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Betaloc ZOK prolonged release tablets are given once daily, preferably in the morning. The prolonged release tablets can be divided. They must not be chewed or crushed. The tablets should be swallowed together with at least half a glass of liquid. Concomitant intake of food does not influence the bioavailability.
Dosage should be adjusted individually to avoid bradycardia. The following is valid as guidelines: Hypertension: 50-100 mg once daily. In patients not responding to 100 mg, the dose could be combined with other antihypertensive agents, preferably diuretics and calcium antagonists of the dihydropyridine type, or increased.
Angina pectoris: 100-200 mg once daily. If needed, the dose can be combined with nitrates or increased.
Maintenance treatment after myocardial infarction: Long-term treatment with metoprolol in doses of 200 mg given once daily has been shown to reduce the risk of death (including sudden death), and to reduce the risk of reinfarction (also in patients with diabetes mellitus).
Impaired renal function: The elimination rate is insignificantly affected by renal function, and dose adjustment is therefore not needed in impaired renal function.
Impaired hepatic function: Usually Betaloc ZOK is given in the same dose to patients suffering from liver cirrhosis as to patients with normal liver function. Only when there are signs of very severe impairment of liver function (e.g. shunt-operated patients), a dose reduction should be considered.
Elderly: Dose adjustment is not needed.
