Cardiovascular diseases are the most common. In order to quickly reduce the pressure, reduce heart rate, alleviate angina, migraine headaches, taking medication “Bleeding”. Counterparts also are nominated quite often for one reason or another. Medication has no contraindications, so before its use, it is necessary to consult a doctor.
The Drug belongs to beta-blockers. Is made in the form of tablets of white color which have a valium, a round shape, a chamfer, and unilateral risk. Available in two dosages:
Additional ingredients for both formulations are the same and represented by lactose monohydrate, magnesium stearate, povidone K30, croscarmellose sodium, silicon dioxide, colloidal talc.
Tablets are Packed in aluminium blisters of 10 pieces. In the package can be from 3 to 10 blisters. Attached to medication usage instructions.
“Often” is a cardioselective beta-blocker that does not exhibit sympathomimetic activity and has no membrane stabilizing qualities. Has antihypertensive, antiarrhythmic, antianginal properties.
The Brakes in a small amount of β1-adrenergic receptors of the heart, reduces catecholamines activated the formation of cyclic amp from ATP, reduces intracellular calcium ion current. Having a negative batmo-, Chrono-, dromo - and inotropic effect.
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The CSO at the start of the use of beta-blockers increases, but after a few days the use of medications returned to the initial level, prolonged use decreases.
The Antihypertensive properties due to the decrease in cardiac output and synthesis of renin, inhibition of the renin-angiotensin and Central nervous systems, restoration of the sensitivity of baroreceptors of the aortic arch and ultimately a decrease in peripheral sympathetic influences. Reduced blood pressure at rest and during physical and neuro-mental load.
The Hypotensive effect is achieved in a matter of minutes. So, systolic blood pressure was reduced in fifteen minutes to a maximum of two hours. The achieved effect lasts for six hours. Diastolic blood pressure changes more slowly. Its stabilization can be achieved only after several weeks of taking the drug.
Antianginalnye of quality of a medicine is determined by the reduction of requirement of a myocardium for oxygen because of reduction in heart rate. Decreases the susceptibility of the myocardium to the effect of sympathetic innervation, the number and severity of angina attacks. Increases physical endurance.
Anti-Arrhythmic properties appear when removing the arrhythmogenic manifestations, reduce the excitation of the sinus and ectopic rhythms, but also the inhibition of AV-conduction. When manifestations supraventricular tachycardia, the occurrence of fibrillation and the detection of sinus tachycardia associated with heart disease and in hyperthyroidism, the medication lowers the heart rate. Sometimes restores sinus rhythm. Relieves migraine and prevent its occurrence in the future.
When used in high therapeutic doses, unlike nonselective beta-blockers, has a less pronounced effect on bodies containing β2 adrenergic receptors and carbohydrate metabolism. When used in high doses (more 100 mg / day) exerts a blocking effect on both subtypes of β-adrenoceptor.
Metoprolol 95% absorbed from the stomach and intestines. The maximum concentration in plasma observed after 1-2 hours. Due to the active metabolism of the first drug bioavailability is 50 %. Subsequent use of the drug, it increases to 70 %. Eating every time increases the bioavailability of 20-40 %.
“Often” is connected to the blood supply by 10 %, Vd - 5.5 l/kg. Passes through GEB and placentary barrier. Excreted in breast milk in small doses.
Almost all the Drug is metabolized in the liver. Two main metabolite are characterized by three beta adrenoblokiruyuschee properties. In the metabolism of the drug is involved isozyme of the cytochrome P450 (CYP 2D6). Excretion lasts about 3.5 hours. The drug is excreted in the urine, and 5 % goes unchanged.
Kidney Disease inhibit the metabolism of metoprolol. Significantly increased bioavailability in cirrhotic patients. The active substance is not excreted from the body during hemodialysis.
“Bleeding” should be used strictly on prescription for hypertension. It is used as monotherapy or in combination with other antihypertensive agents. The indication for use is tachycardia, ischemic heart disease, myocardial infarction. Often use “Tincture of 100”, analogs to prevent strokes and in violation of heartrhythm, prevention of migraine.
“Tincture of 50”, as well as the preparation in the dose of 100 mg should not be taken during cardiogenic shock. A contraindication is AV blockade II and III degree and sinoatrial block. Do not take the drug in the syndrome of weak sinus node, expressed aetiology. Ban are failures of the peripheral circulation and heart failure. Don't take pills for angina, acute myocardial infarction and hypotension.
It is Impossible to combine taking the medicine “Tincture of 50" (similar to when necessary will help you to choose the attending physician) with the use of monoamine oxidase inhibitors and intravenous injections “Verapamil”.
The Drug is not prescribed during the period of breast feeding, persons under eighteen years of age, and people with high sensitivity to metoprolol, additional substances in the composition of the funds.
With extreme caution taking medication for diabetes, asthma, emphysema, metabolic acidosis, chronic bronchitis, obstructive form. Only under the supervision of a doctor should use medication people with diseases of the peripheral vessels, renal and hepatic insufficiency. Circumspect in the use of tablets “Bleeding” should be patients with myasthenia gravis, AV-blockade of I degree, as well as in pheochromocytoma, depression, and thyrotoxicosis. Be wary appoint it for psoriasis and elderly people.
During pregnancy, tablets “Often” is discharged only in cases of emergency, when the fetus is caused bradycardia, hypotension, hypoglycemia. In this case, the therapeutic process should take place under close medical supervision. In the future conduct continued oversight of the newborn for 48-72 hours after delivery.
The Impact of metoprolol on the baby first days of life have not been studied, so the ladies who use the drug are advised to stop breast-feeding.
Therapeutic course for each patient is determined by the doctor and depends on the disease. Only a specialist should prescribe taking and drug dose “Bleeding”. Instructions for use (analogues of drugs from Russian manufacturers are much cheaper) describes only classical regimens for certain diseases.
So, when arterial hypertension and angina the drug is consumed orally 100 mg once daily or 50 mg twice a day. If necessary, the amount of drug increase up to 100 mg, taken twice a day. The highest possible daily dose is 200 mg.
In functional disorders of the heart, causing tachycardia, initial ingestion of the prescribed amount of 50-100 mg per day. This volume can be divided into two times. As necessary daily dose increased to 200 mg.
To prevent migraines the drug is prescribed 100 mg once daily or 50 ml morning and evening. When the therapeutic effect is achieved, the dose should be reduced. This process should be done slowly and under the close supervision of a doctor.
Elderly people with kidney disease and for hemodialysis daily dose is not reduced. Failure the liver the daily amount of the drug decrease, focusing on the patient's condition.
In all these cases the ‘Corvida” it is taken orally, after meals and washed down with a small amount of water. The tablets should be swallowed without chewing. If drug drink once a day, its admission must have been morning. The two use take pills morning and evening.
The Medicine is “Bleeding” in case of overdose, immediately stop taking. Symptoms of abuse of remedy are sinus bradycardia, nausea, dizziness, low blood pressure, gagging, cyanosis, arrhythmia, bronchospasm, syncope, ventricular extrasystoles.
The degree of Acute overdose “Bleeding” (analogues in Russia, you can buy in any pharmacy from 30 rubles and above) manifests as cardiogenic shock, coma, AV-blockade, loss of consciousness, cardialgia. Typically, the first signs of excessive consumption of the medication occur 20 minutes to 2 hours after ingestion.
The First thing the patient washed stomach and prescribe absorbent products. If there was a sharp decrease in blood pressure, the person is placed in the Trendelenburg position. If the pressure drops to a critical level and there is heart failure, bradycardia, administered intravenously with an interval of 2-5 minutes beta-agonists. The procedure is carried out to a positive result. Intravenous can be made by injection in a dose of 0.5-2 mg “Atropine sulfate”.
If the desired effect is not achieved, then apply medication, such as "Dopamine", "Norepinephrine", "Norepinephrine” or “Dobutamine”. Sometimes prescribed 1-10 mg “Glucagon” or establish a transvenous intracardiac pacemaker. In the event of bronchospasm injected into the vein of beta-agonists. If there are convulsions, then slowly make into a vein injection"Diazepam". Hemodialysis in this case does not work.
Regular use of the drug is “Bleeding” (tablets) may provoke on the part of the Central nervous system, headache, muscle weakness, excessive fatigue, dizziness, cause inhibition of mental and physiological reactions, paresthesia of the hands and feet. Manifests depression, anxiety and fear, disturbed concentration. Concerned about drowsiness, negative dreams, insomnia, confusion, short-term memory loss. Can occur asthenic syndrome.
“Bleeding” and its analogues can cause blurred vision, dry eyes and soreness, reduced production of tear fluid. In rare cases, appear conjunctivitis, rhinitis. Observed noise in the ears.
The Drug can cause cardiovascular system in the form of bradycardia, sinus type, increased heart rate, a sharp decrease in pressure, hypotension orthostatic in nature. In rare cases, a decrease of contractions of the myocardium, worsening heart failure, arrhythmia, vasospasm. Disrupted permeability of the myocardium. Cardialgia arises.
With regular medication were observed violations of the gastrointestinal tract that are manifested as nausea, gag reflex, pain in the abdomen, diarrhea, dry mouth. Some patients noted a change in tastes, increase the activity of liver enzymes. In rare cases, manifested hyperbilirubinemia.
As a result of therapy were observed dermatological reactions. This psoriasis and its exacerbation, redness, rash. It was noted excessive perspiration, alopecia reversible type and photodermatosis.
Side effects of the respiratory system were found in the form of difficulty breathing and nasal passages. Some patients suffered from shortness of breath.
There were occasional hypoglycemia and hypothyroid state. Bothered patients thrombocytopenia, leukopenia, and agranulocytosis. Had any allergies in the form of itching, urticaria and rash. Was seen for back pain (joint pain), weight gain, loss of libido, potency.
In the use of the drug should be special monitoring of heart rate, blood pressure and glucose levels, especially in patients with diabetes. In the latter case, the dose is selected in accordance with the picture of the disease.
It Should teach the patient methods of calculating heart rate and instruct on the need of consulting a doctor when the heart rate less than 50 beats/min
If set to high dose (200 mg daily), then reduced kardioselektivnost. In patients with heart failure therapy in the period of compensation.
Perhaps the increased severity of hypersensitivity reactions (against the background of the burdened allergological anamnesis) and the lack of effect from the usual doses of "Epinephrine".
The background of the drug may increase symptoms of human peripheral blood circulation.
Cancel treatment produced gradually, reducing the dose to a minimum for ten days. Do not abruptly stop taking the drug, as may occur with angina and increased blood pressure.
Patients with angina the dose is selected so that the heart rate was equal to 55-60 beats/min, and during physical activity did not exceed 110 beats/min
People with contact lenses should know that during therapy, beta-blockers may decrease production of the tear fluid.
Metoprolol, in some cases, mask the manifestations of thyrotoxicosis. Patients with thyrotoxicosis is contraindicated abrupt withdrawal of the drug, as this will only exacerbate the disease.
Patients with diabetes can not immediately detect the tachycardia-induced hypoglycemia. “Bleeding” not not increase insulin-induced hypoglycemia and delay recovery of the glucose concentration in the blood to normal levels.
The Elderly when taking the drug should continuously monitor kidney function, as well as patients with renal insufficiency.
Caution needs to take medication of a person with depression, as pills can increase the severity of the disease.
In the period of treatment should refrain from driving and to terminate the activity associated with concentration, requiring a quick reaction.
During treatment, you should wear closed clothes, as the drug can cause photosensitivity.
In some cases, the drug can cause many side effects or just not be suitable in their effect, so the doctor can replace the “Bleeding”. Analogues have similar properties that give the same therapeutic effect and are composed of metoprolol tartrate. They are quite popular and are sold in almost every pharmacy, and the price of some of them barely reach 50 rubles.
Following are able to replace “Bleeding” counterparts with the same activekomponentom:
Similar action have the following drugs: “Arial”, “Ashtekar”, “Bisomer”, “Benecol”, “Atenolol”, “Cardinorm”, “Betacam”, “Sci”, “Nebilet”, “Bisogamma” and other drugs.
When changing from one medication to another, it should be remembered that the analog does not always work as effectively as the original drug, past a series of tests and a lot of research.
It Always can replace “Bleeding” counterparts? Patient testimonials say that it is difficult to find a drug with the same long-lasting effect, despite the fact that produced many products containing the same active substance. Cure is often more expensive substitutes, but, as experience has shown, the analogs are less effective. Reviews indicate that "Bleeding" effectively reduces the pressure and prevents the development of migraines.
50 pills of 100 mg will cost 250-300 rubles, the same amount in a dosage of 50 mg is about 220 -250 rubles.
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Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."
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