Beta blockers are multidisciplinary drugs - they are used not only to lower blood pressure, but also to improve general functional state heart, blood vessels. Modern drug is Egilok, which is excellent for a number of heart diseases.
What kind of medicine is Egilok?
Egilok tablets are produced by the Egis-Rus company (Hungary), included in the pharmacological group of beta blockers, cost 140 rubles for 30 pieces with a dosage of 100 mg. The composition contains metoprolol - a cardioselective beta blocker - in the form of metoprolol tartrate (based on tartaric acid salts). Also on sale you can find tablets with a dosage of 25 and 50 mg in packages of 30 and 60 pieces.
The list of excipients looks like this:
The active substance normalizes the functioning of the sympathetic system, thereby suppressing the strength of its effect on heart function. Metoprolol also fights arrhythmia, quickly lowering the heart rate and cardiac output. Against the backdrop of such effects arterial pressure normalizes or decreases, in any position of the patient and for a significant period. This is due not to the sharp, but slow decline vascular resistance. In parallel, with a course of taking Egilok, the weight and volume of the left ventricle decreases, its work is optimized. Other positive effects of the drug:
Metoprolol has fewer side effects than non-selective beta blockers, has virtually no effect on insulin production, carbohydrate metabolism, and does not provoke attacks of sudden low blood sugar. After 1-2 years of use, the drug also regulates cholesterol levels.
Indications and contraindications
Egilok is widely used for various forms of hypertension. It may serve as the only drug of choice or participate in complex therapy hypertension. Also, angina pectoris due to coronary artery disease can be considered an indication for the use of Egilok tablets. The medicine reduces the frequency of attacks, reduces their severity, treats asymptomatic forms of pathology, and optimizes performance.
For heart attacks, the drug has also found application - it seriously reduces the mortality rate because it prevents ventricular fibrillation.
Egilok is taken almost immediately after a heart attack has occurred in complex treatment, it is also shown in a late stage acute disorder coronary circulation.
Especially good results the remedy shows in patients diabetes mellitus(for heart attack compared to other medications). In addition, early start of taking the pills reduces the risk of another heart attack. Other testimony of Egilok:
The medicine has a number of important contraindications. It should not be taken if you have allergies, intolerance to metoprolol or all beta blockers, 2-3 degree AV blockades, decreased rhythm (less than 50 beats), or pacemaker weakness. Medicine is also prohibited in the following cases:
Treat with caution in diabetes mellitus and any type bronchial asthma, COPD, myasthenia gravis, other types of heart block. Also, strict instructions on how much and how to drink the product, and regular examinations will be necessary for patients with Raynaud's syndrome, renal failure, and psoriasis. The use of Egilok during pregnancy is possible according to vital signs, but generally not recommended. This is associated with the risk of respiratory depression and bradycardia in the newborn. Also, within 2-3 days from the moment of birth, sugar and blood pressure levels are assessed in children whose mothers received treatment with Egilok.
Egilok's instructions
According to the annotation, the tablets must be taken orally; the order of therapy does not depend on food. A pill with any dosage can be divided in half, it has a convenient risk. Initially, the minimum dosage is prescribed, which is then left the same or increased.
It is important to select the dose gradually to prevent a strong decrease in blood pressure and bradycardia.
Take no more than 200 mg of Egilok per day, or 2 tablets/100 mg. Usually, for hypertension at the initial, middle stage, 25-50 mg in the morning and evening is enough. In severe cases of the disease, the dose is increased to 100 mg twice a day, or other drugs are added at another time or together with Egilok. Other treatment recommendations:
In case of advanced renal dysfunction, the drug is not taken; in other cases of renal dysfunction, the usual dose is taken. In case of liver damage, dose adjustment is also not necessary, except in situations of severe liver failure or recent hepatic vascular surgery.
Side effects
The medicine is well tolerated by patients, but moderate severity side effects quite common at the beginning of therapy. Some negative phenomena continue to be observed or increase in severity, which forces Egilok to be replaced with another medicine.
Often the tablets cause dizziness and a feeling of increased fatigue, and less often - headaches.
The drug can reduce concentration, cause drowsiness during the day and insomnia at night. It can provoke seizures, depression, and hyperexcitability. The heart may react with bradycardia and the development of hypotension, fainting, cold hands and feet, worsening heart block, and arrhythmias are possible. Isolated cases of gangrene have been described in patients with impaired peripheral circulation.
From the gastrointestinal tract, constipation, nausea, and dry mouth are often observed. Various forms may develop allergic reactions, hair loss, exacerbation of psoriasis. Many patients experience coughing, shortness of breath, and dry eyes.
Important instructions
When taking Egilok, it is important to regularly measure blood pressure, heart rate, and, in case of diabetes, blood sugar. The dose of insulin and hypoglycemic agents may increase during the treatment period. Other instructions for correct therapy:
When wearing contact lenses Dry eyes may cause discomfort. It is necessary to use drops to additionally moisturize the mucous membrane. Egilok is able to mask tachycardia caused by other diseases. Before any operation, you need to warn your doctor about taking Egilok, since the selection of special forms of anesthesia will be required.
Analogues and interaction
Among the analogues, there are other drugs based on metoprolol, but some drugs include other components, so you cannot change the prescribed drug yourself:
Egilok mutually enhances the effect of other antihypertensive drugs. More pronounced side effects develop while taking calcium channel blockers. Caution should be observed when taking it in combination with antiarrhythmics - there is a risk of developing bradycardia and heart block.
Egilok, a drug produced in Hungary, is becoming increasingly popular among hypertensive patients. Having a blood pressure-lowering effect, at the same time egilok alleviates the condition of those affected by complications of hypertension and atherosclerosis of the heart. The drug also helps with diseases not directly related to high blood pressure. Many patients prefer Egilok, ignoring analogues, of which there are many. What motivates them to make a particular choice?
Instructions for use
The name "egilok" is a trademark, given medicine manufacturer (Hungary). There is also Indian egilok.
Egilok's INN is metoprolol. This is the main active ingredient, supplemented by auxiliary ingredients: anhydrous colloidal silicon dioxide, microcrystalline cellulose, magnesium stearate, sodium carboxymethyl starch and povidone. Dosage form release: tablets.
Auxiliary components serve to preserve the base (active ingredient - metoprolol tartrate) until use. They serve as enterosorbents, emulsifiers, fillers, and stabilizers. The components are arranged in such a way that they ensure the stability of the composition and the safety of the medicine. Once in the body, they help the main component fully exhibit the desired effect.
In Latin Egilok is Egilok, and in current beginning designated: Metoprolol tartat, if it is a fast-acting form. Extended-release egilok retard contains another metoprolol compound – succinate. Accordingly: Metoprolol succinate.
Tablets are dosed in milligrams active substance, three types of dosage: 25, 50, 100 mg. All of them are white or close to white, biconvex. On tablets of a lower (25 mg) dosage, the surface is marked with a cross-shaped notch. This makes it easier to split (break) the tablet when even smaller doses are needed. Usually, at the beginning of taking the drug, when the optimal dosage is being selected, this is necessary.
Large dosage tablets have risks that help them break neatly. The tableted drug has no odor.
Pharmacological group, mechanism of action
Pharmacotherapeutic group of Egilok: beta1-blockers. Egilok is a cardioselective drug that targets the myocardium and the coronary vessels that supply it.
Selective beta1-blockers at a reasonable dosage work only with beta1-adrenergic receptors, blocking only them. Another type, responsible for breathing, gestation of the fetus, peripheral vessels - β2-adrenergic receptors - calmly continues to work, the egilok is not directed at them. The medicine purposefully moves towards its intended target, finding the receptors for which it was created. By binding to them, egilok does not allow catecholamines to produce a strong shake-up in the body under provoking factors:
- Emotional stress;
- Increased physical activity;
- Sudden changes in weather (almost 100% of “vascular” patients react to this by worsening their condition).
The sympathetic system, under the influence of egilok, reduces activity towards the myocardium. Egilok, by blocking β1-adrenergic receptors, slows down the pulse, reduces four important values at once: heart rate, cardiac output, force of contractility and blood pressure numbers.
Such support for the heart and its vessels improves the quality of life and significantly prolongs it.
When beta1-adrenergic receptors are blocked, the heart works calmly. Its blood filling is carried out more completely and without overload, at the moment of relaxation (diastole phase) of the ventricles. The group's medicines are a lucky find for pharmacists. Egilok () is a typical representative of a number of beta-blockers.
The problem for patients with high blood pressure is left ventricular dysfunction, enlargement of the ventricle due to excess load (blood pressure) on it. Regular long-term use of Egilok allows you to reverse this pathology. The ventricle, without experiencing overload, changes size: it returns closer to normal.
Normalizing the size and function of the left ventricle and restoring the time needed for rest (diastole) has a direct impact on patient survival. Mortality from vascular accidents, especially in men, is significantly reduced. Why egilok tablets are taken: to prevent such misfortunes as heart attacks, strokes, cases sudden death. If hypertension is moderate, “mild,” then the therapeutic effect is more pronounced.
The need of the heart muscle for oxygen supply with blood decreases, and blood supply increases. The preload on the heart is reduced; it does not have to make as much effort to pump blood as before taking the medicine. Oxygen is absorbed better than what happened at high heart rate and pressure.
The selectivity of Egilok is an advantage over non-selective drugs of the same group. It has almost no spasmodic effect (with adequate doses) on the respiratory muscles (bronchi), as well as on the smooth muscles of the walls of peripheral vessels. It also does not affect tissues of muscles not included in the myocardial zone. It works only cardiologically, with a positive effect.
Egilok is good for diabetics: without affecting metabolic processes, it does not provoke hypoglycemia. Insulin secretion does not depend on the presence of metoprolol (egilok) in the blood. Cholesterol levels with prolonged therapy with Egilok are significantly reduced.
Pharmacokinetics
Absorption of the active substance after passing through the metabolic barrier of the liver occurs quickly. The process improves with an increase in the percentage of bioavailability if egilok tablets, according to the instructions for its use, are consumed with food. The liver controls everything entering the gastrointestinal tract, so it is easier to “slip” it unchanged through the gastrointestinal tract with food. It becomes 40% more accessible to the body than taken on an empty stomach. Metabolites lose the therapeutic activity of egilok.
The percentage of binding of metoprolol to blood proteins varies. It is small at healthy liver, but reaches 10% – with its pathology.
The drug is eliminated by the kidneys. It may slow down renal failure, but it does not cause any significant harm.
Indications for use
For egilok, the indications for its use are similar to the use of other beta-blockers. What these tablets are prescribed for can be understood by studying the mechanism of action of egilok. The drug is used for:
- Hypertension of all stages ( arterial hypertension) – monotherapy or as a component in a complex of drugs;
- Tachyarrhythmias (tachycardias) of inorganic origin are functional reversible malfunctions of the myocardium;
- Arrhythmias with organic causes: supraventricular, paroxysmal tachycardia, atrial, ventricular, supraventricular extrasystole;
- Angina pectoris, stable course;
- Prevention of exacerbation of migraine, prevention of painful attacks;
- Hyperthyroidism (symptom relief, addition of specific therapeutic methods);
- Angina pectoris complicated by infarction – egilok in the complex of main therapeutic measures. Treatment of the post-infarction state, simultaneous prevention of recurrence, prevention of a new heart attack.
The instructions for use indicate at what pressure Egilok is effective. It is prescribed for any stage of this disease. If blood pressure levels are slightly higher than normal, one drug may help (monotherapy). Then the instructions for use provide a minimum - 25 mg of egilok per dose may already be enough.
Ischemia – narrowing, infringement. In fact, there is no infringement, there is a strong narrowing of the feeding arteries. In acute cases, and - their blockage, closure of the lumen with atherosclerosis (plaques come off), thrombosis (blockage of a vessel with a blood clot). When the lumen of the vessels is narrowed, the nutrition of the myocardium is inevitably disrupted. Egilok relaxes blood vessels, facilitating the passage of blood through them to the myocardium. IHD is a form of angina “with experience”, its dangerous phase. By improving the blood supply and nutrition of the heart, egilok helps it survive.
Used after heart attacks, protects against recurrences, increases survival
This happens in neuroses, in those suffering from dystonia, and other disorders. nervous system or cardiovascular. Among the whole range of symptoms, tachycardia often comes out ahead of the rest. It worries more, creates fear, intensifies itself and intensifies the rest of the symptoms. There is no better remedy than beta blockers. Egilok will calm down a rapid pulse and, having some anxiolytic and anti-anxiety effect, will calm a person. At the same time, other unpleasant symptoms will go away: fear, sweating, tremors. Even a heart that does not have organic changes anxiety no good. The drug will help return everything to normal.
Arithymia of organic origin
Complex, severe rhythm disturbances. Called different reasons: atherosclerosis, impaired conduction of myocardial impulses, pathology of the sinus node. Beta blockers regulate the rhythm during tachycardia (reduce heart rate). Some types of ecstasystole are amenable to egilok, the rhythm is evened out. Or extrasystoles at least become less frequent, gain sinus rhythm instead of cluttered. The medicine egilok is sometimes used even for implicit bradycardia - for health reasons. Special caution is needed here, but the patient’s life must be saved. Even Egilok 25 may turn out to be an excess, it is divided, and initially dosed with a quarter of such a tablet. And this small dose will still have the desired impact. Almost without slowing down the pulse contractions.
The instructions for use list bradycardia as a contraindication for Egilok, but reviews from practicing cardiologists indicate: sometimes, in the smallest doses, it is necessary. Grind (again contrary to the instructions), directly under the tongue - for speed of action. This will save lives in an acute situation, and the selection of other drugs will come later.
If the heart rate allows (not too low), beta blockers help with this diagnosis. Attacks of angina pectoris, it is not for nothing that it is named with the addition of the word “stress,” occur during physical or mental stress. Egilok, taken constantly, relieves stress. Attacks become rare and mild.
Migraine, attack prevention
The disease is common, but little studied. The culprit of pain today is considered to be dilatation (expansion) of cerebral vessels due to their overflow with blood and increased pressure.
By lowering blood pressure, egilok warns and blocks dilatation.
Additionally, it has an anti-anxiety effect: it has been noted that migraine attacks are a frequent occurrence in anxious people. No anxiety - no migraine.
The disease cannot be treated with beta blockers. But they are used for an auxiliary purpose. Egilok will help reduce the rapid pulse characteristic of the disease. At the same time, the intensity of sweating, tremor, and blood pressure decrease. The symptoms of hyperthyroidism are smoothed out, this is important for the patient’s well-being.
Prevention of recurrent heart attacks
The drug, in combination with others, helps protect a person from the risk of a recurrence of a heart attack. A weakened heart may not be able to withstand a second heart attack. Here the role of medications and the doctor’s ability to navigate their selection and development of treatment tactics are vitally important.
Now you know what egilok helps with. It's time to find out when it's not shown. Contraindications to taking Egilok are:
Use with caution
- Pheochromocytoma – combination with alpha-blockers is necessary; without them, Egilok is not used.
- Diabetes mellitus has a dose-dependent effect; at high doses, stimulation of hypoglycemia cannot be ruled out.
- Metabolic acidosis – interference with failure may occur metabolic processes beta blocker with unpredictable results.
- Bronchial asthma – small effect on controllers respiratory system receptors of the second type - β2-adrenergic receptors are occasionally found in sensitive, asthmatic patients.
- Obliterating endarteritis, pathology of peripheral vessels.
- Failure - renal, hepatic: possible clearance problems, delayed elimination, increased concentration of the drug above the recommended level in the body.
- Depression is a stage of exacerbation or remission.
- Tendency to allergies - if it is necessary to administer anti-shock drugs (adrenaline), the body may not respond to them under the influence of egilok.
- Hyperthyroidism (thyrotoxicosis) – increased hormonal activity of the affected person thyroid gland requires careful selection of drugs and doses, even for symptomatic treatment.
- COPD - severe lung disease makes the respiratory system sensitive even to almost neutral selective beta blockers. The cardioselectivity of Egilok does not exclude micro-influences on other systems. If they are impaired by disease, special control is required.
Pregnancy, lactation
If both are at risk: the mother from stopping Egilok, the fetus from using it, doctors compare the risks. If possible, a drug that is gentle on the baby is selected for the pregnant woman. If such a possibility is excluded, and it is egilok that is needed (for health reasons), they try to save both. The effect of the drug on the developing organism is carefully monitored.
The newborn is immediately examined, checked for possible pathological deviations of systems and organs.
If there are any, carry out intensive care, trying to correct Negative influence drug received in utero.
The child may be under observation for a long time.
Directions for use, dosage
Take the drug without strictly linking the time of administration with food. There is no need to wait minutes before or after eating. You can - right along with food, it will be absorbed even better. The daily dose of egilok is divided according to the instructions in the instructions into two doses - morning and evening. The minimum is set based on the condition and concomitant diseases. Start with small doses. Through gradual selection they reach the optimal one. At each such increasing “step” they stay for up to two weeks to check the effectiveness.
Daily maximum: 200 mg, no more should be taken, the risk of side effects will increase. If the recommended daily dose is exceeded, the selectivity of egilok is partially lost. The active substance may begin to block both types of adrenergic receptors, which should not be allowed. The doctor's prescriptions should be carried out scrupulously: he knows how much to prescribe and takes into account all the features of the drug.
The dosage of Egilok can and should vary depending on the type of disease. There may be the same doses for some diagnoses.
The dosage of Egilok varies from the initial dose of 25 mg to the maximum dose of 200 mg. The selection is individual, stepwise. Reception according to the scheme: morning + evening, the dose is divided in half. They settle on the most comfortable dose that provides the expected effect. Arterial hypertension, detected in time, at the onset stage, can be corrected with Egilok monotherapy. If the disease persists and blood pressure levels are high, well-combined drugs from other groups that lower blood pressure are added.
Start with 25 or 50 mg, depending on the patient’s condition and overall tolerance to the medication. For ischemic heart disease, this dosage is taken twice or three times a day. The daily dose can be increased to 200 mg. If such an amount is poorly tolerated, and a smaller amount does not give the desired effect, leave it in a normally tolerated amount. The treatment is adjusted by adding another medicine that complements Egilok, which alleviates the patient’s condition.
Functional tachyarrhythmia
Prescription: morning and evening – 50 mg each. If the effect is insufficient - 100 mg. Monotherapy usually works well.
Extrasystole, tachycardia
Start with 25 or 50 mg. Frequency of administration: three times a day. If it is well tolerated but has little effectiveness, the dose is increased. Do not exceed the maximum level - 200 mg. You can practice combined treatment of arrhythmias. It’s better to start – stationary.
Stable exertional angina
The treatment regimen is similar to the treatment of coronary heart disease, since coronary artery disease develops with the progression of angina pectoris and is one of its stages.
Preventing migraine attacks
Dose selection is individual. Usually it is 100 mg, divided into two doses. Or - the maximum daily dose of two hundred milligrams. Also divided in half, taken twice (morning + evening).
If migraine attacks are rare, continuous use is not practiced. The approach of an attack is characterized by precursors (decreased vision, flashing of bright spots before the eyes). When such precursors are present, immediately take Egilok in a pre-selected dose. Continue for several days.
For frequently annoying migraines, Egilok is indicated for use - constantly
Up to four doses per day. The maximum daily dose or close to it (150 – 100 mg).
Prevention of recurrent heart attacks. Maximum or half daily dose agents (200 or 100 mg). Divided into two, reception: morning and evening.
Side effects
Egilok has side effects, which is understandable: the medicine, even with its selectivity, is in the systemic circulation. Organisms are different, so is reactivity. What is useful for most is not suitable for everyone. Undesirable effects from taking Egilok:
- Headache, dizziness;
- Inhibition or activation of nervous processes: from excessive excitability to severe fatigue;
- Sexual dysfunction – decreased libido/potency;
- Amnestic-confabulatory syndrome (memory problems);
- Increased unmotivated anxiety;
- Feeling of cold feet;
- Drying of the mucous membranes of the mouth;
- Insomnia or drowsiness;
- Symptomatic exacerbation of heart failure;
- Orthostatic hypotension;
- Hallucinations;
- Painful heartbeat;
- Cardiogenic shock;
- Liver failure;
- Abdominal pain,
- Cardiac conduction disturbances;
- Constipation;
- Gangrene (due to worsening peripheral circulatory disorders);
- Vomit;
- Tinnitus;
- Conjunctivitis;
- Distortion of taste perception;
- Decreased vision;
- Rhinitis;
- Alopecia;
- Bronchospasm;
- Irritation of the mucous membranes of the eyes;
- Photosensitivity;
- Shortness of breath on exertion;
- Hives;
- Arthralgia;
- Heavy sweating;
- Increased weight gain.
An overdose of Egilok during therapy with blood pressure-lowering drugs, taking barbiurates, or in the presence of ethanol in the body is more dangerous. Symptoms intensify, the prognosis worsens.
Emergency assistance is needed, hospitalization and a set of rehabilitation measures are required.
Before the ambulance arrives, if consciousness is preserved, you can give an enterosorbent and try to induce vomiting.
drug interaction
Concomitant use with antihypertensive drugs causes an additive effect. Combination therapy is prescribed, started and monitored by a doctor. The overall effect is the goal of such treatment, but it should not be excessive. Excessive doses are dangerous due to hypotension, which can cause a number of complications. Some of them are more dangerous than high blood pressure.
It is risky to combine Egilok and other beta blockers with calcium channel blockers (slow). Particularly dangerous intravenous use verapamil, there is a risk of asystole (cardiac arrest).
Antiarrhythmics taken orally (cordarone, quinine) can provoke atrioventricular block. Severe bradycardia cannot be ruled out.
Do not combine Egilok with cardiac glycosides: the conductive function of the heart may be affected and severe bradycardia may develop.
Reserpine and some other antihypertensive drugs are not combined with egilok, a representative of beta-blockers. The situation is fraught with hypotension and bradycardia.
If clonidine is still taken with egilok, long-term use of clonidine is not currently practiced. It is impossible to cancel drugs at the same time. The order is as follows: first stop taking metoprolol (egilok). Clonidine remains “on the drug menu” for several more days. Then it is cancelled. If you do otherwise, remove clonidine first, there is a high probability of two consequences. The development of a hypertensive crisis and the formation of drug dependence occur.
CNS depressants (neuroleptics, tranquilizers, ethanol and other substances of similar action) together with egilok can cause critical hypotension. Will be required emergency measures recovery. And if someone taking a beta blocker is given anesthesia, there is a risk of asystole.
Do not combine alpha and beta sympathomimetics with Egilok (severe hypotension, clinically significant bradycardia, high risk of cardiac arrest).
Ergotamine has a vasoconstrictor effect; a beta blocker cannot resist it in this combination.
Egilok has many incompatibilities with medications. NSAIDs – anti-inflammatory drugs of this type reduce its effectiveness.
Antihyperglycemic agents and insulin increase their activity when paired with Egilok (risk of hypoglycemia).
Estrogens prevent beta blockers from lowering blood pressure
Inhibitors of various enzymes and neurotransmitters - the effect of the drug is enhanced by increasing its concentration in the body.
Barbiurates and other enzyme inducers inhibit metoprolol, and the effect of egilok weakens.
If substances that block the nodes (ganglia) of the sympathetic nervous system (nervous system) and drugs of the same group with egilok (beta-blockers) are used, even when this is - eye drops- requires special control. The body's reactions to these combinations are unpredictable.
special instructions
Analogs
Egilok, as the instructions for use reveal, is the same as metoprolol (price and place of production vary).
The medicine is effective, common, and necessary for many people. Egilok has many analogues in the country and around the world. Most are given a name that matches active substance, some - by the companies that produce them. The price of Egilok is not the lowest, nor is it low: for thirty 100 mg tablets the patient will pay 130 - 150 rubles. Can buy cheap analogue egilok, instructions, composition, properties are the same: metoprolol (after agreeing on a replacement with the doctor) - German, the same packaging - 55 rubles.
The most famous analogues are:
- Metoprolol: Russia, Poland;
- Lidalok: Russia;
- Metoprolol Teva: Israel;
- Metolol: Russia;
- Metoprolol ratiopharm: Germany;
- Emzok: Germany;
- Metoprolol organic: Russia;
- Metoprolol zentiva: Slovenia;
- Egilok Retard (extended): Switzerland, Hungary;
- Metoprolol-Obl: Russia;
- Metoprolol succinate: India;
- Metozok: Russia;
- Metokor adifarm: Bulgaria;
- Metoprolol tartrate: Ukraine;
- Corvitol 50: Germany;
- Betaloc, Betaloc ZOK (extended): Sweden, France;
- Metocard: Russia, Poland;
- Metoprolol-acri: Russia;
- Vasocardin: Slovenia;
- Betalok: Sweden;
- Egilok S (extended): Hungary;
- Serdol: Romania;
- Egilok: Hungary.
Dispensation by prescription.
INN: Metoprolol
Manufacturer: CJSC "EGIS Pharmaceutical Plant"
Anatomical-therapeutic-chemical classification: Metoprolol
Registration number in the Republic of Kazakhstan: No. RK-LS-5No. 012141
Registration period: 15.02.2018 - 15.02.2028
KNF (medicinal product included in the Kazakhstan national formulary medicines)
ALO (Included in the List of free outpatient drug provision)
ED (Included in the List of drugs within the framework of the guaranteed volume of free medical care, subject to purchase from the Single Distributor)
Limit purchase price in the Republic of Kazakhstan: 20.53 KZT
Instructions
Tradename
Minternational nonproprietary name
Metoprolol
Dosage form
Tablets 25mg, 50mg, 100mg
Compound
One tablet contains
active substance- metoprolol tartrate 25mg, 50mg, 100mg,
Excipients: microcrystalline cellulose, sodium starch glycolate (type A), colloidal anhydrous silicon dioxide, povidone (K-90), magnesium stearate.
Description
Tablets white or almost white, round in shape, with a biconvex surface, with a cross-shaped dividing line and a double bevel (“double snap”) on one side and an engraving of a stylized letter “E” and the number 435 on the other side, odorless or almost odorless (for dosage25mg)
Tablets are white or almost white, round in shape, with a biconvex surface, scored on one side and engraved with the stylized letter “E” and the number 434 on the other side, odorless or almost odorless (for dosage50mg)
Tablets are white or almost white, round in shape, with a biconvex surface, chamfered, scored on one side and engraved with the stylized letter “E” and number 432 on the other side, odorless or almost odorless (for dosage100mg)
Pharmacotherapeutic group
Drugs for the treatment of diseases of cardio-vascular system. Beta-blockers are selective. Metoprolol.
ATX code C07A B02
Pharmacological properties
Pharmacokinetics
Metoprolol is rapidly and completely absorbed from gastrointestinal tract. In the therapeutic dose range, the drug is characterized by linear pharmacokinetics. The maximum concentration in blood plasma is achieved 1.5-2 hours after administration. Despite significant individual variations in plasma drug levels, these differences are minor in each individual patient. After absorption, metoprolol undergoes significant first-pass metabolism through the liver. The bioavailability of metoprolol is approximately 50% with a single dose and approximately 70% with multiple doses. At the same time, eating can increase the bioavailability of metoprolol by 30 - 40%. Binds to plasma proteins by approximately 5-10%. Metoprolol is widely distributed in tissues and has a high volume of distribution (5.6 l/kg). Metoprolol is metabolized in the liver by cytochrome P-450 enzymes CYP2D6. Metabolites have no clinical significance. The half-life averages 3.5 hours (range 1 to 9 hours). The total clearance of the drug is approximately 1 l/min. About 95% of the dose taken orally is excreted in the urine, of which 5% is unchanged (in in some cases can reach 30%).
Special patient groups
There were no significant changes in the pharmacokinetics of metoprolol in elderly patients.
Impaired renal function does not affect the systemic bioavailability or excretion of metoprolol. However, in these cases there is a decrease in the excretion of metabolites.
In severe renal failure (GFR 5 ml/min), significant accumulation of metabolites is observed. However, this accumulation of metabolites does not enhance the degree of β-adrenergic blockade. Impaired liver function has little effect on the pharmacokinetics of metoprolol. However, in severe liver cirrhosis and after a portacaval shunt, bioavailability may increase and total clearance may decrease. After portacaval shunt, the total clearance of the drug is approximately 0.3 L/min, and the area under the concentration-time curve increases approximately 6-fold compared with healthy individuals.
Pharmacodynamics
Metoprolol is a cardioselective β1-blocker that does not have intrinsic sympathomimetic or membrane-stabilizing activity. It has antihypertensive, antianginal and antiarrhythmic effects.
Metoprolol interferes with the stimulating effect of the sympathetic nervous system on the heart and causes a rapid decrease in heart rate. heart rate, contractility, minute volume and blood pressure during physical and mental stress and stress.
At elevated level endogenous adrenaline, metoprolol has a lesser effect on blood pressure than non-selective beta-blockers. If necessary, metoprolol in combination with a β2-agonist can be prescribed to patients with obstructive pulmonary diseases. IN therapeutic doses metoprolol has a lesser effect on the bronchodilatory effect of β2-agonists than non-selective β-blockers.
Compared to non-selective β-blockers, metoprolol has less effect on insulin production and carbohydrate metabolism. The drug does not significantly alter the cardiovascular response to hypoglycemia and does not increase the duration of hypoglycemia attacks.
IN clinical studies It was found that metoprolol slightly increases the level of triglycerides and slightly decreases the level of free fatty acids in the blood plasma. In some cases, a slight decrease in HDL levels was observed. This decrease was less pronounced than with the use of non-selective beta-blockers. However, in a long-term study, a statistically significant reduction in cholesterol levels was observed after several years of treatment with metoprolol. During treatment with metoprolol, the quality of life did not change or improved. Treatment with metoprolol after myocardial infarction improved quality of life.
For arterial hypertension it lowers blood pressure in patients standing and lying down. At the beginning of treatment with metoprolol, a short-term (lasting for several hours), clinically insignificant increase in peripheral vascular resistance was observed. The long-term antihypertensive effect of the drug is associated with a gradual decrease in total peripheral vascular resistance.
In arterial hypertension, long-term use of the drug leads to a statistically significant decrease in the mass of the left ventricle and an improvement in its filling and diastolic function.
In men with moderate or moderate arterial In hypertension, metoprolol reduces mortality from cardiovascular disorders (primarily sudden death, fatal and non-fatal myocardial infarction and stroke).
Like other β-blockers, metoprolol reduces myocardial oxygen demand by reducing systemic blood pressure, heart rate and myocardial contractility. By reducing heart rate and correspondingly prolonging diastole, metoprolol improves blood supply and oxygenation to areas of the myocardium with impaired blood flow.
For heart rhythm disturbances(supraventricular tachycardia, atrial fibrillation and ventricular extrasystole) metoprolol lowers the heart rate and the number of ventricular extrasystoles).
With myocardial infarction metoprolol reduces mortality by reducing the risk of sudden death. This effect is primarily associated with the prevention of episodes of ventricular fibrillation. The mechanism of this effect is twofold:
(1) central excitation vagus nerve has a beneficial effect on the electrical stability of the myocardium,
(2) blocking the effects of the sympathetic nervous system reduces myocardial contractility, heart rate and blood pressure. A reduction in mortality can also be observed with metoprolol in both the early and late phases, as well as in high-risk patients (with cardiovascular disease) and patients with diabetes. Use of the drug after a myocardial infarction reduces the likelihood of a non-fatal recurrent heart attack.
treatment of functional heart disorders with palpitations.
Metoprolol can be used for prevention of migraine attacks.
At hyperthyroidism metoprolol reduces clinical manifestations diseases, thus it can be used as an adjunctive therapy.
Indications for use
Arterial hypertension (as monotherapy or in combination with other antihypertensive drugs;
Stable and unstable angina (as monotherapy or in combination with other antianginal drugs, as well as for the prevention of angina attacks)
Secondary prevention after myocardial infarction (maintenance therapy)
Heart rhythm disturbances ( sinus tachycardia, supraventricular tachycardia, ventricular extrasystoles)
Preventing migraine attacks
Functional cardiac disorders accompanied by tachycardia (including hyperthyroidism)
Dosage and administration
The tablets can be taken regardless of meals. If necessary, the tablet can be divided into equal doses. The dose is selected individually to avoid excessive bradycardia.
For arterial hypertension: The recommended initial dose is 25-50 mg twice a day (morning and evening). If the clinical effect is insufficient, the daily dose can be increased to 100 mg twice a day, or Egilok can be used in combination with other antihypertensive drugs. Maximum dose 200 mg per day, divided into several doses.
For angina pectoris: The recommended initial dose is 25-50 mg 2-3 times a day. If the clinical effect is insufficient, this dose can be gradually increased to 200 mg per day or Egilok can be used in combination with other antianginal drugs.
Maintenance therapy after myocardial infarction: recommended dose
50-100 mg twice a day (morning and evening).
For arrhythmias: The recommended initial dose is 25-50 mg 2-3 times a day. If the clinical effect is insufficient, this dose can be gradually increased to 200 mg or Egilok can be used in combination with other antiarrhythmic drugs.
To prevent migraine attacks: The recommended dose is 50 mg twice a day (morning and evening); if necessary, it can be increased to 100 mg twice daily.
For functional disorders of cardiac activity accompanied by tachycardia (including hyperthyroidism): The recommended daily dose is 50 mg twice a day (morning and evening); if necessary, it can be increased to 100 mg twice daily.
Special patient groups:
When prescribing the drug patients with impaired renal function or elderly people there is no need to adjust the dosage regimen.
When prescribing the drug patients with severe liver dysfunction(for example, in patients with cirrhosis who have undergone bypass surgery) its dose may need to be reduced. In patients with liver cirrhosis, there is no need to adjust the dosage regimen due to the low binding of metoprolol to plasma proteins (5-10%).
Children and adolescents under 18 years of age
There is limited experience with the drug in children and adolescents. There is no data on the effectiveness and safety of Egilok tablets.
Side effects
The following side effects have been reported in clinical trials and during therapeutic use of metoprolol. In some cases, the connection between an adverse event and the use of the drug has not been reliably established.
Very common (≥1/10)
Increased fatigue
Often (≥1/100 -<1/10)
Dizziness, headache
Bradycardia, cold extremities, increased heart rate, orthostatic hypotension, which is very rarely associated with syncope
Nausea, abdominal pain, diarrhea, constipation
Tension dyspnea
Uncommon (≥1/1000 -<1/100)
- increased symptoms of heart failure, first degree atrioventricular block, peripheral edema, pain in the heart, cardiogenic shock in patients with acute myocardial infarction
Depression, impaired concentration, sleep disturbance, drowsiness, insomnia, nightmares
Paresthesia, muscle spasms
Skin itching, rash, urticaria, psoriasis-like skin lesions, dystrophic skin lesions, increased sweating
Bronchospasm (even in the absence of diagnosed obstructive pulmonary disease)
Weight gain
Rarely (≥1/10,000 -<1/1000)
Dry mouth
Complaints about paresthesia, muscle spasms, nervous excitability, anxiety
Impaired potency, impaired sexual function
Arrhythmias, myocardial conduction disorders
Changes in liver function tests, hepatitis
Hair loss
Conjunctivitis, dry and irritated eyes (which may be problematic for contact lens wearers), blurred vision
Very rare (≥1/10,000)
Amnesia, memory loss or impairment, confusion, hallucinations, tinnitus, hearing loss
Worsening of pre-existing peripheral circulatory disorders , increased symptoms of intermittent claudication or Raynaud's disease, gangrene in patients with previous severe peripheral circulatory disorders
Photosensitivity
Exacerbation of psoriasis
Change in taste sensations
Thrombocytopenia
Joint pain (arthralgia)
Taking Egilok should be discontinued if any of the above effects reaches a clinically significant intensity, and its cause cannot be reliably determined.
Contraindications
Hypersensitivity to metoprolol or other components of the drug, as well as to other beta-blockers
Arterial hypotension
Atrioventricular block II or III degree
Decompensated heart failure
Clinically significant sinus bradycardia
Sick sinus syndrome
Cardiogenic shock
Severe peripheral circulatory disorders
Acute myocardial infarction if:
heart rate below 45 beats per minute,
P-Q interval exceeds 240 m/s,
systolic blood pressure below 100 mmHg.
Patients requiring chronic or intermittent treatment with inotropes (β-agonists)
Concomitant intravenous administration of verapamil or other similar calcium channel blockers
Severe peripheral vascular diseases with threat of gangrene
First trimester of pregnancy and lactation period
Children under 18 years of age (due to lack of sufficient clinical data).
Drug Interactions
The antihypertensive effects of Egilok and other antihypertensive drugs are usually cumulative, therefore, to avoid the development of arterial hypotension, careful monitoring of the condition of patients receiving combinations of such drugs is necessary. However, the additive effects of antihypertensive drugs can be used, if necessary, to achieve more effective blood pressure control.
Intravenous administration of calcium channel blockers such as verapamil is not recommended for patients taking β-blockers. The simultaneous use of metoprolol with calcium channel blockers such as verapamil or diltiazem leads to an increase in negative inotropic and chronotropic effects.
Caution should be exercised when combined with the following drugs
When used simultaneously with oral antiarrhythmic drugs (such as quinidine and amiodarone), as well as parasympathomimetics, there may be a risk of developing arterial hypotension, bradycardia, and atrioventricular block.
When used simultaneously with digitalis glycosides, there may be a risk of developing bradycardia and conduction disorders; metoprolol does not affect the positive inotropic effect of digitalis preparations.
When used simultaneously with other antihypertensive drugs (guanethidine, reserpine, methyldopa, clonidine, guanfacine), severe bradycardia may develop.
In combination therapy with clonidine, the latter should be discontinued several days after metoprolol is discontinued in order to avoid a hypertensive crisis.
When used simultaneously with barbiturates, tranquilizers, tri- and tetracyclic antidepressants, antipsychotics and ethanol, there may be a risk of developing arterial hypotension.
Inhalation anesthetics (hydrocarbon derivatives) when used simultaneously with Egilok increase the risk of inhibition of myocardial contractile function and the development of arterial hypotension.
When used simultaneously with β- and β-sympathomimetics, there is a possible risk of developing arterial hypertension, severe bradycardia, and a possible risk of cardiac arrest.
When used simultaneously with ergotamine, peripheral blood circulation may be increased.
When used simultaneously with β2-sympathomimetics, functional antagonism is possible.
When used simultaneously with non-steroidal anti-inflammatory drugs (indomethacin), the hypotensive effect of metoprolol may be reduced.
When used simultaneously with estrogens, the antihypertensive effect of metoprolol is reduced.
When taken simultaneously with oral hypoglycemic drugs, their effect may be reduced; with insulin - an increased risk of developing hypoglycemia, increasing its severity and prolongation, masking the symptoms of hypoglycemia.
With simultaneous use, Egilok enhances the effect of curare-like muscle relaxants.
With simultaneous use of Egilok with inhibitors of microsomal liver enzymes (cimetidine, ethanol, hydralazine; serotonin reuptake inhibitors - paroxetine, fluoxetine and sertraline), the effects of metoprolol may be enhanced due to an increase in its concentration in plasma.
With simultaneous use of Egilok with inducers of microsomal liver enzymes CYP2D6 (rifampicin and barbiturates), it is possible to accelerate the metabolism of metoprolol, which leads to a decrease in the concentration of metoprolol in the blood plasma and a decrease in the effect of Egilok.
During therapy with Egilok, patients simultaneously taking ganglion blockers, other β-blockers (including in the form of eye drops) or MAO inhibitors should be under close medical supervision.
special instructions
Clinical experience with metoprolol in children is limited.
In patients taking metoprolol, anaphylactic shock is more severe.
Very rarely, during therapy with Egilok, patients with conduction disorders may experience a deterioration in their condition, sometimes with the development of atrioventricular block. If bradycardia develops during treatment, the dose of the drug should be reduced or the drug should be gradually discontinued.
The use of Egilok may worsen the symptoms of peripheral arterial circulation disorders.
The drug is discontinued gradually, reducing the dose over approximately 14 days. Abrupt cessation of treatment may increase the symptoms of angina and increase the risk of coronary events. When discontinuing the drug, special attention should be paid to patients with coronary artery disease.
Despite the fact that cardioselective β-blockers have less effect on respiratory function compared to non-selective β-blockers, Egilok is prescribed with caution to patients with chronic obstructive respiratory diseases. When prescribing metoprolol to patients with bronchial asthma, simultaneous use of β2-adrenergic agonists (in the form of tablets or aerosol) is necessary.
Selective β-blockers, unlike non-selective ones, relatively rarely affect carbohydrate metabolism or mask the symptoms of hyperglycemia. In patients with diabetes mellitus taking Egilok, blood glucose levels should be regularly monitored and, if necessary, the dose of insulin or oral hypoglycemic drugs should be adjusted.
In patients with pheochromocytoma, Egilok should be used in combination with β-blockers.
If surgical intervention is necessary, it is necessary to warn the anesthesiologist about the therapy being carried out with Egilok (choosing a drug for general anesthesia with minimal negative inotropic effect); discontinuation of the drug is not required.
Pregnancy and lactation
The use of the drug during pregnancy requires a careful assessment of the risks and benefits. If it is necessary to prescribe the drug during this period, careful monitoring of the condition of the fetus and newborn is necessary for 48-72 hours after birth, since intrauterine growth retardation, bradycardia, arterial hypotension, respiratory depression, and hypoglycemia are possible. Metoprolol passes into breast milk only in small quantities; however, it is recommended to stop breastfeeding.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms.
Metoprolol adversely affects the patient's ability to drive vehicles and perform work with an increased risk of accidents, especially at the beginning of treatment and while taking alcohol (dizziness and fatigue may develop). In patients whose activities require increased attention and speed of psychomotor reactions, dose selection should be decided only after assessing the patient’s individual response to the drug.
Overdose
Symptoms: arterial hypotension, severe sinus bradycardia, heart failure, asystole, nausea, vomiting, bronchospasm, cyanosis, hypoglycemia; in case of acute overdose - loss of consciousness, cardiogenic shock, atrioventricular block, coma. The first symptoms of an overdose appear 20 minutes - 2 hours after taking the drug.
The above symptoms may be aggravated when taking the drug simultaneously with alcohol, other antihypertensive drugs, quinidine and barbiturates.
Treatment: Gastric lavage (if lavage is impossible and if the patient is conscious, vomiting can be induced), administration of adsorbents, symptomatic therapy. Intensive therapy and careful monitoring of circulatory and respiratory parameters, renal function, blood glucose levels, and serum electrolytes are required. Atropine sulfate (0.25-0.5 mg IV for adults, 10-20 µg/kg for children) should be given before gastric lavage (due to the risk of vagus nerve stimulation). For severe arterial hypotension, bradycardia and threatening heart failure - intravenous administration of β-adrenergic stimulants at intervals of 2-5 minutes or by infusion until the desired effect is achieved or intravenous administration of atropine. If there is no positive effect, dopamine, dobutamine or norepinephrine are used. Administration of glucagon in doses of 1–10 mg may also be useful in achieving reversal of the effects of strong β-receptor blockade. In cases of severe bradycardia that are resistant to pharmacotherapy, implantation of a cardiac pacemaker may be required. For bronchospasm, intravenous administration of a β2-agonist (for example, terbutaline). These antidotes can be used in doses exceeding therapeutic ones. Metoprolol cannot be effectively removed by hemodialysis.
Release form and packaging
- Egilok, instructions, price, analoguesAdvantages: low price, efficiency
Disadvantages: has contraindications
Not all of us can boast of the absence of health problems. Sooner or later, one or another chronic disease overtakes or worsens a person. Often, both women and men experience problems associated with heart rhythm disturbances, increased blood pressure, and frequent headaches.
Today we will talk about a drug like Egilok.
Egilok
Ekilog is a cardioselective b-adrenergic receptor blocker.
This drug does not have intrinsic sympathomimetic and membrane-stabilizing activity.
Ekilog provides:
Antihypertensive;
Antiarrhythmic;
Antianginal actions.
Egilok is available in two dosages, 25 and 50 mg.
The price fluctuates around 130 - 180 rubles per package.
Production: Hungary.
According to the instructions for use, Egilok:
After several weeks of regular use of the drug, it was noticed among patients that Egilok reduces blood pressure quite quickly, usually this occurs within 15-120 minutes.
Reduces frequent attacks of angina pectoris and myocardial excitability.
Prevents migraine attacks and frequent headaches.
Reduces blood cholesterol levels.
Typically, Egilok is prescribed by a therapist or cardiologist, either as monotherapy or in combination with other antihypertensive drugs, for example, Concor, Bisoprolol, Lisinopril, Captoril, Cardiomagnyl, etc.
Indications for use are:
Chronic heart failure, prevention of myocardial infarction, heart rhythm disturbances;
Hyperkinetic cardiac syndrome, hyperthyroidism;
Prevention of migraine attacks.
The drug has contraindications, so carefully read the instructions for use before use!
The active ingredient in the drug "Egilok" is metoprolol tartrate.
Excipients: MCC, colloidal silicon dioxide, sodium carboxymethyl starch, povidone, magnesium stearate.
Analogues in composition are the following drugs:
* Betalok (UK) price from 470 rubles;
* Egilok S (Hungary) price from 320 rubles;
* Metokard (Poland) price from 70 rubles;
* Metoprolol (Russia), price from 50 rubles
The method of administration and dosage is strictly determined by the attending physician and depends on the nature of the disease, as a rule, it is 50-200 mg per day, divided into 2 doses.
Inna, 54 years old
I have chronic heart failure and hypertension. I suffered for a very long time with constantly fluctuating high blood pressure and periodic pain in the heart, until the therapist prescribed Egilok in combination with Concor. For life. While I’m taking it, it helps, and my blood pressure is within reason and my heart doesn’t go crazy, I’m afraid to think what would have happened without these drugs.
Yuri, 50 years old
Very often I was bothered by excruciating headaches, high blood pressure, fatigue, and weakness. I took one pill, then another, until Egilok was recommended. I bought it in the smallest dosage - 25 mg. I took it 2 times a day for 10 days. And, lo and behold, my blood pressure returned to normal and I began to feel great. What is noteworthy is that the effect of taking Egilok lasted for a month.
Evelina, 45 years old
During menopause, problems with migraines and heart rhythm disturbances arose. I went to work like I was dead, sometimes I just didn’t want to live because of the wild headache. It was impossible to be upset at all, just a little stress - immediately my heart hurts, my hands go numb, and I get a migraine. Finally I turned to a very good specialist. It turned out that symptoms worsened during menopause. They prescribed hormonal therapy - Femoston, vitamins with magnesium for the heart, and Egilok for the prevention of migraines. Everything in the complex helped. The preparation is very good, with it I forgot about migraines forever.
Before use, be sure to consult a specialist
Video review
| All(5) |
|---|
Egilok is a complex drug that regulates heart rate and normalizes blood pressure. This is an indispensable medicine for the elderly and all those who suffer from cardiovascular problems. The range of indications for the use of Egilok is very wide.
In this article we will look at why doctors prescribe Egilok, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Egilok can be read in the comments.
Composition and release form
The active ingredient is metoprolol tartrate. Currently, the drug Egilok is available in the following three varieties:
- Egilok tablets with regular duration of action: 25 mg, 50 mg and 100 mg;
- Egilok Retard tablets with prolonged action, 50 mg and 100 mg;
- Egilok S tablets with prolonged action of 25 mg, 50 mg, 100 mg and 200 mg.
Clinical and pharmacological group: beta1-blocker.
Egilok - what do these tablets help with?
In general, Egilok tablets have the following indications for use:
- angina pectoris;
- tachycardia;
- arrhythmias of various kinds;
- thyrotoxicosis;
- hyperthyroidism;
- primary and secondary hypertension;
- previous myocardial infarction and clearly undefined heart disease;
- migraine;
- elevated blood cholesterol levels.
The drug is a beta-blocker, that is, it reduces the effect of adrenaline, thereby reducing the number of systolic contractions of the heart during an attack.
pharmachologic effect
Cardioselective beta blocker without sympathomimetic and membrane stabilizing activity.
The main effect is hypotensive. Able to reduce heart rate. Reduces the severity and frequency of angina attacks, improves the patient’s physical well-being, and reduces the risk of recurrent myocardial infarction.
Has certain antiarrhythmic activity. Most effective for rhythm disturbances with increased heart rate.
Instructions for use
The drug in tablets is taken regardless of food; the dose selection is strictly individual and should be carried out gradually. Egilok should not be taken more than 200 mg/day. To achieve the effect, regular use of the drug is important.
- For angina pectoris, the initial dose is 25-50 mg 2-3 times a day. Depending on the effect, the dose can be gradually increased to 200 mg/day or another antianginal drug can be added.
- For cardiac arrhythmias, the initial dose is 25-50 mg 2-3 times a day; in case of insufficient effectiveness, increase it to 200 mg/day or add another antiarrhythmic drug to the treatment regimen.
- The recommended dose of the drug for maintenance therapy after myocardial infarction is 100-200 mg/day, divided into 2 doses (morning and evening).
- For cardiac arrhythmias, the initial dose is 25-50 mg 2-3 times a day. If necessary, the daily dose can be gradually increased to 200 mg/day or another antiarrhythmic agent can be added.
- For hyperthyroidism, the usual daily dose is 150-200 mg in 3-4 doses.
- For functional heart disorders accompanied by a feeling of palpitations, the usual dose is 50 mg 2 times a day (morning and evening); if necessary, the dose can be increased to 200 mg in 2 doses.
- For the prevention of migraine attacks, the recommended dose is 100 mg/day in 2 divided doses (morning and evening); if necessary, the dose can be increased to 200 mg/day in 2 divided doses.
Treatment with the drug should be completed gradually, reducing the dose every 2 weeks. Abrupt withdrawal of the drug may worsen the patient's condition.
Contraindications
The drug is contraindicated in the following diseases and situations:
- cardiogenic shock,
- hypersensitivity to metoprolol and other components of the drug,
- sinus bradycardia,
- lactation period (breastfeeding),
- Prinzmetal's angina,
- simultaneous use of inhibitors.
Prescribed with caution when:
- metabolic acidosis,
- chronic bronchitis,
- diabetes mellitus,
- liver failure,
- psoriasis,
- bronchial asthma,
- pregnancy.
Side effects
In some cases, Egilok may cause side effects.
- Cardiovascular system: palpitations, sinus bradycardia, decreased blood pressure, orthostatic hypotension.
- Central and peripheral nervous systems: weakness, increased fatigue, slowed motor and mental reactions, headache.
- Digestive system: nausea, abdominal pain, diarrhea or constipation, vomiting, dry mouth, liver dysfunction; flatulence, dyspepsia, heartburn, hepatitis.
- Respiratory system: difficulty exhaling, nasal congestion, shortness of breath.
- Hematopoietic system: agranulocytosis, thrombocytopenia, leukopenia.
- Dermatological reactions: rash, dystrophic skin changes, reversible alopecia, photosensitivity, exacerbation of psoriasis; itching, erythema, urticaria, hyperhidrosis.
- Other: slight weight gain, joint and back pain, decreased libido.
Symptoms of overdose are arterial hypotension, acute heart failure, bradycardia, cardiac arrest, AV block, cardiogenic shock, bronchospasm, impaired breathing and consciousness/coma, nausea, vomiting, generalized convulsions, cyanosis (manifest 20 minutes - 2 hours after administration).
Egilok, Egilok Retard and Egilok S
All three varieties of the drug Egilok are imported into the countries of the former USSR, and therefore differences in their costs in different pharmacies are due to wholesale prices, customs duties, exchange rates and overhead costs. This means that there is no difference between the more expensive and cheaper drugs, and you can buy Egilok, which is sold at the lowest cost.
Analogs
Analogues of Egilok are medicines that contain metoprolol. These include:
- Metoprolol,
- Revelol,
- Betalok,
- Metocard,
- Metokor.
Attention: the use of analogues must be agreed with the attending physician.
