Betaloc Zok

Metoprolol succinate

Reduce BP & risk of CV, & coronary mortality (including sudden death) & morbidity. Angina pectoris. Cardiac arrhythmias especially including supraventricular tachycardia, reduction of ventricular rate in atrial fibrillation & ventricular extrasystoles. Migraine prophylaxis. Prevention of cardiac death & reinfarction after acute phase of MI.

Mild to moderate HTN 50 mg once daily. Patients unresponsive to 50-mg dose May be increased to 100-200 mg once daily &/or combined w/ other antihypertensive agents. Angina pectoris 100-200 mg once daily. May be combined w/ other anti-anginal agents if needed. Cardiac arrhythmias & migraine prophylaxis 100-200 mg once daily. Prophylactic treatment after MI 200 mg once daily. Functional heart disorders w/ palpitations 100 mg once daily, may be increased to 200 mg if needed.

May be taken with or without food: Preferably taken in the morning. Tab can be divided to halves. Swallow tab/divided tab whole w/ liqd, do not crush/chew.

Hypersensitivity to metoprolol or other β-blockers. 2nd- or 3rd-degree AV block, unstable decompensated cardiac heart failure (pulmonary oedema, hypoperfusion or hypotension), continuous or intermittent inotropic therapy acting through β-receptor agonism, marked clinically relevant sinus bradycardia, sick sinus syndrome (unless permanent pacemaker is in place), cardiogenic shock, severe peripheral arterial circulatory disorder. Not to be given to patients w/ suspected acute MI as long as the heart rate is <45 beats/min, PQ interval is >0.24 sec or systolic BP is <100 mmHg.

Not to be given w/ IV administration of verapamil-type Ca antagonists. Not recommended to discontinue β-blocker treatment in patients undergoing surgery. More severe form of anaphylactic shock. Adjust β₂-agonist dose in treating patients w/ asthma. Treat heart failure decompensation before & during treatment. May aggravate moderate preexisting AV conduction disorder (possibly leading to AV block); peripheral arterial circulatory disorders symptoms. Administer concomitant α-blocker in patients suffering from phaeochoromocytoma. Gradually w/draw or give in lower doses if increasing bradycardia develops. Gradually w/draw dose at least 2 wk into half doses until final dose is ½ tab of 50 mg & give for at least 4 days before discontinuation. Inform anaesth of therapy prior to surgery. Avoid acute initiation of high-dose therapy to patients undergoing non-cardiac surgery; abrupt interruption of medication. May affect the ability to drive & use machines. Serious hepatic impairment. Perform maternofetal monitoring to pregnant women on treatment. Not to be given during pregnancy & lactation. May cause bradycardia in foetus, newborn & breastfed infant. Childn.

Fatigue. Bradycardia, postural disorders, cold hands & feet, palpitations; dizziness, headache; nausea, abdominal pain, diarrhoea, constipation; dyspnoea on exertion.

Increased plasma levels w/ antiarrhythmics, antihistamines, H₂-receptor antagonists, antidepressants, antipsychotics, COX-2 inhibitors; alcohol & hydralazine. Lowered plasma conc w/ rifampicin. Concomitant use w/ sympathetic ganglion blocking agents, other β-blockers (ie, eye drops), or MAOIs & clonidine. Possible negative inotropic & chronotropic effects w/ Ca antagonists (verapamil- & diltiazem-type) &/or antiarrhythmic agents. Enhanced negative inotropic & negative dromotropic effect of antiarrhythmic agents of quinidine-type & amiodarone. Increased AV conduction time & induced bradycardia w/ digitalis glycosides. Enhanced cardiodepressant effect w/ inhalation anaesth. Decreased antihypertensive effect in concomitant use w/ indomethacin or other prostaglandin synthetase inhibiting drugs.

Beta-Blockers

C07AB02 - metoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

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