Betalok

Betalok has antianginal, antiarrhythmic and antihypertensive effect.

[1], [2], [3]

Indications Betaloca

Tablets are used for such pathologies:

• increased blood pressure;
• heart rhythm disorder;
• disturbances of cardiac function, against which there is tachycardia ;
• angina pectoris.

As a component of combined treatment is used after a previous myocardial infarction, as well as with thyrotoxicosis. In addition, it can be used to prevent migraine attacks.

Use of the solution is assigned:

• with tachycardia;
• with ischemic lesion of the myocardium;
• at pains which arise at a myocardial infarction or presence of suspicion on its development.

In addition, the solution can be prescribed to prevent ischemic damage to the myocardium or tachycardia.

Release form

The release is carried out in the form of an injection liquid, and in tablets that contain 100 pieces in a bottle.

Pharmacodynamics

The component of metoprolol significantly reduces or completely eliminates the effect of catecholamines, resulting from strong physical, mental or emotional stress. Together with this, it moderately weakens myocardial contractility and heart rate. Also, the substance has an antihypertensive effect.

Betalok is able to slightly increase the values of TG and reduce the level of free fatty acids inside the blood serum. Sometimes there is also an insignificant decrease in the indices of high-density lipoproteins.

The use of the solution in the treatment of myocardial infarction helps to reduce the intensity of pain, and besides it helps to reduce the likelihood of ventricular fibrillation and atrial fibrillation. At an early stage, the infarction helps to limit the site of the lesion and prevents the spread of necrosis.

Pharmacokinetics

The solution undergoes propagation inside the body at high speed - within just a few minutes. The use of dosages not exceeding 20 mg leaves the pharmacokinetic parameters of the drug linear. Half-life is about 3-4 hours on average. The suction rate is 95%; the remainder of the drug is excreted unchanged.

[4]

Dosing and administration

Schemes of application of solution.

Injection liquid is allowed to be administered exclusively to a medical specialist with the necessary experience and skills, and also if there are all the necessary conditions for carrying out resuscitation procedures, if necessary.

In the treatment of paroxysmal tachycardia, the size of the initial portion is 5 mg (or 5 ml), which is administered at a rate of 1-2 mg / minute. It is required to administer the drug at intervals of 5 minutes, until the required effect is obtained (usually it takes about 10-15 mg of the substance). Do not use more than 20 mg of the drug.

To prevent or treat ischemic myocardial damage, as well as in the therapy of myocardial infarction and tachycardia, first inject 5 mg (or 5 ml) of medication with intervals lasting 2 minutes until the desired effect is achieved. Exceeding a dose of 15 mg is prohibited. 15 minutes after the end of the final injection, the treatment is continued with oral metoprolol (50 mg at intervals of 6 hours for 2 days).

Schemes of use of the tablet form of the preparation.

Tablets should be consumed orally, along with food or on an empty stomach. When administering tablets, the following dosing portions are usually used:

• increased indicators of blood pressure: taking 0.1-0.2 grams of medicine once in the morning (or split the dose into 2 uses - in the morning and then in the evening). If required, the portion is allowed to be increased or taken in addition to another antihypertensive agent;
• problems with the heart rhythm: requires the use of 0.1-0.2 grams of LS per day, which use two techniques (in the morning, and after the evening). If necessary, it is allowed to add one more antiarrhythmic agent;
• problems with cardiac function due to tachycardia: a single intake of 0.1 g per day (recommended in the morning). If necessary, it is allowed to increase the portion;
• thyrotoxicosis: intake of 0.15-0.2 g per day, 3-4 consumption;
• angina: daily use of 0.1-0.2 g, twice daily (morning and evening). If necessary, sometimes add another antianginal substance;
• supportive measures in people who have had myocardial infarction: daily use of 0.2 g of drugs, twice a day, in the morning, and then in the evening;
• prevention of migraine development: taking 0.1-0.2 g of the drug per day, in 2 uses (in the morning, and also in the evening).

[7], [8]

Use Betaloca during pregnancy

Use in pregnant women.

The medication can not be administered to pregnant women if the doctor evaluates the ratio of the benefits and risks of drug use to the second factor. Since β-blockers weaken the placental circulation, it can cause fetal death inside the womb, and besides this, the reason for the immaturity of development and premature onset of labor.

Like other β-blockers, the Betaloc injectable substance can have a negative effect on the fetus, the baby or the newborn (the most likely option is the development of hypoglycemia or bradycardia). There is also a high likelihood of development in the newborn complications affecting the lungs.

The injection liquid was injected under close monitoring after the 20th week of pregnancy - with the increase in blood pressure caused by it. But in this case, although the medicine passes through the placenta and is found inside the cord blood, it was not possible to detect any signs of a negative effect on the fetus.

Use in lactation.

Breastfeeding when using drugs is prohibited. Although the volumes of metoprolol penetrating into the mother's milk do not lead to a significant β-blocking effect on the baby, if the woman uses Betaloc in standard portions.

Contraindications

The main contraindications:

• the presence of hypersensitivity to the drug and other β-blockers;
• AV-blockade, which has a 2-3 degree of severity;
• Sinus type bradycardia, which has clinical significance;
• cardiogenic shock;
• Short's syndrome;
• decreased values of blood pressure;
• heart failure of decompensated nature;
• disorder of peripheral blood flow in pronounced form;
• myocardial infarction in the acute stage, against which a heart rate of 45 beats / minute and below is observed, which is less than 100 mm Hg. Systolic BP indices, and besides it has a duration of more than 0.24 seconds PQ-interval;
• peripheral vascular disease in severe degree (if there is a threat of gangrene development).

Along with this, this drug can not be used by people, at times or regularly using inotropes and β-adrenergic receptor stimulants.

Caution is required when appointing persons with AB-blockade of the first degree of severity, COPD, diabetes mellitus, kidney failure of severe nature and spontaneous angina.

In addition, the injectable substance can not be used to treat a supraventricular tachycardia if the blood pressure is less than 110 mmHg; tablets are prohibited for use in people who use inotropes for a long time during intermittent treatment (because they affect the activity of β-adrenergic receptors).

Side effects Betaloca

Emerging with the use of drugs, negative symptoms are usually curable and have a slight degree of severity.

During the tests, the following adverse events were identified:

• problems with the function of CCC: cold extremities, cardiogenic shock (in people with acute myocardial infarction), syncope, AV blockade of the first degree of severity and other various disorders of cardiac conduction, as well as increased heart rate;
• disorders in the work of the gastrointestinal tract: the appearance of diarrhea, abdominal pain, nausea, vomiting or constipation;
• disorders affecting the epidermis: hyperhidrosis and rashes;
• symptoms of metabolic processes: an increase in body fat;
• lesions affecting the central nervous system: headaches, impaired attention, increased fatigue, a feeling of drowsiness. In addition, paresthesia, dizziness, depression, insomnia or nightmares, and convulsions;
• problems with respiratory activity: bronchial spasms and development of dyspnea under physical loads.

Occasionally, there is increased nervous excitability, an arrhythmia, a feeling of depression or anxiety, gangrene, memory disorder, dry oral mucosa, impotence and hallucinations.

Individual people had problems with hepatic function, photosensitivity, alopecia, runny nose, hepatitis, exacerbation of psoriasis. In addition, there were problems such as conjunctivitis, visual disturbance, ear ringing, eye irritation, dysfunction of taste receptors, thrombocytopenia and arthralgia.

[5], [6]

Overdose

Use of the solution in a portion of 7.5 g can cause fatal poisoning. The use of portions equal to 1.4, as well as 2.5 g, led to a moderate and severe form of poisoning.

Intoxication can cause asystole, AV blockade of 1-3 degree of severity, weak peripheral perfusion, bradycardia, heart failure, significant lowering of blood pressure level and cardiogenic shock. In addition, there may be problems with respiratory function and apnea. Also, there is a breakdown and loss of consciousness, and besides this, severe fatigue. You can expect the development of vomiting, hyperhidrosis, tremors, spasms, hyper- or hypoglycemia, seizures, nausea, temporary myasthenic syndrome, hyperkalemia and paresthesias.

The first manifestations of intoxication are noted after the expiration of 20-120 minutes after the use of drugs.

To eliminate the violations use gastric lavage or the use of activated carbon. At the same time, symptomatic activities are performed. If required, appropriate pulmonary ventilation and intubation can be made, the level of BCC can be filled, ECG indicators monitored, atropine and glucose infusion introduced.

With oppression of the myocardium use dopamine or dobutamine. Glucagon can also be administered in a 50-150 μg / kg dose (IV method with administration every 60 seconds until the desired effect occurs). Sometimes adrenaline is also injected.

With the increase of the ventricular complex and arrhythmia, a sodium solution is used. The pacemaker can also be used.

To prevent the development of spasm of the bronchi, terbutaline is used. When cardiac arrest is stopped, resuscitation procedures are performed.

When poisoning with tablets, complications such as vomiting, sinus-type bradycardia, AV blockade, nausea, coma, bronchial spasm, cardiogenic shock, severe depression, heart failure or stopping, cyanosis, and mental disturbance occur.

Symptomatic measures are taken during therapy. Basically perform gastric lavage and prescribe the use of activated charcoal.

With a significant decrease in blood pressure, heart failure and bradycardia, β1-adrenoreceptor stimulants are used (at intervals of 3-5 minutes, until the effect is obtained). In addition, atropine sulfate, dopamine, sympatholytics (such as dobutamine with noradrenaline), as well as glucagon in a dose of 1-10 mg are used. A pacemaker can be used.

To eliminate bronchial spasm, intravenously injected stimulants of β2-adrenergic receptors.

Interactions with other drugs

When the drug is combined with MAOI, ganglion blockers, and in addition, agents that block the activity of β-receptors, it is required to closely monitor the patient's condition.

If, together with Betalok, clonidine is used in treatment, it is necessary to cancel the reception of the first one a few days earlier than the application of the latter.

In addition, the drug is not allowed to be combined with verapamil and other antiarrhythmic drugs, but also with barbiturates, calcium antagonists and propafenone.

Anesthetics of inhalation type in combination with Betaloc intensify the cardiodepressive effect.

Medications that slow down or induce metabolism have an effect on the plasma parameters of the drug. Its antihypertensive effect is weakened when combined with drugs that slow down the binding of PG.

[9], [10], [11]

Storage conditions

Betalok must be kept in a dark place, with temperature values not exceeding 25 ° C.

[12]

Shelf life

Betalok is allowed to be used within 5 years from the date of manufacture of the therapeutic drug.

[13]

Application for children

There is no data on the possibility of safe and effective use of medicines in children.

Analogues

Analogues of the drug are the drugs Azoprol Retard, Betaloc ZOK, Metocor with Vasocardinum, and in addition Metoprolol, Egilok Retard, Mtoprolola Tartrate with Corvitol and Metoprolol Zentiva.

Reviews

Betalok usually receives positive feedback - patients note a fairly high efficiency and good tolerability. But it must also be borne in mind that in some people there have been the appearance of such negative symptoms as feelings of irritability and weakness, as well as general deterioration of health.