Selomet 25 Tablet

Indications

ln the administration of hypertension and angina pectoris. Cardiac arrhythmias, particularly supraventricular tachyarrhythmias. Aide to the treatment of hyperthyroidism. Early intercession with Metoprolol in intense myocardial dead tissue diminishes infarct measure and the rate of ventricular fibrillation. Torment help may too diminish the require for sedative analgesics. Metoprolol has been appeared to decrease mortality when managed to patients with intense myocardial dead tissue.

Pharmacology

Metoprolol may be a particular beta1-blocker. Metoprolol diminishes or restrains the agonistic impact on the heart of catecholamines (which are discharged amid physical and mental stretch). This implies that the normal increment in heart rate, cardiac yield, cardiac contractility and blood weight, delivered by the intense increment in catecholamines, is diminished by Metoprolol. Metoprolol meddling less with Affront discharge and carbohydrate digestion system than do non-selective beta-blockers. Metoprolol meddling much less with the cardiovascular reaction to hypoglycaemia than do non-selective beta-blockers.

Dosage & Administration

Oral-

Hypertension: Total daily dosage Metoprolol 100-400 mg to be given as a single or twice daily dose. The starting dose is 100 mg (two Metoprolol-50 tablets) per day. This may be increased by 100 mg per day at weekly intervals. lf full control is not achieved using a single daily dose, a b.i.d. regimen should be initiated. Combination therapy with a diuretic or other anti-hypertensive agent may also be considered.

Angina: Usually Metoprolol 50 mg (one Metoprolol-50 tablet) to 100 mg (two Metoprolol-50 tablets) twice or three times daily.

Cardiac arrhythmias: Metoprolol 50 mg (one Metoprolol-50 tablet) b.i.d or t.i.d should usually control the condition. It necessary the dose can be increased up to 300 mg per day in divided doses. Following the treatment of an acute arrhythmia with Metoprolol injection, continuation therapy with Metoprolol tablets should be initiated 4-6 hours later. The initial oral dose should not exceed 50 mg t.i.d.

Hyperthyroidism: Metoprolol 50 mg (one Metoprolol-50 tablet) four times a day.The dose should be reduced as the euthyroid state is achieved.

Myocardial infarction: Orally, therapy should commence 15 minutes after the last injection with 50 mg every 6 hours for 48 hours. Patients who fail to tolerate the full intravenous dose should be given half the suggested oral dose. Maintenance – The usual maintenance dose is 200 mg daily given in divided doses. Elderly’ There are no special dosage requirements in otherwise healthy elderly patients. Signidcant hepatic dysfunction: A reduction in dosage may be necessary.

Injection-

Arrhythmias: By intravenous injection, up to 5 mg at a rate of 1-2 mg/minute, repeated after 5 minutes if necessary, total dose 10-15 mg.

In surgery: By slow intravenous injection 2-4 mg at induction or to control arrhythmias developing during anaesthesia; 2 mg doses may be repeated to a maximum of 10 mg.

Myocardial Infarction: Early intervention within 12 hours of infarction, by intravenous injection 5 mg every 2 minutes to a maximum of 15 mg, followed after 15 minutes by 50 mg by mouth every 6 hours for 48 hours; maintenance 200 mg daily in divided doses.

Impaired Renal Function: Dose adjustment is not needed in patients with impaired renal function.

Impaired Hepatic Function: Dose adjustment is not normally needed in patients suffering from liver cirrhosis because Metoprolol has low protein binding (5-10%). When there are signs of serious impairment of liver function (e.g. shunt-operated patients), a reduction in dose should be considered.

Elderly: Dose adjustment is not needed.

Interaction

Co-administration with CYP2D6-metabolized drugs, such as aspirin, can elevate the plasma level of metoprolol. Antiarrhythmics, antihistamines, H2 receptor antagonists, antidepressants, antipsychotics, and COX-2 inhibitors are only a few of the medications on the market. Rifampicin lowers the plasma concentration of Metoprolol.

Contraindications

AV block in the second or third degree, sick sinus syndrome, hypotension, decompensated heart failure, sinus bradycardia, severe peripheral arterial circulatory abnormalities, cardiogenic shock, severe asthma and bronchospasm, untreated phaeochromocytoma, Prinzmetal's angina, metabolic acidosis

Side Effects

Bradycardia, bronchospasm, hypotension, headache, weariness, sleep and gastrointestinal disorders, dizziness, vertigo, vision disturbances, and other symptoms are common.

Pregnancy & Lactation

Metoprolol should not be used during pregnancy or lactation unless the benefit surpasses the risk to the fetus or newborn, according to the doctor.

Precautions & Warnings

If the heart rate is less than 40 beats per minute, the P-R interval is greater than 0.26 seconds, and the systolic blood pressure is less than 90 mmHg, or if dyspnoea or cold sweating worsens, the second or third dose should be avoided. Calcium antagonists of the Verapamil type should not be given intravenously to individuals who are on beta-blockers. The patient's haemodynamic condition should be closely evaluated after each of the three 5 mg intravenous doses for treating patients with suspected or confirmed myocardial infarction. Pregnancy and Breastfeeding: Metoprolol should not be used during pregnancy or lactation unless it is regarded absolutely necessary. Beta-blockers, like all antihypertensive drugs, can induce negative effects in the fetus, newborn, and breast-fed infant (e.g. bradycardia). When the mother is treated with Metoprolol doses within the typical therapeutic range, the amount of Metoprolol eaten via breast-milk appears to be minimal in terms of beta-blocking impact in the newborn.

Therapeutic Class

Beta-blockers are medications that inhibit the beta-adrenoceptor.

Storage Conditions

Store in a cold, dry, and light-protected location. Keep out of children's reach.

Pharmaceutical Name

Unimed Unihealth Pharmaceuticals Ltd