Metoprolol retard. 200 mg. 30 tablets
- Coronary artery disease
- Hyperkinetic heart syndrome
- Intense or long-term treatment after myocardial infarction (prevention of re-infarction)
- Prophylactic migraine.
Metoprolol retard. 200 mg. 30 tablets
Active substance : Metoprolol tartrate
Each modified-release tablet contains ; Active substance : metoprolol tartrate, 200 mg;
Excipients : ammoniomethacrylate copolymer, lactose monohydrate, macrogol 4000 , magnesium stearate, maize starch, methylhydroxypropylcellulose, colloidal anhydrous silica, talc, dyestuff E 171 .
Pharmacological group and packaging:
Original package with 50 modified-release tablets Original package with 100 modified-release tablets
Drug blocking beta receptors ( beta-blockers )
- High blood pressure
- Coronary artery disease
- Hyperkinetic heart syndrome
- Intense or long-term treatment after myocardial infarction (prevention of re-infarction )
- Prophylactic migraine
When you should not use Metoprolol Stada 200 retard? Metoprolol Stada 200 retard should not be used in :
- Second or third degree AB block
- Sinus syndrome
- Disorders of the sino-atrial cardiac impulse conduction ( block CA - ) ,
- Manifest myocardial insufficiency
- Bradycardia ( heart rate below 50 beats per minute before treatment )
- Hypotension (systolic blood pressure less than 90 mm Hg ) ,
- Increased acidity of the blood ( acidosis )
- Advanced forms of interference in the peripheral arterial circulation
- Bronchial hyperactivity (e.g., bronchial asthma ) ,
- Enovremenno treatment with MAO inhibitors ( except MAO -p ) inhibitors ,
- Proven hypersensitivity to Metoprolol Stada 200 retard or other beta blockers .
Intravenous calcium antagonists of the verapamil or diltiazem type or other antiarrhythmics (such as disopyramide ) are contraindicated in patients treated with Metoprolol Stada 200 retard ( except under conditions of special surveillance ) .
When should you use Metoprolol Stada 200 retard only after consultation with your doctor ?
Under the following conditions Metoprolol Stada 200 retard should be used with caution. Discuss with your doctor also if you have suffered any of these predi.Metoprolol Stada 200 retard should be used with caution in :
patients with first degree AB block
- Diabetics with a strong instability of blood glucose concentrations (due to risk of severe hypoglycaemic attack )
- Patients on a strict diet for long periods of time and those exposed to heavy physical exertion (due to risk of severe hypoglycaemic attack )
- Patients with pheochromocytoma ( hormone - secreting tumors of the medullary portion of the adrenal gland ), Metoprolol Stada 200 retard in these cases can only be used after prior treatment with alpha -blockers
- Patients with abnormal liver function .
In patients with hereditary or already developed psoriasis beta blockers are prescribed only after careful consideration of the anticipated benefits against potential riskove.Betablokerite may enhance susceptibility to allergens and the severity of anaphylactic reactions. Therefore, they should be used only if they are indispensable in patients with a predisposition to severe hypersensitivity reactions and those receiving specific anti-allergic drugs ( due to risk of excessive anaphylactic reactions) .
What you should know if you are pregnant or breastfeeding ?
Metoprolol Stada 200 retard should not be administered during pregnancy ( especially during the first 3 months) only under strict indications and rigorous assessment of the expected benefits against the potential risks.
There is evidence to suggest that metoprolol reduced placental perfusion and therefore may impair fetal growth . The use of other beta-blockers was associated with miscarriage , premature birth and fetal death intramatochna . Treatment with metoprolol should be discontinued 48-72 hours before the estimated date of birth, because the drug can cause bradycardia , hypotension and hypoglycemia in the newborn . If this is not possible, the newborn should be monitored closely during the first 48-72 hours after razhdaneto.Metoprololat is excreted in breast milk at levels similar to maternal serum levels . Infants should be monitored for signs of beta- blockade. The amount of metoprolol, taken with milk may be reduced by breast-feeding after 3-4 hours after taking this medicine.
Precautions for use :
In case of severe hepatic dysfunction elimination of Metoprolol Stada 200 retard delayed and therefore the dose should be namalena.Tay as warning signs of reduced concentration in blood sugar may be masked , need regular blood- sugar.
Wearing contact lenses should be taken into account the reduction of tear fluid from patients with severe renal failure in some cases have been reported worsening of renal function during treatment with beta-blockers . Therefore, treatment with Metoprolol Stada 200 retard should be accompanied by careful monitoring of renal function.
Interruption or change of treatment is only allowed as medical advice . If treatment with Metoprolol Stada 200 retard should be interrupted or discontinued after prolonged use , it should be done slowly because abrupt withdrawal can lead to cardiac ischemia by provoking angina pectoris ( angina ) , heart attack or high blood pressure .
What you should consider when driving , operating machinery or working on unstable platforms ?
Patients taking this drug should be under constant medical supervision. Individually different reactions can alter attention to such an extent as to impair the ability to actively participate in road traffic, operating machinery or working on unstable platforms . This applies more prominently at the beginning of treatment , an increase in dose or abrupt change of treatment , and the concomitant use of alcohol.
Which drugs interfere with the action of Metoprolol Stada 200 retard or reverse ? With concomitant Metoprolol Stada 200 retard with insulin or oral antidiabetic agents , the effect of the past can be enhanced by mask or dilute the symptoms of low concentration of blood sugar (hypoglycaemia ) , increased heart rate (tachycardia) , especially tremor . Hence the need for regular monitoring of blood sugar levels . Concurrent use of Metoprolol Stada 200 retard and tricyclic antidepressants , barbiturates, phenothiazines, glyceryl , diuretics, vasodilators , and other antihypertensive drugs can cause a severe drop in blood pressure.
Concomitant Metoprolol Stada 200 retard with calcium channel blockers such as nifedipine can cause rapid drop in blood pressure and, in isolated cases - developing heart ??????????????.?????????????????? action Metoprolol Stada 200 retard and that of antiarrhythmic drugs may be superimposed .
Patients taking concomitant Metoprolol Stada 200 retard and calcium channel blockers of the verapamil or diltiatsema atniaritmichni or other means (such as disopyramide ) should be carefully monitored because there is a risk of hypotension , bradycardia or heart rhythm disorders .
Intravenous treatment with calcium channel blockers of the verapamil or diltiatsema atniaritmichni and other intravenous drugs ( such as disopyramide ) is contraindicated in patients treated with Metoprolol Stada 200 retard ( except in intensive care mode ) .
Co-administration of Metoprolol Stada 200 retard and cardiac glycosides , reserpine , alpha -methyldopa , clonidine, guanfacine or clonidine can cause severe reductions in cardiac rhythm or conduction delays cardiac impulse .
Venzapnoto discontinuation of use of clonidine during concomitant Metoprolol Stada 200 retard may lead to an excessive increase in blood pressure. Therefore, when clonidine was given concomitantly with Metoprolol Stada 200 retard, should not be interrupted until the administration of metoprolol was not stopped a few days before. Only then clonidine mine is progressively reduced to discontinuation ( see prescribing information for clonidine ) . Concurrent use of Metoprolol Stada 200 retard with noradrenaline , adrenaline or other sympathomimetics (eg, constituting the preparations cough , nasal drops, or eye ) , can cause a significant increase in blood pressure. Patients treated with 200 Metoprolol Stada retard can react less dose of epinephrine commonly used in the treatment of allergic reactions. MAOIs should not be used concomitantly with Metoprolol Stada 200 retard because of the risk of excessive increase in blood nalyagane.Indometatsinat and rifampicin may reduce the antihypertensive effect of Metoprolol Stada 200 retard.
Cimetidine may increase the plasma concentration of Metoprolol Stada 200 retard. Metoprololat may reduce the excretion of other drugs (eg, lidocaine ) . Concurrent use of Metoprolol Stada 200 retard and drugs / analgesics may cause very low blood pressure. Negative inotropic effects of these drugs can be naslozhat.Nervnomuskulnata blockade of peripheral muscle relaxants (eg, succinylcholine halide, tubocurarine) can be enhanced by inhibition of beta- receptors of Metoprolol Stada 200 retard.
If Metoprolol Stada 200 retard can not be stopped before procedures requiring general anesthesia or prior use of peripheral muscle relaxants, anasteziologyt must be informed of its use.
Note that this information applies to recently used drugs.
Dose , route and duration of administration :
The instructions below apply if the doctor has prescribed otherwise. Please observe them for effective and safe treatment with Metoprolol Stada 200 retard. How many tablets Metoprolol Stada 200 retard and how often should you take ? The dosage should be individually adjusted, mainly by treatment outcome and should not be changed without advice . If the doctor advises otherwise , it is recommended that the following dosage:
- Hypertension :
1/2 modified-release tablet Metoprolol Stada 200 retard once daily ( equivalent to 100 mg of metoprolol tartrate per day).
- Coronary artery disease :
½ - L tablet Metoprolol Stada 200 retard or 1/2-1 daily modified-release tablet once daily ( equivalent to 100-200 mg daily metoprolol tartrate ) .
- Hyperkinetic heart syndrome:
1/2 modified-release tablet Metoprolol Stada 200 retard once daily ( equivalent to 100-200 mg daily metoprolol tartrate ) .
Tachycardia arrhythmias : 34-1 modified-release tablet Metoprolol Stada 200 retard once daily ( equivalent to 100-200 mg daily metoprolol tartrate ) .
- Long-term treatment after myocardial infarction (prevention of re-infarction ):
Metoprolol Stada 200 retard is used in patients who are not contraindicated treatment with beta-blockers . After the acute phase of myocardial infarction patients should receive a maintenance dose of 1/1-1 modified-release tablet Metoprolol Stada 200 retard once daily (equivalent to 100-200 mg daily metoprolol tartrate ) . In the event that the heart rate and / or blood pressure is reduced so much that require therapeutic intervention or in the case of other complications , treatment with 200 Metoprolol Stada retard must be stopped immediately .
- Preventive migraine :
14-1 modified-release tablet Metoprolol Stada 200 retard once daily (equivalent to 100-200 mg daily metoprolol tartrate ) .
In patients with severe impairment of liver function , eliminating Metoprolol Stada 200 retard delayed and therefore the dosage should be reduced.
How and when should I take Metoprolol Stada 200 retard?
Modified-release tablets should be swallowed whole with a sufficient quantity of water after meals.
How to share Metoprolol Stada 200 retard?
Put the tablet Metoprolol Stada 200 retard on a hard surface with the groove up . Press your thumb on top and the tablet will break into two equal pieces.
How long should I take Metoprolol Stada 200 retard?
The duration of treatment should be determined by your doctor.
Overdose and other errors in the application :
What should you do in case of an overdose ( intentional or unintentional ) of Metoprolol Stada 200 retard?
In case of overdose , please contact your doctor immediately . Depending on overdose may cause severe hypotension , bradycardia, to the point of cardiac arrest, heart failure and cardiogenic shock. Other signs of overdose may include difficulty breathing , bronchospasm , vomiting, clouding of consciousness , and in isolated cases - generalized seizures .
In case of overdose or very slow heart rate, hypotension or treatment with Metoprolol Stada 200 retard should be stopped .
What should you do if you take more than the prescribed dose or you miss a dose ?
Continue with Metoprolol Stada 200 retard as prescribed and do not take a double dose after dose.
What should you do if you interrupt or stop treatment prematurely ?
Treatment with Metoprolol Stada 200 retard may be interrupted or suspended only in medical instruction. Abrupt stopping can cause myocardial ischemia by exacerbation of angina ( angina ) , myocardial infarction , or an increase in blood pressure .
Undesirable effects :
Especially at the beginning of treatment there were isolated reports of disturbances in the central nervous system such as fatigue, dizziness , depression , dizziness, confusion, headache , sweating , nightmares or abnormal increased activity of dreaming , sleep disturbances and hallucinations . These side effects are usually mild and transient.
In rare cases have been reported gastrointestinal symptoms , including nausea , vomiting , abdominal pain, constipation or diarrhea, which are also transient. Sometimes you may experience dyspnea exertional, and rarely - bronchospasm (see Contraindications ) .
There are isolated reports of paresthesia and a feeling of cooling of the extremities and less muscle weakness or muscle cramps.
There have been isolated reports of aggravated symptoms in patients with intermittent claudication and impaired peripheral circulation ( including patients with Raynaud's syndrome ) . There was rarely reported lower blood pressure such as when rising from a lying position (orthostatic hypotension ), sometimes with loss of consciousness, syncope , palpitations , bradycardia, atrioventricular conduction disturbances , exacerbation of myocardial failure with peripheral edema and / or dyspnea on exertion .
In patients with angina pectoris may not be excluded that the deterioration of these attacks , observed in individual cases .
Patients with bronhoslastichna disease ( especially those with obstructive airway disease ) can obtain apnea, because this drug increases airway resistance .
There have been rare reports of dry mouth, conjunctivitis or reduced tear secretion (to be considered in patients wearing contact lenses) and isolated reports of disturbances in zrenieto.Metoprolol Stada 200 retard may mask the symptoms of thyrotoxicosis . There have been rare reports of " unlock " latent diabetes or worsening of the symptoms one. Patients complying with the absolute diet long period of time and those subject to large physical stress can obtain hypoglycaemia if used at the same time 200 Metoprolol Stada retard. The warning signs of hypoglycemia ( in particular tachycardia and tremor) may be masked . In isolated cases there have been reports of decreased libido and impotence . There were also isolated reports of hair loss, hearing impairment and tinnitus , weight gain, personality changes (eg, emotional lability, short term memory loss ), thrombocytopenia (reduced platelet count ) or leukopenia ( decrease in white blood cells ) , allergic rhinitis or disease Peyroni.Imalo is occasionally reported allergic skin reactions ( erythema , pruritus , exanthema , photosensitivity ) .
Treatment with Metoprolol Stada retard 200 may be associated with a disruption of the lipid metabolism . While total cholesterol was generally normal , HDL- cholesterol was reduced and plasma triglycerides were elevated . Prolonged use of Metoprolol Stada 200 retard in isolated cases has been associated with arthropathy (affecting one or more joints) . There were isolated reports of elevations of serum transaminases (GOT, GPT) or hepatitis.
Cautionary Notes :
Beta-blockers in isolated cases may provoke or worsen psoriasis or induce psoriasiform skin rashes.
Beta-blockers may enhance susceptibility to allergens and the severity of anaphylactic reactions. Patients with a history of severe hypersensitivity reactions and those of specific immunotherapy / desensitization can get excessively strong anaphylactic reaktsii.Ako get any side effects not listed in this leaflet, make sure your doctor or pharmacist.
Shelf life and storage instructions :
The deadline date is printed on the box.
Do not use after this date.
Keep at polecat , +25 ° C.
Keep all medicines out of reach of children!