure may increase.
In patients with angina pectoris, the dose is selected so that the heart rate is 55-60 beats / min, and with physical activity it does not exceed 110 beats / min.
People with contact lenses should be aware that tear fluid production may decrease during beta-blocker therapy.
Metoprolol in some cases masks the manifestations of thyrotoxicosis. Patients with thyrotoxicosis are contraindicated in a sharp withdrawal of the drug, as this will only aggravate the course of the disease.
In patients with diabetes, tachycardia provoked by hypoglycemia may not be immediately detected. Corvitol does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentrations to normal levels.
When taking medication, older people should constantly monitor kidney function, as well as patients with kidney failure.
People with a depressed state should take the medicine with caution, since tablets can increase the severity of the disease.
During therapy, you should refrain from driving and stop activities associated with concentration, requiring a quick response.
Closed clothes should be worn during treatment, as the drug can cause photosensitivity.
How to replace Corvitol?
In some cases, the drug can cause many side effects or simply do not fit its action, so the doctor can replace “Corvitol”. Analogs have similar properties, give the same therapeutic effect and have tartrate in metoprolol. They are quite popular and are sold in almost every pharmacy, and the price of some of them barely reaches 50 rubles.
The following are analogues capable of replacing Corvitol with the same active component:
- Betalok.
- "Egilok."
- "Metozok."
- "Metoprolol."
- "Serdol."
- "Vasocardine."
- Lidalk.
The following drugs have similar effects: Aritel, Estecor, Bisomor, Binelol, Atenolol, Cordinorm, Betak, Biol, Nebilet, Bisogamma and other medicines.
When replacing one medication with another, it should be remembered that the analogue does not always work as effectively as the original drug, which has passed a number of tests and many studies.
The cost of the drug, reviews
Can analogues always replace Corvitol? Patient reviews say that it is difficult to find a drug with the same long-lasting effect, despite the fact that many products containing exactly the same active substance are produced. A medicine often costs more than substitutes, but, as experience has shown, analogs are less effective. The reviews indicate that Corvitol effectively reduces pressure and prevents the development of migraine.
50 tablets of 100 mg each will cost 250-300 rubles, the same amount in a dosage of 50 mg costs about 220-250 rubles.