Instruction for use: Metocard

Trade name of the drug – Metocard

Dosage Form: tablets

Active substance: Metoprololum

ATX

C07AB02 Metoprolol

Pharmacotherapeutic group: Beta-blockers

The nosological classification (ICD-10)

I10 Essential (primary) hypertension: hypertension; Arterial hypertension; Arterial hypertension crisis course; Essential Hypertension; Essential hypertension; Essential hypertension; Essential hypertension; Essential hypertension; Primary hypertension; Arterial hypertension, complications of diabetes; The sudden increase in blood pressure; Hypertensive disorders of blood circulation; hypertensive condition; hypertensive crises; arterial Hypertension; malignant Hypertension; Hypertonic disease; hypertensive crises; accelerated hypertension; malignant hypertension; The aggravation of hypertensive disease; Transient hypertension; Isolated systolic hypertension

I15 Secondary hypertension: Arterial hypertension, complications of diabetes; hypertension; The sudden increase in blood pressure; Hypertensive disorders of blood circulation; hypertensive condition; hypertensive crises; hypertension; arterial Hypertension; malignant Hypertension; hypertensive crises; accelerated hypertension; malignant hypertension; The aggravation of hypertensive disease; Transient hypertension; hypertension; Arterial hypertension; Arterial hypertension crisis course; renovascular hypertension; Hypertension symptomatic; Renal hypertension; Renovascular hypertension; renovascular hypertension; Symptomatic hypertension

I20 Angina [angina]: Heberden disease; Angina pectoris; The attack of angina pectoris; recurrent angina; Spontaneous angina; Stable angina pectoris; Angina rest; Angina progressing; Angina mixed; Angina spontaneous; stable angina; Chronic stable angina; Angina Syndrome X

I47.1 Supraventricular tachycardia: Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmia; supraventricular tachycardia; Supraventricular arrhythmias; Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmias; supraventricular tachycardia; Neurogenic sinus tachycardia; orthodromic tachycardia; Paroxysmal supraventricular tachycardia; Paroxysm of supraventricular tachycardia; Paroxysm of supraventricular tachycardia with WPW-syndrome; Paroxysm of atrial tachycardia; Paroxysmal supraventricular tachyarrhythmia; Paroxysmal supraventricular tachycardia; Politopnye atrial tachycardia; Atrial fibrillation; Atrial tachycardia is true; Atrial tachycardia; Atrial tachycardia with AV block; reperfusion arrhythmias; Reflex Bertsolda-Jarisch; Recurrent sustained supraventricular paroxysmal tachycardia; Symptomatic ventricular tachycardia; Sinus tachycardia; Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmia; supraventricular tachycardia; supraventricular arrhythmia; supraventricular arrhythmias; Tachycardia of AV connections; supraventricular tachycardia; Tachycardia orthodromic; sinus tachycardia; The nodal tachycardia; Chaotic atrial tachycardia politopnye; Wolff-Parkinson-White

I49.4 Other and unspecified premature depolarization: extrasystole arrhythmia; extrasystole; extrasystole unspecified

I49.9 Irregular heartbeat, unspecified: Paroxysmal supraventricular tachycardia; extrasystole arrhythmia; Atrial fibrillation tachysystolic; supraventricular tachyarrhythmia; supraventricular arrhythmias; AV reciprocating tachycardia; AV-nodal reciprocating tachycardia; ventricular fibrillation; Irregular heartbeat; Antidromic reciprocating tachycardia; Cardiac arrhythmias; Arrhythmias; Arrhythmia; Heart arythmy; Arrhythmia due to hypokalemia; ventricular tachyarrhythmias; The high frequency of ventricular contraction; Cardiac arrhythmias; Paroxysmal supraventricular arrhythmia; Paroxysmal supraventricular arrhythmia; Paroxysmal dysrhythmia; Paroxysmal atrial-ventricular rhythm; cardiac arrhythmias; supraventricular tachycardia; tachyarrhythmia; Precordial abnormal pulsation

Composition (per tablet): metoprolol tartrate 50 mg 100 mg

Excipients: lactose; PVP; magnesium stearate; carboxymethylcellulose; rice starch

In blisters of 10 pcs .; in a stack of cardboard 3 packaging.

Pharmacological Properties of Metocard

Pharmachologic effect - antianginal, antihypertensive, anti-arrhythmic.

Selectively blocking beta1-adrenergic receptors, it inhibits the action of endogenous catecholamines, inhibits the activity of the renin-angiotensin system.

Pharmacodynamics

It reduces cardiac output and heart. It depresses the central sympathetic impulses. It has no membrane stabilizing action, and has no intrinsic sympathomimetic activity.

Pharmacokinetics

Quickly and almost completely absorbed from the gastrointestinal tract. Cmax and Tmax Metokard when receiving 100 mg or retard Metokard constitute 99,4 ± 33 ng / ml and 1.58 ± 0.55 hours, or 152.9 ± 72.8 ng / ml and 2.75 ± 0.87 hours . protein binding - 11-12%. It is metabolized in the liver, T1 / 2 -. 3.5 hours Excreted in the kidney (95%). It passes through the placenta.

Indications for Metocard

Hypertension, angina pectoris (prevention of attacks), cardiac arrhythmias, including supraventricular tachycardia, arrhythmia (except Metocard retard).

Contraindications for Metocard

Hypersensitivity, AV block II and III degree, congestive heart failure, sinus block, bradycardia, hypotension, congestive heart failure IIB-III stage, cardiogenic shock, late stage and severe peripheral circulatory disorders, co-administration of MAO inhibitors, intravenous calcium channel blockers (verapamil, diltiazem) or others. antiarrhythmics (disopyramide), breast-feeding.

Pregnancy and breast-feeding

Perhaps during pregnancy if the expected effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Side effect of Metocard

From the nervous system and sensory organs: headache, dizziness, nightmares, insomnia, depression, short-term amnesia, disorientation, paresthesia; blurred vision, dry eyes, tinnitus.

Cardio-vascular system and blood (blood, hemostasis): bradycardia, palpitations, hypotension, disturbance of AV conduction, circulatory failure, thrombocytopenia, agranulocytosis.

From the respiratory system: bronchospasm, dyspnea.

From the digestive tract: dry mouth, heartburn, bloating, stomach pain, vomiting, constipation / diarrhea.

Allergic reactions: itching, rash, psoriatic skin changes.

Other: Peyronie's disease, myalgia, alopecia.

Interaction

Enhances hypoglycemic effect of insulin and oral antidiabetic drugs, cardiodepressivny effect of anesthetic and antiarrhythmic agents, deprimiruyuschie - alcohol. Cimetidine increases the concentration in the blood, rifampicin - lowers. Cardiac glycosides increase the likelihood of bradycardia, reserpine, verapamil and other calcium antagonists, -. Cardiac arrhythmias and hypotension, ergotamine derivatives - disorders of the peripheral circulation.

Dosage and Administration

The inside is not liquid, squeezed small amounts of liquid.

Arterial hypertension - 50 mg 2 times a day; after a week if necessary to increase the dose of 200 mg / day (Table 2. 100 mg). In the absence of a positive therapeutic result may use the drug in combination with other antihypertensive or diuretic agents.

Angina - 50-100 mg 2-3 times a day, if necessary, may increase the dose to 400 mg / day.

When arrhythmias - 50 mg 2-3 times a day.

In the treatment of elderly patients should be cautious (basically dose adjustment is not required).

The maximum dose - 400 mg / day.

Overdose

Symptoms: increased severity of side effects.

Treatment: symptomatic therapy; if necessary, atropine sulfate (2.1 mgintravenously ), isoprenaline sulphate (intravenously slow).

Precautionary measures

To use caution in diabetes, peripheral circulatory disorders, including Raynaud's syndrome, pheochromocytoma, severe violations of the kidneys and liver, bronchial asthma, obstructive bronchitis, hyperthyroidism, prolonged fasting, acidosis, patients in the elderly. It should refrain from the use Metokarda retard in pediatric patients (safety and effectiveness are not determined). It is necessary to cancel 48-72 hours before delivery (development of bradycardia and hypotension in the newborn). Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention.

Storage conditions of Metocard

In a dry, dark place at a temperature no higher than 25 ° C.

Keep out of the reach of children.

Shelf life

3 years.

Do not use beyond the expiration date printed on the package.