Betazok 95 mg

HTN. Angina pectoris. Symptomatic mild to severe chronic heart failure as an adjunct to other heart failure therapy. Disturbances of cardiac rhythm including supraventricular tachycardia. Maintenance treatment after MI. Functional heart disorders w/ palpitations. Migraine prophylaxis.

Mild to moderate HTN Adult 50 mg once daily, may be increased to 100-200 mg once daily &/or combined w/ other anti-hypertensive agents. Adolescent & childn ≥6 yr Initially 1 mg/kg once daily, may be increased to a max daily dose of 2 mg/kg not exceeding 50 mg once daily. Angina pectoris 100-200 mg once daily. May be combined w/ other anti-anginal agents if needed. Cardiac arrhythmias 100-200 mg once daily. Maintenance treatment after MI 200 mg once daily. Functional heart disorders w/ palpitations 100 mg once daily, may be increased to 200 mg if needed. Migraine prophylaxis 100-200 mg once daily. Chronic heart failure Initially 25 mg once daily during the 1st 2 wk. Patient w/ NYHA III-IV Initially ½ of 25 mg tab once daily in the 1st wk, doubled every 2nd wk up to max target dose of 200 mg once daily (or to the highest tolerated dose).

May be taken with or without food: Swallow whole w/ liqd, do not chew/crush. May be halved along the score-line, but the divided halves should not be chewed/crushed.

Hypersensitivity to metoprolol or other β-blockers. 2nd or 3rd degree AV block, unstable decompensated cardiac failure (pulmonary oedema, hypoperfusion or hypotension), continuous/intermittent inotropic therapy acting through β-receptor agonism, clinically relevant sinus bradycardia, sick-sinus syndrome, cardiogenic shock, severe peripheral arterial circulatory disorder. Patients w/ suspected acute MI w/ heart rate <45 beats/min, P-Q interval >0.24 sec, or systolic BP <100 mmHg.

Should not be given w/ IV verapamil-type Ca antagonists. Dosage of β₂-agonists in asthma patients may require adjustment (increase) when treatment w/ metoprolol CR is started. Risk of interfering w/ carbohydrate metabolism or masking hypoglycemia. May aggravate pre-existing AV conduction disorder of moderate degree & symptoms of peripheral arterial circulatory disorders. α-blocker should be given concomitantly for patients w/ pheochromocytoma. Lower doses or gradually w/draw therapy if increasing bradycardia develops. Avoid abrupt w/drawal. Gradually discontinue treatment over at least 2 wk reducing dose by ½ in each step down to the final step when a whole 25 mg tab is reduced to a ½ tab; final dose should be taken for at least 4 days before discontinuation. Do not stop treatment in patients undergoing surgery. Avoid acute initiation of high doses to patients undergoing non-cardiac surgery. Risk of a more severe form of anaphylactic shock. Occasional dizziness or fatigue may occur which may impair ability to drive or use machines. Should not be given during pregnancy & lactation unless considered essential. Efficacy & safety in childn <6 yr have not been studied.

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

Increased plasma levels w/ CYP2D6 substrates eg, antiarrhythmics, antihistamines, H₂-receptor antagonists, antidepressants, antipsychotics, & COX-2-inhibitors; alcohol & hydralazine. Lowered plasma conc w/ rifampicin. Closely monitor w/ concomitant sympathetic ganglion blocking agents, other β-blockers (ie, eye drops), MAOIs. If concomitant clonidine is to be discontinued, β-blocker should be w/drawn several days before clonidine. Increased -ve inotropic & chronotropic effects w/ Ca antagonists of the verapamil & diltiazem type. May enhance -ve inotropic & dromotropic effect of antiarrhythmic agents of the quinidine type & amiodarone. May increase AV conduction time & induce bradycardia w/ digitalis glycosides. Enhanced cardiodepressant effect w/ inhalation anaesth. Decreased anti-hypertensive effect w/ indomethacin or other prostaglandin synthetase inhibiting drugs. When administered w/ adrenaline, cardioselective β-blockers interfere much less w/ BP control than non-selective β-blockers. Dosages of oral antidiabetics may have to be readjusted.

Beta-Blockers

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

Rx