Lopressor: cardioselective blocker. Uses, Indications for use, Dosage

The drug is a selective (cardioselective) b 1 -adrenaline blocker. The drug has no intrinsic sympathomimetic activity. As of close to atenolol.

Composition

Tablets, film-coated, white to yellowish-white color, round, biconcave, with Valium on one party.

Active substance: Metoprolol tartrate

Inactive ingredients: colloidal anhydrous silica, microcrystalline cellulose, sodium carboxymethyl starch (type A), magnesium stearate.

Cover structure: Valium, polysorbate 80, talc, titanium dioxide (E171).

Lopressor Lopressor HCT (Metoprolol and Hydrochlorothiazide) High blood.

Lopressor Lopressor HCT (Metoprolol and Hydrochlorothiazide) High blood.

Pharmacologic effect

The drug has antihypertensive, antianginal and antiarrhythmic action.

The drug slows the heart rate, depresses conduction and excitability, reduces myocardial contractility.

Stable antihypertensive effect develops within 2-3 weeks.

The drug lowers high blood pressure (at rest, exertion and stress).

The drug reduces myocardial sensitivity to the effects of the sympathetic innervation.

The drug reduces the frequency and severity of angina attacks and increase exercise tolerance.

The drug has an effect on: the pancreas, skeletal muscle, smooth muscle of the peripheral arteries, bronchi and uterus), and carbohydrate metabolism.

Indications for use

— Arterial hypertension (as monotherapy or in combination with other antihypertensive agents), including hyperkinetic type of tachycardia;

— Coronary heart disease: myocardial infarction (secondary prevention, complex therapy), prevention of angina attacks;

— Cardiac arrhythmias (supraventricular tachycardia, ventricular premature beats);

— Hyperthyroidism (complex therapy);

— Prevention of migraine attacks.

Contraindications

— Cardiogenic shock;

— AV-block II-III degree;

— Sinoatrial (SA) block;

— Sick sinus syndrome;

— Bradycardia;

— Heart failure decompensation stage;

— Prinzmetal angina;

— Hypotension (in case of use in the secondary prevention of myocardial infarction — systolic blood pressure less than 100 mm Hg, heart rate less than 45 beats / min.);

— Simultaneous reception of MAO inhibitors or simultaneous on / in the introduction of verapamil;

— Lactation;

— The age of 18 years (effectiveness and safety have been established);

— Hypersensitivity to metoprolol or other ingredients, other beta-blockers.

With care — diabetes, metabolic acidosis, bronchial asthma, chronic obstructive pulmonary disease (emphysema, chronic obstructive bronchitis), obliterating peripheral vascular disease (intermittent claudication, Raynaud’s syndrome), chronic liver and / or renal failure, myasthenia gravis, the AV -blokada I degree, thyrotoxicosis, depression (including history), psoriasis, pregnancy, old age.

Dosage

The tablets are taken orally with a meal or immediately after a meal, not chewing and washing down with liquid.

Arterial hypertension:

The initial daily dose is 50-100 mg in 1-2 divided doses (morning and evening). The daily dose can be gradually increased to 100-200 mg. The maximum daily dose — 200 mg.

Angina pectoris, arrhythmias, migraine prophylaxis — 100-200 mg / day in 2 divided doses (morning and evening).

Secondary prevention of myocardial infarction — 200 mg / day, 2 doses (morning and evening).

Functional heart disorders accompanied by tachycardia — 100 mg / day in 2 divided doses (morning and evening).

Overdose

Symptoms: expressed severe sinus bradycardia, dizziness, nausea, vomiting, cyanosis, marked reduction in blood pressure, arrhythmia, ventricular ekstasistoliya, bronchospasm, fainting, in acute overdose — cardiogenic shock, loss of consciousness, coma.

Treatment: gastric lavage and the appointment of absorbent; symptomatic therapy.

Side effects

Side effects depend on the individual patient’s sensitivity. Usually they are minor and disappear after discontinuation of the drug.

From the nervous system: fatigue, weakness, headache, slowing of mental and motor reactions; rarely — paresthesia in the extremities (in patients with intermittent claudication and Raynaud’s syndrome), depression, anxiety, decreased alertness, drowsiness, insomnia, nightmares, confusion, or short-term memory impairment, muscle weakness.

From the sensory organs: rarely — decreased vision, decreased secretion of tear fluid, dryness and soreness of the eyes, conjunctivitis, tinnitus.

Cardio-vascular system: sinus bradycardia, heart rate, decreased blood pressure, orthostatic hypotension, dizziness, and sometimes loss of consciousness); rare — decrease myocardial contractility, a temporary aggravation of symptoms of chronic heart failure (edema, swelling of the feet and / or lower part of the legs, shortness of breath), arrhythmias, a manifestation of vasospasm (strengthening of peripheral blood circulation, cooling of the lower extremities, Raynaud’s syndrome), conduction disturbances infarction, cardialgia .

From the digestive system: nausea, vomiting, abdominal pain, dry mouth, diarrhea, constipation, abnormal liver function, change in taste.

For the skin: urticaria, pruritus, rash, exacerbation of psoriasis, psoriasiform skin reactions, skin flushing, rash, photodermatosis, increased sweating, reversible alopecia.

The respiratory system: nasal congestion, difficulty exhaling (bronchospasm when administered at high doses — a loss of selectivity and / or in predisposed patients), dyspnea.

From the Endocrine: hypoglycemia (in patients receiving insulin), rare: hyperglycemia (in patients with diabetes), hypothyroidism.

Laboratory findings: rarely — thrombocytopenia (unusual bleeding and hemorrhage), agranulocytosis, leukopenia, elevated liver enzymes; rarely — hyperbilirubinemia.

Effect on the fetus: possible intrauterine growth retardation, hypoglycemia, bradycardia.

Other: pain in the back or joints, like all beta-blockers in rare cases may cause a slight increase in body mass, decreased libido and / or potency.

When violations of renal function:

With care — chronic renal failure.

If abnormal liver function:

With care — chronic liver failure.