Metoperolol Akrichin Instructions for use. Metoprolol Akrichin Instructions for applying indications for the use of metoprolol retard

If the attending physician prescribed a tablet comprising a metoprolol substance, it is worth checking the manufacturer of the drug. The price and quality may depend on it. Akrichin is a manufacturer of funds from a group of beta blockers.

His drug metoprolol Akrichin aims to treat hypertension by reducing arterial pressure, pulse frequency to the desired value. When deciding to buy this medicine, it is worth familiar with the instructions for use to clarify contraindications and side Effects In case, not all nuances of the health status have been reported to the doctor.

Metoprolol Akrichin - Description of the drug

Metoprolol Akrichin - This is a drug from the group of beta blockers to reduce blood pressure and solving heart problems. Akrichin is a manufacturer of a drug contained in tablets in a certain dose.

Because of the manufacturer, the price of metoprolol can differ significantly. If the doctor discharges a recipe for metoprolol, it is worth clarifying the manufacturer and their interchangeability.

Medicinal properties:

• antiarrhythmicity;
• antianginality;
• nipotenziness.

There are reviews that the multi-year metoprolol reception rate can lead to a decrease in blood cholesterol.

Composition and pharmacology

The main substance that is part of the tablet - metoprolol. In one tablet it contains 50 mg, the remaining components are auxiliary:

• lactose;
• potato starch;
• silicon dioxide colloid;
• magnesium stearate;
• povidone;
• sodium glycolat starch.

Tablets are available in blisters packed in a cardboard box of 10 or 30 pieces. The shape of the tablets are round with rounded edges, the color of the product from white and gray to yellowish.

Metoprolol acryer testimony for use

Take Metoprolol Akrinin is under heart disease and pressure problems. These are the main indications for the use of the medication. In the application instructions, more indications are indicated to which the drug effect is aimed.

Full list Indications for use from the instructions:

• arterial hypertension;
• ischemic disease hearts;
• prevention of angina;
• tachycardia or other diseases associated with impaired heart rhythm;
• hyperthyroidism B. complex treatment;
• migraine Prevention.

The drug result of metoprolol acrycine can be achieved in a complex with other medicines or a course of only these tablets.

Instructions for use

Metoprolol Akrichin, instructions for use of tablets is attached to the medicine, it is necessary to appoint a doctor in the specified dosage.

Tablets need to be taken:

• in the process or immediately after the cessation of food intake;
• do not chew;
• squeeze with a small amount of fluid.

With high arterial pressure, heart disease doctor may indicate to take 1-2 tablet 2 times a day:

• in the morning;
• in the evening.

If the drug effect is not achieved with such a dosage, it can be gradually increased by 2 times. The maximum dose of the substance per day must be no more than 200 mg.

If the patient has problems in the functioning of the kidneys, the dose of the drug must be reduced.

Contraindications and side effects

Metoprolol Akrichin has a sufficient list of contraindications with which it is worth familiar with the instructions for use. The doctor, prescribing the medicine, is based on the facts known to him. Before applying tablets, you need to make sure that the doctor is aware of all the ailments and allergies that are associated with the patient's body.

In order for the use of tablets to bring the desired drug result, you need to read the instructions for the use of medication, find out if there are no contraindications to the admission of medication, and also consider the list side effects.

Contraindications for reception medication:

• sinus node weakness syndrome;
• synoyatrial blockade;
• obvious bradycardia;
• cardiogenic shock;
• angina printela;
• chronic heart failure in the decompensation stage;
• after myocardial infarction with systolic blood pressure below 100 mm Hg. and pulse 45 shots per minute;
• lactation period;
• personal intolerance of the incoming components into the drug.

Take Metoprolol Akrichin to children under 18 undesirable due to the insufficient number of safe reception experiments, the facts of positive drug Effect.

Medical personnel Can use medicine with caution when:

• diabetes;
• bronchial asthma;
• lung diseases;
• chronic hepatic and / or renal failure;
• thyrotoxicosis;
• depression;
• psoriasis;
• pregnancy;
• elderly age.

Side effects may occur in different areas The functioning of the body.
There may be violations in the work of the central nervous system as side effect of metoprolol Acricin:

Fast fatiguability;
headache;
reduction of mental and motor reaction;
depression;
anxiety;
insomnia;
nightmares;
memory problems;
Muscular weakness.

The influence on the senses is reflected in:

• reduce vision;
• reducing the tear fluid
• feeling dryness in the eyes;
• the appearance of conjunctivitis;
• noise in the ears.

Side effect on the cardiovascular system:

• sinus bradycardia;
• heartbeat;
• decrease in blood pressure;
• ortostatic hypotension;
• deterioration of symptoms of heart failure;
• cold in limbs;
• arrhythmia. In rare cases it is possible to promote the formation of thromboms.

Analogs

Metoprolol Akrichin, analogues of which can be represented by drugs from a group of beta blockers, is distributed due to its small price per pack. If you refuse to receive funds due to points of instructions for use, coincidence with one of the contraindications, the occurrence of side effects during the use of tablets The doctor may offer to choose analogs:

• Betalki;
• Biol;
• Vazocardin;
• Metozok;
• Metocardial;
• Metolol;
• Doll;
• Egilov;
• Emzoc.

Buy the drug in pharmacies for a doctor's prescription. Prices for metoprolol fluctuate from 50 rubles per pack. It is necessary to take into account manufacturers of tablets containing methoprolol substance.

If the Akrichin manufacturer, the price will increase to 200 rubles per package of 30 pieces. Tablets with this substance from another manufacturer will be much cheaper.

Among drugs with this substance from different manufacturers can be found:

• Metoprolol-acry;
• Metoprolol-ratiopharm;
• Metoprolol-OBL;
• Metoprolol organizing;
• Metoprolol Zentiva.

Prices for analogues are in the same price category with metoprolol Akrichin. Patient reviews are approximately equally divided by analogues, when choosing a drug, it is worth considering individual nuances.

Form release

Pills

Structure

Metoprolol Succinate 23.83 mg, which corresponds to the content of metoprolol Tartrate 25 mg; Auxiliary substances: Hyprocell slide - 155.96 mg, Ludipress LCER (monohydrate lactose - 94.7-98.3%, Pisidone - 3-4%) - 117.21 mg, silicon colloidal dioxide - 1.5 mg , magnesium stearate - 1.5 mg. The composition of the shell: the finished mixture of "Oddray II" of orange color (polyvinyl alcohol - 6 mg, talc - 2.22 mg, macrogol - 3.03 mg, titanium dioxide - 3.36 mg, red oxide dye - 0.009 mg, Iron dye oxide yellow - 0.378 mg, iron dye black - 0.003 mg) - 15 mg.

Pharmacological effect

Cardooselective beta1 adrenoblocator. It does not have a membrane-stabilizing effect and does not have internal sympathomimetic activity. It has antihypertensive, anti-infanal and antiarrhythmic effect.; Blocking in low doses of β1-adrenoreceptors of the heart, reduces the formation of CATCHOLAMINS, the formation of CAMF from ATF, reduces intracellular current of calcium ions, has a negative chrono-, dromo-, butmol, and inotropic action (CHS cuts, inhibits conductivity and excitability, reduces myocardial reductions). OPS at the beginning of the use of beta adrenobloclars (in the first 24 hours after oral reception) Increases (as a result of reciprocal increase in the activity of the ADRENORTERSPORTORS and eliminating the stimulation of β2-adrenoreceptors), after 1-3 days it returns to the original, and during long-term purpose decreases .; antihypertensive effect is due to a reduction in the minute volume of blood flow and the synthesis of Renin, the oppression of the activity of Rase (has More important in patients with initial hypersection of renin) and CNS, the restoration of the sensitivity of the borerotors of the arc of the aorta (there is no amplification of their activity in response to the decrease in blood pressure) and as a result, a decrease in peripheral sympathetic influences. Reduces increased blood pressure at rest, with physical stress and stress. Antihypertensive effect lasts more than 24 hours; the anti-infanal effect is determined by the decrease in the need of myocardial in oxygen as a result of the decrease in heart rate (lengthening of diastole and improved myocardial perfusion) and a reduction, as well as a decrease in myocardial sensitivity to the effects of sympathetic innervation. Reduces the number and severity of angina attacks and increases the tolerability of physical exertion. Due to the increase in the final diastolic pressure in the left ventricle and an increase in the tension of muscle fibers of the ventricles can increase the need for oxygen, especially in patients with chronic heart failure.; The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, the increased activity of the sympathetic nervous system, increased CAMF content, arterial hypertension), reducing the speed of spontaneous excitation of sine and ectopic rhythm drivers and a deduction of AV-conduct (mainly in the antegrade and to a lesser extent in retrograde directions through AV-node) and for additional ways.; for supritericular tachycardia, atrial flications, sinus tachycardia with functional diseases Hearts and thyrotoxicosis regenerates heart disease or can even lead to restoration of sinus rhythm.; warns the development of migraine.; unlike non-selective beta-adrenoblockers in the appointment in the average therapeutic doses Less pronounced effect on organs containing β2-adrenoreceptors (pancreas, skeletal muscles, smooth muscles peripheral arteries, bronchi and uterus) and for carbohydrate exchange; The severity of atherogenic action does not differ from the action of propranolol. With many years of reception, it reduces the concentration of cholesterol in the blood. When applied in large doses (more than 100 mg / day), it has a blocking effect on both subtype of β-adrenoreceptors.

Pharmacokinetics

Suction; absorption when taking inside full (95%). Solubility in fats moderate. It is subjected to intense preyed metabolism, bio-sauna - 50% at the first reception and increases to 70% during re-use. The time of reaching Cmax in the blood plasma is 6-12 hours after receiving the drug. During the course treatment, bioavailability increases. Eating increases bioavailability by 20-40%.; Distribution; binding to plasma proteins - 10%. Quickly distributed in the tissues, penetrates the BC, a placental barrier. Penetrates in breast milk.; Metabolism; Metabolized in the liver, 2 metabolite possess beta-adrenoblocking activity. In the metabolism of the drug, the CYP2D6 isoenzyme takes part.; Elimination; T1 / 2 - from 3.5 to 7 hours when taking inside. It is not removed during hemodialysis.; Pharmacokinetics in special clinical cases; a significant accumulation of metabolites is observed in patients with QC 5 ml / min, while the beta-adrenoblocking activity of the drug does not increase .; bioavailability increases in the cirrhosis of the liver, while its overall clearance is reduced.

Indications

Arterial hypertension; - chronic heart failure of the II-IV functional class according to the NYHA classification under compensation (as part of complex therapy); - IBS: Prevention of attacks stable angina, reduced mortality and frequency of myocardial repeated heart attack after the acute phase of myocardial infarction; - Disturbances of the heart rhythm, including supertoday tachycardia, reducing the frequency of ventricles during atrial fibrillation and ventricular extrasystoles; - functional violations of cardiac activity, accompanied by tachycardia; - Prevention of migraine attacks.

Contraindications

Cardiogenic shock; - AV blockade of II-III heat; - synoyatrial blockade; - SCC; - pronounced bradycardia (heart rate less than 50 hp / min); - acute heart failure or chronic heart failure in the decompensation stage; - arterial hypotension (systolic blood pressure less than 100 mm Hg); - acute myocardial infarction (heart rate less than 45 ° C. / min, PQ interval more than 0.24 ° C, systolic blood pressure is less than 100 mm Hg); - severe bronchial asthma; - severe disorders of peripheral blood circulation; - simultaneous reception of Mao inhibitors or simultaneous V / in the introduction of verapamil; - Feochromocytoma (without simultaneous reception of alpha adrenoblockers); - age up to 18 years old (efficiency and security are not established); - lactation period; - lactase deficiency, lactose intolerance, glucose / galactose malabsorption syndrome; - increased sensitivity to metoprolol and other beta adrenoblockers.; With caution, it should be prescribed a drug with diabetes mellitus, AV blockade of I heat, angina printelasta, metabolic acidosis, bronchial asthma, COPD, renal and / or liver failure Heavy degree, Miasthenia, Feochromocytoma (with simultaneous adre-adrenoblochetors), thyrotoxicosis, depression (incl. In history), psoriasis, peripheral circulatory disorders (interspersed chromoty, Reino syndrome), pregnancy, and elderly patients.

Application in pregnancy and breastfeeding

During pregnancy, the drug Metoprolol Restard-Akrichin should be applied only by strict indications when the expected benefit for the mother exceeds the potential risk to the fetus / child (due to possible development Newborn bradycardia, reduction of blood pressure, hypoglycemia and respiratory paralysis). At the same time, careful observation is carried out especially for the development of the fetus. Treatment is stopped in 48-72 hours before the occurrence of childbirth. If this is not possible, the newborn must be under a particularly thorough observation within 48-72 hours after childbirth.; The use of the drug metoprolol Retard-acryoin is contraindicated during lactation. If necessary, the use of the drug during the lactation breast-feeding Need to stop.

Method of application and dose

The drug metoprolol retard-acryer is taken inside 1 time / day. Tablets are recommended to take in the morning, not chewing, drinking water. Metoprolol Readend-Akrichin can be taken regardless of meals.; In order to prevent bradycardia, the dose is selected individually and increase gradually.; In arterial hypertension and angina, the initial dose - 50 mg 1 time / day, with insufficient therapeutic effect The daily dose can be increased to 100-200 mg / day. With arterial hypertension in the ineffectiveness of the drug at a dose of 100-200 mg / day, another hypotensive agent can be added.; With chronic heart failure of the II functional class according to NYHA classification (without exacerbation of the last 6 weeks and unchanged in comprehensive therapy for the last 2 weeks) Recommended Initial dose - 25 mg 1 time / day. After 2 weeks, the daily dose can be increased to 50 mg, then in 2 weeks - up to 100 mg, after another 2 weeks - up to 200 mg.; With chronic heart failure of the III-IV functional class on the NYHA classification, the recommended initial dose - the first 2 weeks 12.5 mg 1 time / day. It is possible to use metoprolol in another dosage formFor example, 25 mg tablets with risk. During the period of increasing the dose, the patient must be under observation, because In some patients, symptoms of heart failure may worsen.; After 1-2 weeks, the dose can be increased to 25 mg 1 time / day. Then after 2 weeks, the dose can be increased to 50 mg 1 time / day. Patients who are well transferred to the drug can double dose every 2 weeks before reaching a maximum dose of 200 mg 1 time / day.; When secondary prophylaxis Myocardial infarction and heart rate disorders The initial dose is 100 mg 1 time / day; with functional violations of cardiac activity, accompanied by tachycardia, are prescribed 50 mg / day, if necessary, a dose can be increased to 200 mg / day; for the prevention of migraine attacks are prescribed. 100-200 mg 1 time / day; elderly patients, patients with renal failure or patients on hemodialysis, dose correction is not required.; Violations of the liver function affect the removal of metoprolol, therefore, a dose correction may be required depending on the clinical state.

Side effects

The frequency of side effects: very often (\u003e 1/10), often (\u003e 1/100 and less than 1/10), infrequently (\u003e 1/1000 and less than 1/100), rare (\u003e 1/10,000 and less than 1 / 1000), very rare (less than 1/10,000, including individual messages).; On the part of cardio-vascular system: often - bradycardia, orthostatic hypotension (including fainting), cooling lower extremities, feeling of heartbeat; infrequently increased strengthening of heart failure symptoms, cardiogenic shock in patients with myocardial infarction, AV degree AV blockade; rarely - the conductivity violations of myocardium, arrhythmia; Very rarely - gangrene (in patients with peripheral circulatory disorders).; from the CNS: Very often - increased fatigue, reducing the rate of mental and motor reactions; Often - dizziness, headache; infrequently - paresthesia, convulsions, depression, decline in the concentration of attention, drowsiness, insomnia, nightmarish dreams; rarely - asthenia, tremor, increased nervous excitability, anxiety; Very rarely - amnesia / violation of memory, depression, hallucinations, myasthenia.; on the part of the senses: rarely - impairment of vision, dryness and / or eye irritation, conjunctivitis; Very rarely - ringing in the ears, violation of taste sensations.; on the part digestive system: often - nausea, abdominal pain, constipation or diarrhea; infrequently vomiting; Rarely - dry oral mucosa, violation of the liver function, hepatitis.; from the side skin Pokrov: infrequent - urticaria, strengthening of sweating; rarely alopecia; Very rarely - photosensibilization, aggravation of the flow of psoriasis, psoriazo-like skin reactions.; From the side of the respiratory system: often - shortness of breath; infrequently - bronchospasm in patients with bronchial asthma; Rarely rhinitis.; on the part of laboratory indicators: very rarely thrombocytopenia (unusual bleeding and hemorrhage), agranulocytosis, leukopenia, increased activity of hepatic enzymes, hyperbilirubinemia.; from endocrine system: often - hypoglycemia (in patients diabetes 1 type), rarely - hyperglycemia (in patients with type 2 diabetes), hypothyroid state.; Other: infrequently - an increase in body weight; rarely - impotence / sexual dysfunction; Very rarely - arthralgia, thrombocytopenia.

Overdose

Symptoms: pronounced bradycardia, AV blockade (up to the development of the full transverse blockade and stopping heart), excessive decrease in blood pressure, impaired peripheral blood circulation, strengthening symptoms of heart failure, cardiogenic shock, inhibition of breathing, apnea, cyanosis, increased fatigue, dizziness, loss of consciousness , coma, tremor, convulsions, increased sweating, paresthesias, bronchospasm, nausea, vomiting, it is possible to develop esophagospasm, hypoglycemia or hyperglycemia, hypercalemia, transient miastic. The first signs of overdose are manifested in 20 minutes after taking the drug.; Treatment: if the drug is adopted recently - washing the stomach and reception of adsorbing agents; in violation of AV conductivity and / or bradycardia - in / in the introduction of 1-2 mg of atropine, epinephrine (adrenaline) or the setting of the temporary pacemaker; When declining the patient's blood pressure should be transferred to the Trendelenburg position. If there are no signs of pulmonary edema - in / in plasma-substituting solutions, with ineffectiveness - the introduction of epinephrine, dopamine, dobutamine; with acute heart failure - heart glycosides, diuretics; for convulsions - in / in diazepam; With bronchospasm - inhalation or parenterally beta2-adrenomimetics.

Interaction with other drugs

Means that reduce the stocks of catecholamines (for example, reserpine, Mao inhibitors) while simultaneously use with metoprolol can enhance the hypotensive effect or cause pronounced bradycardia. A break in the treatment between the intake of inhibitors of Mao and Metoprolol should be at least 14 days .; Metoprolol is the substrate of the CYP2D6 isoenzyme. Drugs that inhibit or induce CYP2D6 activity can affect the plasma concentration of metoprolol.; CYP2D6 inhibitors (some antidepressants and neuroleptics, quinidine, terbinefin, celecoxib, conpaphenon, diphenhydramine, hydroxychlorine, cimetidine) increase the concentration of metoprolol in blood plasma.; Cyp2D6 inductors. (Bribeuric acid derivatives, rifampicin) reduce the concentration of metoprolol in blood plasma.; simultaneous metoprolol with heart glycosides, clonidine, slow calcium channel blockers (verapamil, diltiazem), amiodarone, antiarrhythmic means I class, a means for general anesthesia, methyldop, Guangfatin can lead to a decrease in blood pressure and pronounced bradycardia.; Funds for inhalation Narcosis (hydrocarbon derivatives), while simultaneously use with metoprolol, increase the risk of oppression of the myocardial function and the development of arterial hypotension.; Simultaneous in / in the introduction of verapamil can trigger the heart stop.; NSAIDs and beta adrenemeters weaken the antihypertensive effect of beta-adrenobloclars.; Arkaloids Metoprolol raises the risk of peripheral circulatory disorders.; With a joint method of metoprolol with oral hypoglycemic drugs, it is possible to reduce their effect; With insulin - raising the risk of development of hypoglycemia, lengthening and enhancing its severity, masking some symptoms of hypoglycemia (tachycardia, sweating, increased blood pressure).; Metoprolol reduces xanthin clearance (except diaphiline), especially in patients with initially increased theophylline clearance under the influence of smoking.; Metoprolol reduces lidocaine clearance increases the concentration of lidocaine in plasma.; Metoprolol enhances and prolongs the effect of non-compolant minelaxants; Extlifies the anticoagulant effect of kumarins.; With simultaneous administration of epinephrine (adrenaline) with beta-adrenoblockers, it is possible to increase blood pressure and bradycardia.; Phenylpropanolamine (Norefedrine) with a simultaneous use with metoprolol can increase diastolic blood pressure .; Allergens used for immunotherapy, or allergen extracts for immunotherapy samples When sharing with metoprolol, the risk of systemic allergic reactions or anaphylaxis;; iodine-containing radiopatrical agents for in / in administration with joint use with metoprolol, increase the risk of developing anaphylactic reactions.; With the joint use of metoprolol with ethanol, the risk of a pronounced reduction of blood pressure increases

special instructions

Control of patients receiving beta-adrenoblays include regular observation of heart rate and blood pressure. The patient should be trained by the CSS counting methodology and to instruct the need for medical advice at the heart rate of less than 50 ° C. / min.; It is possible to strengthen the severity of allergic reactions (against the background of an exempted allergological history) and the lack of effect from the introduction of conventional doses of epinephrine (adrenaline); in elderly patients It is recommended that the kidney function is monitored (1 time in 4-5 months).; Reception of the drug Metoprolol Retard-acryoine can increase the symptoms of the impaired peripheral blood circulation.; With a stainlessness of the voltage, a selected dose of the drug should provide heart rate at rest within 55-60 Д. / Min, with a load - no more than 110 ° C. / min.; in smokers patients, the effectiveness of beta-adrenoblastors is lower .; Metoprolol Retard-Akrichin can mask some clinical manifestations thyrotoxicosis (for example, tachycardia). The sharp cancellation of the drug in patients with thyrotoxicosis is contraindicated, since it is capable of strengthening symptoms.; With diabetes mellitus, metoprolol retard-acryene drug can mask tachycardia caused by hypoglycemia.; If necessary, beta2-adrenomimetics are used as concomitant therapy to patients with bronchial asthma; at feochromocytoma - alpha-adrenoblays.; if necessary surgical intervention It is necessary to prevent the anesthesiologist's doctor about taking the drug Metoprolol Restard-Akrichin (a choice of means for general anesthesia with a minimum negative inotropic effect is required), the abolition of the drug is not recommended.; Reciprocal activation wandering nerve It can be eliminated in / in the administration of atropine (1-2 mg).; in case of increasing bradycardia (less than 50 UD / min), arterial hypotension (systolic blood pressure below 100 mm Hg), AV blockade, bronchospasm, ventricular arrhythmias , severe disorders of the liver and kidney function need to be reduced by a dose or discontinue treatment .; It is recommended to stop therapy when the skin rashes and the development of depression caused by the reception of beta-adrenobloclochetors.; With a sharp cancellation of clonidine, it can dramatically increase the blood pressure, while receiving beta-adrenoblockers. In case of cancellation of clonidine, the termination of the reception of beta-adrenobloclockers should be started a few days before the cancellation of the clonidine.; Preparations that reduce the stocks of catecholamines (for example, reserpine) can enhance the effect of beta-adrenobloclars, so patients taking such combinations of drugs should be under constant medical supervision for the detection of excessive decrease in blood pressure or bradycardia.; With a sharp discontinuation of treatment, cancellation syndrome may occur (increase in angina attacks, increased blood pressure). Special attention in the abolition of the drug must be given to patients with angina, chronic heart failure, after the myocardial infarction suffered. The abolition of the drug metoprolol Retard-Akrichin is gradually carried out, reducing the dose for 10 days.; Patients who use contact lenses, I must take into account that against the background of the treatment of beta-adrenoblockers it is possible to reduce the products of the tear fluid.; Effect on the ability to drive vehicles and management of mechanisms; during the treatment period, caution must be taken when driving vehicles and occupation of other potentially hazardous species Activities requiring increased concentration of attention and speed of psychomotor reactions.

Possible names of goods

• Metoprolol Restard-Akrichin Tab.prolong.p.P.O.00MG №30
• Metoperolol Retard -Akri 100 mg tab. Prol.P / O №30
• Metoprolol Restard-Akrichin 0.1 N30 Table Prolong P / Capture / Shell
• Metoprolol Restard-Akrichin Table. Prolong. P / o captivity 100 mg (Polyetha banks) x30
• Metoprolol Retard-Akrichin Tab. Prolong. Action. P / about captivity. 100mg №30
• (Metoprolo Retard Akrichin) Metoprolol Restard-Akrichin Tab.prolong.p.P.O.100MG №30

On our site you can purchase the drug metoprolol Retard-Akrikhin Tab.prolong.p.P.O.00MG No. 30. A convenient system of sorting and filters on the site will help in choosing analogs based on metoprolol so that you have the opportunity to reduce costs and find the best deals. Buyers can read a brief annotation to the drug. It contains all the necessary information - pharmacological properties, Contraindications recommended by dosage and others.

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Profitable proposition

Our clients are available medicinal products High quality from the category "Preparations for the cardiovascular system". We make a purchase favorable at the expense of low prices for Metoprolol Retard-Akrichin Tab.prolong.p.P.O.00MG No. 30 - the cost of 449 rubles. Online pharmacy charges special scores for participants in the "Health Care" program.

During treatment, it is possible to change the results of tests during laboratory studies (increase in urea level, transaminase, phosphatase, LDH).

Precautions

In patients with chronic heart failure, it is possible to deteriorate the contractile ability of myocardium, which causes the need to apply heart glycosides and / or diuretics with careful monitoring of hemodynamic status. In the event of an increasing bradycardia or AV blockade, it is necessary to reduce the dose or in / in entering atropine. Against the background of diabetes mellitus and hyperfunction thyroid gland Metoprolol can mask tachycardia caused by hypoglycemia or thyrotoxicosis. In patients with diabetes, the dose correction of antidiabetic drugs and thorough control of the level of glycemia is needed. When conducting against the background of treatment operational interventionThe means of choice should be a anesthetic agent with the smallest negative inotropic effect. Perhaps more developed development Hypersensitivity reactions and lack therapeutic effect Conventional adrenaline doses against the background of a burdened allergological history. With the termination of the simultaneous treatment with clonidine, the metoprolol is canceled gradually, a few days before the cancellation of the clonidine, due to the danger of the development of severe hypertensive crisis. In patients with feochromocyte, use is possible only with alpha-adreenolithics. The metoprolol reception is stopped in 2-3 days before delivery (the risk of bradycardia, hypotension and hypoglycemia in a newborn), in exceptional cases, newborns after delivery should be under medical control within 48-72 hours. It should be refracted from use in pediatric practice, since the safety and efficiency of its use in children is not defined. When canceling treatment, reduce the dose must be gradually within 10-14 days. Patients with IBS should be under the careful observation of the doctor during this period. With caution to apply during operation to drivers vehicle and people whose profession is associated with increased concentration of attention.

Application Metoprolol Retard Akrichin during pregnancy and feeding

Perhaps if the expected effect of therapy exceeds the potential risk to the fetus. At the time of treatment, breastfeeding should be stopped.

Overdose

Symptoms: arterial hypotension, sharp heart failure, bradycardia, heart stop, AV blockade, cardiogenic shock, bronchospasm, respiratory impairment and consciousness / coma, nausea, vomiting, generalized cramps, cyanosis (manifest after 20 minutes - 2 hours after reception).

Treatment: stomach wash, symptomatic therapy: administration of atropine sulfate (V / in fast 0.5-2 mg) - in bradycardia and violation of AV conduction; glucagon (1-10 mg V / B, then in / in drip 2-2.5 mg / h) and dobutamine - in the event of a decrease in myocardial reduction; adreminimetics (noraderenalin, adrenaline, etc.) - with arterial hypotension; diazepam (in / in slow) - to eliminate seizures; Inhalation of beta adrenomimetics or in / in inkjet administration of Euphillin to relieve bronchospast reactions; Cardiosulation.

Interaction

The hypotension potentiate sympatholytolitis, nifedipine, nitroglycerin, diuretics, hydralazine and other hypotensive drugs. Antiarrhythmic and anesthesia rates increase the risk of developing bradycardia, arrhythmias, hypotension. Preparations of vintage potentiate the deceleration of AV conductivity. Simultaneous in / in the introduction of verapamil and diltiazem can provoke a stop of the heart. Beta adreminimetics, aminoophyllin, cocaine, estrogens, indomethacin and other NSAIDs weaken antihypertensive effect. Enhances and prolong the effect of antide -olarizing muscle relaxants. The combination with alcohol leads to a mutual strengthening of the oppressive effect on the CNS. Allergens increase the risk of severe systemic allergic reactions or anaphylaxis. Changes the effectiveness of insulin and oral antidiabetic agents and increases the risk of hypoglycemia. Oral contraceptives, cimetidine, ranitidine, phenothiazines - increase the level of metoprolol in the blood, rifampicin - reduces. Lower Lidocaine clearance, beta2-adrenomimetics efficiency (a dose increase in the latter). Incompatible with Inhibitors of Mao Type A.

Side effects metoprolol retard Akrichin

From the side of the nervous system and senses: at least 10% - weakness; 1-9.9% - dizziness and headache; 0.1-0.9% - Reducing attention concentration, drowsiness / insomnia, nightmares, depression, muscle cramps, paresthesia; 0.01-0.09% - nervousness, anxiety, weakening of libido, visual impairment, xerofthalmia, conjunctivitis; Less than 0.01% - lethargy, increased fatigue, anxiety, confusion of consciousness, amnesia / short-term loss of memory, hallucinations, noise in ears, violation of taste sensations.

From the cardiovascular system and blood (hematoporation, hemostasis): 1-9.9% - bradycardia, heartbeat, hypotension, cooling limbs; 0.1-0.9% - heart failure, AV blockade, edema syndrome, chest pain; 0.01-0.09% is a decrease in the reduction of myocardium, arrhythmia, less than 0.01% - gangrene (in patients with severe peripheral circulation); Violation of the conductivity of myocardium, syncope, thrombocytopenia, leukopenia, agranulocytosis.

From the head of the gastrointestinal bodies: 1-9.9% - nausea, abdominal pain, diarrhea or constipation; 0.1-0.9% - vomiting; 0.01-0.09% - dryness in the oral cavity, liver function disorders; Meteorism, dyspepsia, heartburn, hepatitis.

From the respiratory system: shortness of breath (1-9.9%), bronchospasm (0.1-0.9%), vasomotor rhinitis (0.01-0.09%), dneap.

From the side of the skin: 0.1-0.9% - rash, dystrophic changes skin; 0.01-0.09% - reversible alopecia; less than 0.01% - photosensibilization, exacerbation of psoriasis; Itching, erythema, urticaria, hyperhydrosis.

Others: Reducing body weight (0.1-0.9%), arthritium, arthritis, Malgy, muscle weakness, Peyroni disease.

Restrictions on application

Sugar diabetes, hypoglycemia, burded allergic history, metabolic acidosis, bronchial asthma, emphysema, non-allergic bronchitis, hyperthyroidism, psoriasis, feuhromocytoma, violation of the liver function and / or kidney, myasthenia, depression, carrying out general anesthesia, elderly and children's age.

Metoprolol retard Akrichin Contraindication

Hypersensitivity, AV blockade II and III degree, Sinoatrial blockade, acute or chronic (in the decompensation stage) heart failure, sine node weak syndrome, expressed sinus bradycardia (heart rate less than 60 ° C. / min), cardiogenic shock, arterial hypotension (garden less than 100 mm Hg. Art.), pronounced Disorders of peripheral blood circulation, pregnancy, breastfeeding.

Indications for the application of metoprolol retard Akrichin

Arterial hypertension moderate and middle severity (monotherapy or in combination with other hypotensive drugs), CDS, hyperkinetic cardiac syndrome, heart rate impaired (sinus tachycardia, ventricular and suproprotative arrhythmia, including paroxysmal tachycardia, sugainant-centricular tachycardia, extrasystole, fluttering and flickering atrial, atrial tachycardia), hypertrophic cardiomyopathy, prolapse mitral valve, myocardial infarction (prevention and treatment), migraine (prevention), thyrotoxicosis ( comprehensive therapy); Treatment of acatus caused by neuroleptics.

pharmachologic effect

Pharmacological action - antianginal, hypotensive, antiarrhythmic. Blocks predominantly beta1-adrenoreceptors of the heart, does not have internal sympathomimetic and membrane-stabilizing activity. Reduces cardiac output and garden, slows the heart rate, weakens the stimulating effect of catecholamines on myocardium when exercise and mental overvoltage, warns reflex orthostatic tachycardia. Antihypertensive action is due to a decrease heart Emission and the synthesis of renin, the oppression of the activity of the renin-angiotensin system and the CNS, the restoration of the sensitivity of the baroreceptors and, as a result, a decrease in peripheral sympathetic influences. The hypotensive effect develops quickly (the garden decreases after 15 minutes, the maximum - after 2 hours) and continues for 6 hours; When taking the subcinate metoprolol - the clinical effect of the blockade of beta1-adrenoreceptors is preserved 24 hours. Dad varies slower: a stable decrease is observed after several weeks of regular reception. The antianginal effect is a consequence of the reduction of the frequency and force of heart rate, the energy costs and the needs of myocardium in oxygen. Reduces the frequency and severity of IBS seizures, the mortality rate in patients with diagnosed myocardial infarction increases the portability of the loads. Metoprolol succinate reduces the risk of death (including sudden death), the occurrence of repeated heart attack (including patients with diabetes mellitus) and improves the quality of life of patients with acute infarction Myocardium and idiopathic dilatation cardiomyopathy. An antiarrhythmic effect manifests itself in the elimination of arrhythmogenic sympathetic effects on the conductive heart system, slowing the sinus rhythm and the speed of excitation of excitation via AV node, braking of automatism and lengthening the refractory period. It has a moderate negative inotropic effect. Cardooselectivity is preserved when using daily doses, not exceeding 200 mg. Due to the election action on beta1-adrenoreceptors, the risk of bronchospasm is theoretically reduced (in patients with bronchial asthma less decreases the life function of the lungs), hypoglycemia and narrowing peripheral vessels.

In experiments on dogs (up to 105 mg / kg / day, for 1 year), rats (up to 800 mg / kg / day, for 2 years) and mice (up to 750 mg / kg / day, for 21 months) Signs of carcinogenicity have not been found, but histological changes in the type of hepatic cell hyperplasia and industuration by macrophages pulmonary fabric. With the introduction of albino mice in doses up to 750 mg / kg / day for 21 months, increased the frequency of the development of benign adenomes in the females, but when re-conducting experience, an increase in the incidence of any tumors was not noted. The results of the test of dominant lethal mutations in mice, studies of chromosome of somatic cells, dough on the anomalies of the nuclei of somatic cells in interfase, etc. indicated the absence of mutagenic properties. In rats received doses, 55.5 times higher than the maximum daily dose for a person (450 mg) did not affect fertility, increased the parameters of the postpact death and reduced the survival rate of newborn animals (there was no signs of teratogenicity).

Metoprolol Tartrate quickly and almost completely (95%) is absorbed when taking inside, subjected to intense preyed metabolism. Bioavailability is about 50% at the first reception and increases to 70% when re-use. About 12% binds to albumin plasma blood. It is quickly distributed in the tissues, penetrates through the GEB (the level in the CNS is 78% of the plasma concentration), the placental barrier, breast milk (concentration exceeds plasma). Distribution volume - 5.5 l / kg. Cmax is achieved after 1-2 hours after taking, the blood level varies significantly. T1 / 2 - from 3 to 7 hours. Biotransformed in the liver, with the formation of two active metabolites. It is removed mainly by the kidneys in the form of metabolites, CL - 1 l / min. When taking inside, less than 5% is excreted with urine unchanged, with in / in infusion - about 10%. If the kidney function is violated, bioavailability does not change, but the rate of excretion of metabolites can decrease. In patients with cirrhosis of the liver, metabolism and general clearance slows down (no dosing mode correction is required). Not removed during hemodialysis. When in / in the infusion of the metoprolol of the tartrate for 10 minutes and the more maximum action is developing after 20 minutes, the demolition of the heart rhythm with doses of 5 and 10 mg is 10 and 15%, respectively. After taking inside in the same doses of Cmax metoprolol, the succinate is 1/4-1 / 2 cmax metoprolol of the tartrate, but is more durable. Bioavailability in doses of 50-400 mg (1 time per day) by 23% less from such after the reception of a similar dose of tartrate. Pharmacokinetic parameters do not depend on the age of patients.

Characteristic

Metoprolol Tartrate: White, almost odorless crystalline powder, well-soluble in water, methylene chloride, chloroform and alcohol, weakly soluble in acetone, insoluble on the air.

Metoprolol Sukcinate: White crystalline powder, easily soluble in water, soluble in methanol, moderately soluble in ethanol, weakly soluble in dichloromethane and 2-propanol, practically insoluble in ethyl acetate, acetone, diethyl ether and heptane.

Chemical name metoprolol retard Akrichin

(±) -1--3 - [(1-methyl ethyl) amino] -2-propanol (in the form of a tartrate or succinate)