Betalok Zok of the tab. of p/o of 50 mg No. 30

tablets "Betalok Zok" are applied at the following indications:

• arterial hypertension;
• stenocardia;
• stable symptomatic chronic heart failure with disturbance of systolic function of a left ventricle;
• prevention of warm death and a repeated heart attack after a sharp phase of a myocardial infarction;
• cardiac arrhythmias, including supraventricular tachycardia, decrease in frequency of reduction of ventricles at fibrillation of auricles and ventricular extrasystoles;
• functional disturbances of warm activity which are followed by heartbeat;
• prevention of migraine.

Structure

Active ingredient - metoprolol (one tablet contains 47.5 mg of a metoprolol of succinate that corresponds to 50 mg of a metoprolol of tartrate).

Excipients: ethyl cellulose, hydroxypropyl cellulose, a gipromelloza, cellulose microcrystalline, paraffin, a macrogoal, silicon dioxide colloidal anhydrous, the sodium stearylfumarating, the titan dioxide (E 171).

Contraindication

• cardiogenic shock;
• a sick sinus syndrome (in the absence of a constant pacemaker);
• blockade of II and III degree;
• heart failure in a decompensation stage (fluid lungs, hypoperfusion or arterial hypotension);
• long or periodic inotropic therapy directed to stimulation of beta receptors;
• symptomatic bradycardia or arterial hypotension;
metoprolol patients should not appoint
• with suspicion of an acute myocardial infarction at heart rate <45 blows / minutes, P-Q an interval> 0.24 seconds, systolic arterial blood pressure <100 mm of a mercury column; in the presence of symptoms of heart failure the condition of patients with the repeating indicators of arterial blood pressure lower than 100 mm of a mercury column in a prone position before an initiation of treatment needs to be estimated repeatedly;
• a serious disease of peripheral vessels with threat of gangrene;
• hypersensitivity to components of medicine or other beta-blockers.

"Betalok Zok" to apply

1 time a day, it is desirable in the morning. Tablets can be shared with the slowed-down release, but they should not be chewed or crumbled. Tablets should be washed down not less than 0.5 glasses of liquid. The concomitant use of food does not affect bioavailability of medicine.

Dose should be selected individually, in order to avoid development of bradycardia. It is recommended dosing which is provided below.

Arterial hypertension

50-100 mg of 1 times a day. If the dose of 100 mg is not enough for achievement of therapeutic effect, medicament can be combined with other antihypertensive medicines, it is desirable diuretics and antagonists of calcium of dihydropyridinic type, or to increase a medicament dose.

Stenocardia

100-200 mg of 1 times a day. In case of need "Betalok Zok" it is possible to combine with nitrates or to increase a dose.

Additional therapy at treatment by inhibitors of angiotensin-converting enzyme, diuretics and, perhaps, medicines of a foxglove of stable symptomatic heart failure

Patients have to have stable chronic heart failure without decompensation episodes within not less than 6 weeks and without significant changes of basic therapy within the last 2 weeks. Treatment of heart failure beta-blockers can lead to temporary deterioration in symptoms. In certain cases perhaps further continuation of therapy or reduction of a medicament dose, in some cases can be required medicament withdrawal. At patients with heavy heart failure (the IV functional class on classification of NYHA) there has to begin therapy with Betalok Zok medicine only the experienced expert.

Stable heart failure, the II functional class

Recommended initial medicament dose "Betalok Zok" in the first two weeks makes 25 mg of 1 times a day. After 2 weeks it is possible to increase a dose to 50 mg of 1 times a day, and further it is possible to double a dose each two weeks. The target medicament dose "Betalok Zok" for long-term treatment makes 200 mg of 1 times a day.

Stable heart failure, the III-IV functional class

Recommended initial dose makes 12.5 mg (half of a tablet of 25 mg) of 1 times a day. The medicament dose is adjusted individually. During increase in a dose the patient has to be under observation of the doctor as at some patients the symptoms of heart failure can worsen. After 1-2 weeks of administration of medicament "Betalok Zok" it is possible to increase a medicament dose to 25 mg of 1 times a day. In two weeks it is possible to increase a medicament dose to 50 mg of 1 times a day. Patients who well transfer high doses can double a dose each two weeks before achievement of the maximum dose of 200 mg a day.

in case of development of arterial hypotension and/or bradycardia the need to reduce a dose of the accompanying medicine or to reduce a medicament dose "Betalok Zok" can arise. Arterial hypotension at the beginning of therapy not necessarily indicates that the medicament dose "Betalok Zok" needs to be reduced. However the dose should be raised while the condition of the patient is not stabilized. Also careful control of function of kidneys can be required.

Cardiac arrhythmia

100-200 mg of 1 times a day. In case of need the dose can be increased.

Preventive treatment after a myocardial infarction

Recommended maintenance dose makes 200 mg of 1 times a day.

Functional disturbances of warm activity which are followed by heartbeat

100 mg of 1 times in day. In case of need the dose can be increased.

Prevention of migraine

100-200 mg of 1 times a day.

Feature of use

Pregnant

Drug "Betalok Zok" should not be used during pregnancy and feeding by a breast if the doctor does not consider that the advantage exceeds possible harm for the fruit/child.

Safety and efficiency of Betalok Zok medicine at children are not determined by

by the specified indications now yet.

Drivers

during treatment by Betalok Zok medicine dizziness and fatigue can arise. Patients whose activity is connected with attention tension, for example, driving and work with other mechanisms should be warned about possibility of such effects.

Overdose

Toxicity

At the adult the reception of a dose of 7.5 g became the cause of lethal intoxication. Reception of 100 mg of medicine by the 5-year-old child was not followed by intoxication symptoms after gastric lavage. Moderate intoxication was caused by a dose of 450 mg in the 12-year-old child and a dose of 1.4 g - in the adult, serious intoxication the dose caused 2.5 g in the adult, and a dose of 7.5 g - very serious intoxication.

Symptoms

Major are cardiovascular symptoms, however in certain cases, especially at children and persons of young age, symptoms from the central nervous system can prevail and respiratory depression. Bradycardia, blockade of the I-III degree, lengthening of an interval of QT (exceptional cases), asystolia, falling of arterial blood pressure, insufficient peripheral perfusion, heart failure, cardiogenic shock. Respiratory depression, apnoea. The first signs of overdose can be observed in 20 minutes - 2 hours after administration of drug.

Treatment is carried out by

in the conditions of the department capable to propose support measures, control and supervision.

Side effects

Side reactions are observed by

approximately at 10% of patients, usually they are dozozavisima. Side reactions are connected with use of a metoprolol.

from the central and peripheral nervous system: very often (≥ 1/10) - fatigue; often (from ≥ 1/100 to <1/10) - dizziness, a headache.

Cardiac disorders: often (from ≥ 1/100 to <1/10) - cold extremities, bradycardia, heart consciousness.

from a respiratory system: often (from ≥ 1/100 to <1/10) - an asthma at physical activity.

from digestive tract: often (from ≥ 1/100 to <1/10) - an abdominal pain, nausea, vomiting, diarrhea, a constipation.

Storage conditions

to Store

at a temperature not above 30 °C, out of children's reach.

Expiration date - 3 years.