Why is the medicine "Metoprolol" necessary? Patient reviews about this drug, its release form, composition and side effects will be presented below. We will also tell you about what contraindications and indications this medicine has, in what dose it should be taken, whether there are analogues and so on.
The composition of the drug and its release form
In what form is the drug “Metoprolol” sold? Reviews of patients say that in the pharmacy you can find three types of this drug. Consider the form of release and composition in more detail.
- Tablets. They contain such an active ingredient as metoprolol tartrate (100, 50 and 25 milligrams). In addition, the medication also includes auxiliary components in the form of silicon dioxide, colloidal anhydrous, microcrystalline cellulose, sodium carboxymethyl starch (type A) and magnesium stearate. The drug goes on sale in 50, 10, 30, 20 or 40 tablets per pack.
- Coated tablets having sustained release properties (Metoprolol Succinate). They contain similar active and auxiliary substances. In pharmacies, such a medicine can be found in 30, 20 or 10 tablets per pack.
- A solution for intravenous injection in ampoules of 5 milliliters. The medicine goes on sale in a carton box of 10 ampoules.
Pharmacological properties of the drug
What is the Metoprolol Medication intended for? Indications for the use of this tool will be presented below. Now I want to tell you about the pharmacological properties of this drug.
Mentioned medicine refers to cardioselective beta-adrenergic blockers. It does not exhibit membrane-stabilizing properties and does not have sympathomimetic internal activity. However, this drug is a hypotensive, antiarrhythmic and antianginal drug.
The medication is able to reduce the patient’s heart rate, reduce myocardial excitability and contractility, slow down AV conduction, and also reduce myocardial oxygen demand.
As a rule, a hypotensive effect is observed in patients only after fourteen days after taking the drug. The drug reduces the frequency of attacks with supraventricular tachycardia, angina pectoris and atrial fibrillation. As a result, the patient’s heart rate is normalized.
Sustained-release tablets ("Metoprolol Succinate") have a significant advantage over conventional ones. They allow you to maintain a constant concentration of the active element in the blood, which ensures a good therapeutic effect throughout the day. It should also be noted that the action of “Metoprolol succinate” helps to reduce the risk of bradycardia and weakness, and to a lesser extent affects the smooth muscles of the bronchi.
Pharmacokinetics (absorption, metabolism and drug excretion)
We will talk about the indications for the use of the drug and the available Metoprolol analogues below, and now let's talk about the pharmacokinetic features.
This tool is very quickly and almost completely (about 95%) absorbed. The maximum concentration in blood plasma is usually achieved 50-110 minutes after ingestion.
At the first application, the bioavailability of the drug is 50%. When repeated, it increases to 70%. By the way, eating food increases the bioavailability of the drug by 20-40%. It also increases if the patient has cirrhosis. Communication with proteins averages 10%.
The aforementioned drug penetrates well through the placental and blood-brain barriers. Also in small quantities, it is excreted in breast milk.
The drug is metabolized in the liver. Moreover, metabolites do not have pharmacological activity. About 5% of the drug is excreted by the kidneys unchanged. Therapy of a patient with reduced kidney function does not require a reduction or other dose adjustment of the drug. However, impaired liver function can slow down the metabolism of the drug. In this case, the dosage should be reduced.
Medication "Metoprolol": indications for use
There is a fairly large list of pathological conditions in which this drug is prescribed. Consider them.
- akathisia, which was caused by antipsychotics;
- arterial hypertension of the 1st and 2nd degree, arterial hypertension (possibly monotherapy, and in severe cases, together with diuretics and other antihypertensive drugs);
- thyrotoxicosis (only as part of complex treatment);
- prevention of an attack of angina pectoris and angina pectoris;
- prevention of migraine attacks;
- heart rhythm disturbance (for example, with extrasystole, paroxysmal and supraventricular tachycardia, supraventricular tachycardia) ;
- to reduce the risk of death and morbidity with cardiovascular failure and coronary artery disease;
- secondary prevention after myocardial infarction and acute myocardial infarction;
- mitral valve prolapse;
- dilated idiopathic cardiomyopathy;
- cardiovascular essential hyperkinesis, cardiac hyperkinetic syndrome, impaired heart function.
Reviews about the drug
According to the reviews of those who have ever taken the drug, it effectively copes with the task and positively affects the work of the heart. However, it should be noted that some patients do not respond well to the medication. As a rule, this is due to the fact that it has many contraindications and side effects. We will tell about what patients complain about while taking the medication in question below.
Contraindications to the use of the medication
So, now you know what the Metoprolol preparation is intended for (indications for use have been described just above). However, this medication has a number of contraindications. These include:
- individual intolerance (i.e. hypersensitivity to the active or auxiliary components);
- atrioventricular blockade of the 2nd and 3rd degree;
- single use with MAO inhibitors;
- sinoauricular block;
- severe circulatory disorders (peripheral);
- sinus bradycardia (if the heart rate is less than sixty per minute);
- hypoglycemia and the labile form of diabetes;
- sick sinus syndrome;
- the patient's predisposition to bronchospasm (that is, with bronchial asthma and bronchial hyperreaction);
- metabolic acidosis;
- arterial hypotension (less than 100 mm RT. Art.);
- cardiogenic shock (the drug is not recommended for patients with a diagnosis of acute myocardial infarction or suspected it);
- heart failure acute, chronic (2nd and 3rd stages) and uncompensated.
Restrictions on the use of the drug (with extreme caution)
In what cases should you limit the use of the drug "Metoprolol"? Reviews of experts say that the dose of this medication should be reduced with hyperthyroidism, emphysema, a burdened allergic history, bronchial asthma, non-allergic bronchitis, psoriasis, pheochromocytoma, disorders of the liver, as well as kidneys (sometimes), depression, myasthenia gravis and general anesthesia.
Can Metoprolol be given to children? The use of this medicine by persons under 18 years of age is prohibited. The ban on taking the drug also applies to pregnant women, nursing mothers. If these recommendations are not followed, there is a huge risk of developing bradycardia, hypoglycemia, and arterial hypotension in a newborn baby.
If you need to take the medication during breastfeeding, then at this time, lactation should be interrupted.
Preparations "Metoprolol" and "Metoprolol Succinate": instructions for use
As a rule, the drug "Metoprolol" per day is taken in an amount of 100 mg. Moreover, the indicated volume is divided into several doses. To achieve the best therapeutic effect, the reception can be increased by 2 times. However, the maximum dose of the drug should not be higher than 400 mg.
With intravenous injection, 2 to 5 mg of the drug is administered once. In this case, the maximum dosage is 15-20 mg. In the absence of the proper effect, it is allowed to introduce the drug substance again (after 5 minutes).
To stop taking this medication should be gradual. This is usually done for ten days under the special supervision of a doctor.
The initial dosage of the drug "Metoprolol succinate" in supraventricular tachycardia, angina pectoris, arterial hypertension and extrasystole is about 50-100 mg once a day. With maintenance therapy for myocardial infarction, the medication is taken in a dose of 200 mg.
The minimum duration of treatment with Metoprolol Succinate is 3 months. If the patient is diagnosed with chronic heart failure, then the dosage is selected individually. First, the drug is taken in an amount of 12.5 mg once a day for 2 weeks, and then every 14 days the dose is doubled.
With relatively good tolerability of the drug, its maximum intake per day can reach 200 mg.
Side effects Patient Reviews
Can the Metoprolol Medication Harm the Body? Reviews about this drug contain a lot of information that after taking it there are negative consequences. What kind of phenomena are we talking about?
- From the side of the nervous system: muscle weakness, increased fatigue, nightmares, depression, headaches, anxiety, slowing down the speed of motor and mental reactions, decreased attention, paresthesia in the extremities, short-term memory impairment, drowsiness, or, conversely, insomnia.
- From the sensory organs: decreased secretion of lacrimal fluid, decreased vision, conjunctivitis, soreness and dryness of the mucous eyes, tinnitus.
- From the cardiovascular system: arrhythmia, sinus bradycardia, cardialgia, impaired myocardial conduction, decreased blood pressure, manifestation of angiospasm, orthostatic hypotension, decreased myocardial contractility and dizziness.
- From the digestive system: dry mouth, abdominal pain, nausea, impaired liver function, constipation, vomiting, diarrhea, and a change in taste.
- On the part of the skin: itching, reversible alopecia, urticaria, hyperemia, rash, increased sweating, exacerbation of psoriasis, photodermatosis, exanthema and psoriasis-like skin reactions.
- From the respiratory system: shortness of breath, nasal congestion, bronchospasm and difficulty exhaling.
- From the endocrine system: hypothyroidism, hypoglycemia and hyperglycemia.
- Laboratory studies: thrombocytopenia, agranulocytosis, hyperbilirubinemia, leukopenia and increased activity of liver enzymes.
- Effect on the fetus when taken by a pregnant woman: intrauterine growth retardation, bradycardia and hypoglycemia.
In addition, after taking the drug, some patients note the occurrence of pain in the joints or back. It is extremely rare for people to indicate that they have slightly increased body weight, decreased libido or potency.
Special instructions for the use of the drug
Currently, in any pharmacy you can buy the drug "Metoprolol." A recipe is not required. However, the patient taking the medication should be regularly monitored by the attending physician. This is especially true for those patients who are diagnosed with diabetes mellitus or angina pectoris.
You should be aware that with an increase in dosage (more than 200 mg per day), cardioselectivity decreases. In the presence of heart failure, therapy is started only after the compensation stage is reached.
People using contact lenses should be aware that the production of tear fluid is reduced during treatment with Metoprolol.
Sometimes this medication masks some manifestations of thyrotoxicosis. At the same time, abrupt cancellation of the drug in patients with the aforementioned disease is contraindicated, as this helps to strengthen the symptoms.
If necessary, the operation of the patient should be sure to warn the anesthetist about drug therapy.
During treatment with Metoprolol, appropriate clothing must be worn. This is due to the fact that the drug can cause allergic reactions on the skin due to exposure to sunlight.
It cannot be said that the medication Metoprolol (including analogues of this medicine) in the elderly can cause the appearance of increasing bradycardia, a marked decrease in blood pressure, and atrioventricular block. That is why such patients need special control.
In addition, during treatment with this drug, one should refrain from driving vehicles and stop engaging in hazardous activities that require an increased concentration of attention and speed of psychomotor reactions. It is also recommended that ethanol be excluded.
Existing drug analogues
What to do if the patient was unable to purchase the medication “Metoprolol” prescribed by the doctor? Analogs of it are available in any pharmacy. Most of them contain a similar active substance, due to which they have the same properties as the mentioned drug. Among these medicines, the following can be noted: “Metoprolol-Acre”, “Metolol”, “Metokor Adifarm” and others.
After acquiring these funds, the patient is advised to read the attached instructions, as well as consult a doctor. This is due to the fact that the methods of administration may differ from the dosages of the aforementioned agent.
What other analogues does this drug have? You can replace the medicine prescribed by your doctor with the following medicines: Bisoprolol, Metoprolol-ratiopharm, Metocard, Corvitol, Metozok, Lidalk, Serdol, Egilok, Emzok and others.
How and how much to store the drug?
Now you know what it is intended for, how and at what dosage the Metoprolol medication is taken. It should be stored in a cool place (for example, in the refrigerator) or in a room where the air temperature does not exceed 25 degrees. In this case, the drug must be protected from direct sunlight.
The shelf life of the drug and most of its analogues is five years from the date of manufacture. At the end of this period, the use of the medication for therapeutic and prophylactic purposes is prohibited. It should be thrown away.