Description overdue on 07/16/2014
- Latin name: Betaloc ZOK
- ATC code: C07AB02
- Active substance: Metoprolol (Metoprolol)
- Manufacturer: AstraZeneca AB (Sweden)
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use Betaloc ZOK
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Analogs
- With alcohol
- Reviews
- Price, where to buy
Composition
The medicine contains metoprolol succinate And excipients such as ethyl cellulose . Valium . paraffin . silicon dioxide . Titanium dioxide . giproloza . MCC . macrogol . sodium fumarate .
Product form
The drug is available in round, biconvex tablets covered with a white envelope. On one side of the notch on the other - engraved " A / ms "As a fraction. One package may be 25, 50 and 100 mg.
Pharmacological action
30K is Betalok cardioselective blocker beta1-adrenergic receptors , Having antiarrhythmic . antianginalnoe and hypotensive action .
Pharmacodynamics and pharmacokinetics
Active ingredient betalok reduces or eliminates a stimulating effect catecholamines with stress and physical exertion, reduces contractility infarction and cardiac output, reduces high arterial pressure and heart rate. In addition metoprolol reduces the need infarction oxygen and prolongs diastole .
The drug may slightly improve TG And slightly reduced HDL fraction and free fatty acid levels in blood plasma.
Tablets are characterized by sustained release of the active substance, however the concentration of drug in the blood plasma remains unchanged, which ensures stable clinical effect during a day or more. The drug has a better tolerability than its analogues, the risk of adverse side effects markedly decreased.
Betaloc ZOK is completely absorbed. Absorption is independent of meal times. The degree of connection with plasma proteins - 5-10%. The active substance is metabolized in the liver with the formation of three metabolites without beta activity adrenoblokiruyuschey .
About 95% of the drug excreted in the urine, the remaining amount - intact. The half-life is on average 3-4 hours.
Indications
From what pills Betalok KRC? First of all, they are administered to patients with:
- hypertension ;
- heart rhythm disorder ;
- angina ;
- functional disorders of the heart, which are accompanied by tachycardia .
As part of the drug used in the treatment chronic heart failure . In addition, Betaloc ZOK used to reduce mortality and the likelihood of re- heart attack after the acute phase myocardial infarction And as a prophylactic against attacks migraine .
Contraindications
The drug is contraindicated in atrioventricular block Degree II-III, inotropic therapy means to activate beta-adrenoceptor , Weakness syndrome sinus node , Violations of peripheral blood circulation Heart failure decompensation phase clinically significant sinus bradycardia . cardiogenic shock , As well as increased sensitivity to blockers beta-adrenergic receptors and any component of the formulation.
In addition, Betaloc ZOK is not suitable for patients with acute myocardial infarction when the heart rate is less than 45 per minute, systolic Blood Pressure less than 100 mm Hg. Art. or the duration of the interval P-Q on ECG greater than 0, 24.
Side effects
Typically, when used correctly, the drug is well tolerated by patients to whom it is prescribed. Side effects are minor or easily reversible.
Cardiovascular system : bradycardia , Cold extremities, increased symptoms Heart Failure . orthostatic hypotension . cardiogenic shock . swelling , Pain in the heart, fainting, palpitations, atrioventricular block I level, arrhythmia .
Gastrointestinal tract : nausea . diarrhea . vomiting , Abdominal pain, constipation .
Skin Rash, increased sweating.
Metabolism : An increase in body fat.
CNS : Fatigue, headache , Convulsions, trouble concentrating, insomnia . dizziness . paresthesia . depression . drowsiness Nightmares.
Respiratory : breathlessness . bronchospasm .
In rare cases, the drug can:
- gangrene ;
- increased nervous irritability;
- memory impairment;
- hallucinations ;
- anxiety;
- depression;
- dryness of the oral mucosa;
- hepatitis ;
- hair loss;
- exacerbation psoriasis ;
- abnormal liver function;
- photosensitivity;
- rhinitis ;
- blurred vision;
- conjunctivitis ;
- dysgeusia;
- irritation and / or dryness of the eyes;
- ringing in the ears;
- arthralgia ;
- thrombocytopenia ;
- impotence . sexual dysfunction .
Instructions for use Betaloc ZOK
Instructions for use Betaloc ZOK involves taking the drug 1 time daily regardless of meals (preferably in the morning). Tablets should not be chewed or crumble. During the selection of dosage should monitor heart rate.
Arterial hypertension 50 mg per day (if the therapeutic effect is not achieved, the dose can be gradually increased up to 100-200 mg per day, with the tablets Betalok KRC operating instruction allows to combine with other antihypertensive means).
Chronic Stable heart failure III-IV functional class: first assigned dosage - 12 5 mg per day (1/2 of 25 mg tablet). If necessary, the dose is gradually increased, but it must be done strictly under the supervision of a physician. After 14 days of initial dose increases to 25 mg per day, in 2 weeks can be assigned to 50 mg per day. Thus, every 14 days, the dose can be increased by 2 times to a maximum dosage of 200 mg. However, it is impossible to raise the dose until a clear evidence of a stable condition of the patient. It is necessary to monitor the work of the kidneys.
Chronic Stable heart failure Functional class II in the beginning is assigned dose - 25 mg. After the first two weeks it may be increased to 50 mg per day, then doubling every 14 days until a therapeutic effect. The maximum dose - 200 mg per day.
Prevention migraine : Assigned 100-200 mg per day.
Angina pectoris : Appointed by 100-200 mg per day (can be combined with other agents for the treatment of angina).
Arrhythmia : Assigned 100-200 mg per day.
Heart disorders with palpitations 100 mg per day (if necessary, bring the dosage to 200 mg).
Overdose
There are cases, when a dose of 7, 5 grams of the drug caused severe intoxication with fatal consequences in the adult. At doses of 1, 2 and 4, 5 g, respectively, were moderate and severe intoxication.
An overdose of the drug can lead to respiratory depression, atrioventricular block I-III degree reduction Blood Pressure , Congestive heart failure, bradycardia . asystole , Weak peripheral perfusion . cardiogenic shock . apnea . In addition, Betaloc ZOK in high doses can cause impaired consciousness, tremor , Excessive sweating and fatigue, bronchospasm , Vomiting, hypoglycemia or hyperglycemia , Kidney malfunction, loss of consciousness, seizures, paresthesia , Nausea, and oesophageal spasm and hyperkalemia .
Initial signs of overdose of the drug will be visible through the 20-120 minutes after ingestion.
As treatment of activated charcoal and if necessary a gastric lavage.
Depending on the symptoms of overdose symptomatic treatment. So it may be necessary intubation and adequate ventilation . ECG monitoring . replenishing BCC and glucose infusion . You need to enter atropine (before gastric lavage) 1-2 mg intravenously. When depression infarction introduced dobutamine or dopamine . Perhaps the use of glucagon intravenously at a dosage of 50-150 mg per 1 kg weight. In some cases, it helps adrenaline . terbutaline (for relief bronchospasm ), As well as an artificial pacemaker. With Arrhythmia and extensive ventricular complexes injected solution of sodium. May need resuscitation.
Cooperation
With simultaneous use of the drug Betalok KRC and other blockers beta-adrenergic receptors , and MAO inhibitors and ganglioblokatorov It requires strict medical supervision.
Do not combine the drug with propafenone . verapamil . At reception diltiazem and / or antiarrhythmic drugs may develop negative for- and chronotropic effect . If you use inhaled anesthetics enhanced cardiodepressivny effect .
Perhaps the influence of inducers or inhibitors microsomal enzymes liver active matter content betalok KRC plasma. Its concentration decreases when combined with the reception rifampicin or raises at the same time taking cimetidine . hydralazine . phenytoin And reuptake inhibitors Serotonin .
If you cancel clonidine Betaloc ZOK is necessary to cancel a few days before.
In combination with inhibitors of COX antihypertensive effect of the drug can be reduced. Also it may need correction of dose oral antidiabetic agents while receiving.
Terms of sale
Prescription.
Storage conditions
The medicine should be stored at temperatures up to 30 ° C.
Shelf life
If all conditions of life - 3 years.
Analogs of Betaloc ZOK
Nebivolol
Biprol
Bisoprol
Concor Cor
Lokren
Concor
Niperten
Betalok
Coronal
Egilok
Nebilet
Atenolol
Metoprolol
In drugstores following analogues Betalok KRC:
- Azoprol Retard ;
- Vazokardin ;
- Korvitol ;
- Metokor ;
- Metoprolol ;
- Metoprolol Zentiva ;
- Metoprolol tartrate ;
- Egilok Retard .
Reviews analogues Betalok KRC quite different. Some of them are almost not inferior to him, and some - a sufficiently low level. So special attention should be paid the price analogues of this tool, as well as their producers. To finalize the order, what medicine is best suited in each case, you should consult your doctor. In addition, prior to use Be sure to read the instructions.
Betaloc ZOK and alcohol
A combination comprising Betalok KRC alcohol and may lead to the fact that the patient's condition deteriorates. The concentration of active substance in blood plasma is lowered.
Reviews of Betaloc ZOK
Reviews betalok KRC indicate that often occur following its use undesirable symptoms. Since patients often report cases rhinitis . Some also complain of inconsistency and instability of the pulse Blood Pressure . Because of this, specialists prescribed additional drugs, which are designed to remove these side effects. Nevertheless, it should be noted that the majority of people still suffer taking this medication easy.
In addition, reviews of Betaloc ZOK pay attention to the fact that the selection of doses should be approached with great care. The condition of the patient is necessary to constantly monitor and time to exclude the risk of deterioration.
Price betalok KRC where to buy
Price Betaloc ZOK 50 mg on average - 270 rub., The price is 25 mg - 160 rbl., And the average value of 100 mg - 370 rub.