EGILOK PILLS 25MG

Indications and usage

- arterial hypertension (in monotherapy or in combination with other antihypertensive drugs);
- chronic heart failure in the stage of compensation (in addition to standard therapy with diuretics, ACE inhibitors, cardiac glycosides);
- IHD (secondary prevention of myocardial infarction, prevention of angina attacks);
- cardiac arrhythmias (supraventricular arrhythmias, ventricular premature beats);
- Hyperkinetic cardiac syndrome;
- hyperthyroidism (as part of complex therapy);
- prevention of migraine attacks.

Contraindications

- cardiogenic shock;
- AV blockade II and III degree;
- sinoatrial block;
- SSSU;
- severe bradycardia (heart rate less than 50 beats / min);
- heart failure in the stage of decompensation;
- angiospastic stenocardia (Prinzmetal's stenocardia);
- severe arterial hypotension (systolic blood pressure below 100 mm Hg);
- lactation period;
- simultaneous administration of MAO inhibitors;
- simultaneous i / v Verapamil;
- Hypersensitivity to Metoprolol and other ingredients of the drug.
WITH caution It should be prescribed for diabetes mellitus, metabolic acidosis, bronchial asthma, chronic obstructive pulmonary disease (pulmonary emphysema, chronic obstructive bronchitis), peripheral vascular disease obliterans (intermittent claudication, Raynaud's syndrome), hepatic insufficiency, chronic renal failure, myasthenia, feohromocytoma. - block I degree, thyrotoxicosis, depression (includingin history), psoriasis, as well as in children and adolescents under the age of 18 years and in elderly patients.

Dosage and administration

EGILOK is prescribed with hypertension in a daily dose of 50-100 mg / day in 1 or 2 doses. With insufficient therapeutic effect, it is possible to gradually increase the daily dose to 100-200 mg.
With angina pectoris, supraventricular arrhythmiasfor prevention of migraine attacks prescribed in a dose of 100-200 mg / day in 2 divided doses (morning and evening).
For secondary prevention of myocardial infarction prescribed in an average daily dose of 200 mg in 2 divided doses (morning and evening).
With functional disorders of cardiac activity, accompanied by tachycardia prescribed in a daily dose of 100 mg in 2 divided doses (morning and evening).
Have elderly patients, patients with impaired renal function, as well as the need for hemodialysis, a change in dosage regimen is not required.
Have patients with severe liver dysfunction should use the drug in smaller doses, due to slower metabolism of metoprolol.
Tablets should be taken orally during or immediately after a meal. pills can be divided in half, but not chewed.

EGILOK RETARD is prescribed 1 time per day, in the morning, while eating or on an empty stomach. The dose is selected individually and gradually increased in order to prevent bradycardia.
The maximum daily dose is 200 mg.
With hypertension prescribed in the initial dose of 50 mg 1 time / day.In the absence of a clinical effect, it is possible to increase the daily dose to 100-200 mg and / or the additional prescription of other antihypertensive drugs.
With angina pectoris the initial dose is 50 mg 1 time / day. With insufficient clinical response, it is possible to increase the daily dose to 100-200 mg and / or the additional prescription of other antianginal drugs.
For secondary prevention of myocardial infarction the drug is prescribed in a daily dose of 200 mg.
In chronic heart failure in the stage of compensation (as part of complex therapy), the initial dose is 25 mg / day. After 2 weeks, the daily dose can be increased to 50 mg, after another 2 weeks, to 100 mg, and after another 2 weeks, to 200 mg.
When heart rhythm disturbances appoint 50-200 mg 1 time / day.
In hyperkinetic cardiac syndrome the drug is prescribed in a dose of 50-200 mg 1 time / day.
For the prevention of migraine attacks the drug is prescribed in a dose of 100-200 mg 1 time / day.
Have elderly patients and patients with impaired renal function, as well as the need for hemodialysis, a change in dosage regimen is not required.
Have patients with impaired liver function The dose of the drug should be selected individually depending on the clinical condition.
Tablets should be taken whole, without chewing, with a liquid. pills can be broken in half.

Adverse reactions

Nervous system: increased fatigueweakness, headache, slowing down of the speed of mental and motor reactions; rarely - paresthesias in the limbs, depression, anxiety, decreased ability to concentrate, drowsiness, insomnia, nightmares, confusion or short-term memory impairment, asthenic syndrome, muscle weakness.
Special senses: rarely - reduced vision, reduced secretion of tear fluid, xerophthalmos, conjunctivitis, tinnitus.
Cardiovascular: sinus bradycardia, palpitations, lowering blood pressure, orthostatic hypotension; rarely, a decrease in myocardial contractility, a temporary worsening of symptoms of chronic heart failure, arrhythmias, an increase in peripheral circulatory disorders (cooling of the lower limbs, Raynaud’s syndrome), myocardial conduction disturbances; in rare cases - AV blockade, cardialgia.
Gastrointestinal: nausea, vomiting, abdominal pain, diarrhea, constipation, dry mouth, change in taste; increased activity of hepatic transaminases; rarely - hyperbilirubinemia.
Dermatologic: urticaria, pruritus, rash, exacerbation of psoriasis, psoriasis-like skin changes, skin flushing, exanthema, photodermatosis, increased sweating, reversible alopecia.
Respiratory: nasal congestion, difficulty breathing out (bronchospasm when administered in high doses or in susceptible patients), shortness of breath
On the part of the endocrine system: hypoglycemia (in patients receiving insulin); rarely - hyperglycemia.
Hemic and lymphatic: thrombocytopenia, agranulocytosis, leukopenia.
Other: back or joint pain, slight weight gain, decrease in libido and / or potency.

Pregnancy and breastfeeding

The use of Egilok during pregnancy is possible only when the intended benefit to the mother outweighs the potential risk to the fetus. If necessary, the appointment of the drug in this period requires careful monitoring of the condition of the fetus and newborn for 48-72 hours after delivery, since intrauterine growth retardation, bradycardia, hypotension, respiratory depression, hypoglycemia are possible.
The effect of metoprolol on a newborn while breastfeeding has not been studied, so women who take Egilok should stop breastfeeding.

Special notes

In the appointment of the drug Egilok should regularly monitor heart rate and blood pressure. The patient should be warned that when a heart rate is less than 50 beats / min, a doctor’s consultation is necessary.
Patients with diabetes should regularly monitor blood glucose levels and, if necessary, adjust the dose of insulin or oral hypoglycemic drugs.
Appointment of Egilok in patients with chronic heart failure is possible only after reaching the stage of compensation.
In patients taking Egilok, it is possible to increase the severity of hypersensitivity reactions (against the background of burdened allergological anamnesis) and the lack of effect from the administration of usual doses of epinephrine (adrenaline).
With the use of Egilok, the symptoms of peripheral circulatory disorders may worsen.
Egilok should be abolished gradually, consistently reducing its dose within 10 days. With a sharp cessation of treatment may cause withdrawal (increased angina attacks, increased blood pressure). In the period of discontinuation of the drug, patients with angina pectoris must be under close medical supervision.
In case of angina pectoris, the selected dose of the drug should provide the heart rate at rest within 55-60 beats / min, with a load - no more than 110 beats / min.
Patients using contact lenses should take into account that, during treatment with beta-blockers, a reduction in the production of tear fluid is possible.
Metoprolol may mask some clinical manifestations of hyperthyroidism (tachycardia). Sharp cancellation in patients with thyrotoxicosis is contraindicated, as it can strengthen the symptoms.
In case of diabetes mellitus, taking Egilok can mask the symptoms of hypoglycemia (tachycardia, sweating, increased blood pressure).
When prescribing metoprolol to patients with asthma, simultaneous use of beta is necessary.2- adrenomimetics.
In patients with pheochromocytoma Egilok should be used in combination with alpha-blockers.
Before any surgical intervention, it is necessary to inform the anesthesiologist about the therapy with Egiloc (the choice of the drug for general anesthesia with minimal negative inotropic effect); drug withdrawal is not required.
In the appointment of the drug in elderly patients should regularly monitor liver function. Correction of the dosing regimen is required only in case of emergence in elderly patients of increasing bradycardia, a pronounced decrease in blood pressure, AV blockade, bronchospasm, ventricular arrhythmias, and severe liver function impairment. Sometimes it is necessary to stop treatment.
It should be a special monitoring of patients with depressive disorders in history. If depression develops, Egilok should be canceled.
Use in pediatrics
Efficacy and safety of using Egilok children and adolescents under the age of 18 not defined.
Influence on ability to drive motor transport and control mechanisms
In patients whose activities require increased attention, the question of prescribing the drug on an outpatient basis should be resolved only after evaluating the patient's individual response.

Symptoms: severe sinus bradycardia, dizziness, nausea, vomiting, cyanosis, hypotension, arrhythmia, ventricular extrasystoles, bronchospasm, syncope; in acute overdose - cardiogenic shock, loss of consciousness, coma, AV-blockade until the development of complete transverse blockade and cardiac arrest.
The first signs of overdose appear 20 min-2 h after administration.
Treatment: gastric lavage, the appointment of adsorbents, symptomatic therapy: with a pronounced decrease in blood pressure - Trendelenburg position, in the case of acute arterial hypotension, bradycardia and threatening heart failure - in / in (with an interval of 2-5 minutes), the introduction of beta-adrenostimulyatorov or in / in the introduction of 0.5 -2 mg of atropine sulfate, in the absence of a positive effect - dopamine, dobutamine or norepinephrine. As a follow-up, it is possible to administer 1-10 mg of glucagon, setting a transvenous intracardial electrostimulator. When bronchospasm - in / in the introduction of beta2-adrenostimulants, with convulsions, slow i.v. administration of diazepam. Metoprolol is poorly excreted by hemodialysis.

With the simultaneous use of Egilok with MAO inhibitors, a significant increase in the hypotensive effect is possible. The interval between taking MAO and Egilok inhibitors should be at least 14 days.
Simultaneous i / v verapamil can provoke cardiac arrest, the simultaneous appointment of Nifedipine leads to a significant reduction in blood pressure.
Means for inhalation anesthesia (derivatives of hydrocarbons) with simultaneous use with Egilok increase the risk of inhibition of myocardial contractile function and development of arterial hypotension.
With simultaneous use of beta-adrenostimulyatory, theophylline, cocaine, estrogen, Indomethacin and other NSAIDs reduce the hypotensive effect of Egilok.
With the simultaneous use of Egilok and ethanol, a strengthening of the inhibitory effect on the central nervous system is noted.
With the simultaneous use of Egilok with ergot alkaloids, the risk of peripheral circulatory disorders increases.
With simultaneous use of Egilok increases the effect of oral hypoglycemic drugs and insulin and increases the risk of hypoglycemia.
With the simultaneous use of Egilok with antihypertensive agents, nitrates, Calcium channel blockers increases the risk of arterial hypotension.
With the simultaneous use of Egilok with verapamil, diltiazem, antiarrhythmic drugs (amiodarone), reserpine, methyldopa, clonidine, guanfacine, general anesthesia and cardiac glycosides, an increase in the severity of heart rate and suppression of AV conduction may be observed.
With simultaneous use of Egilok strengthens and prolongs the action of non-depolarizing muscle relaxants.
Inductors of liver microsomal enzymes (rifampicin, barbiturates) 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.
Inhibitors of microsomal liver enzymes (cimetidine, oral contraceptives, phenothiazines) increase the concentration of metoprolol in the blood plasma.
Allergens used for immunotherapy or allergen extracts for skin tests when used together with Egilok increase the risk of systemic allergic reactions or anaphylaxis.
Iodine-containing radiopaque substances for iv administration with simultaneous use with Egilok increase the risk of Anaphylactic reactions .
With simultaneous use of Egilok enhances the effect of curare-like muscle relaxants.
Egilok with simultaneous use reduces the clearance of xanthines, especially in patients with initially increased clearance of theophylline under the influence of smoking.
With simultaneous use with Egiloc decreases clearance of Lidocaine and increases the concentration of lidocaine in plasma.
When combined with ethanol increases the risk of a pronounced decrease in blood pressure.

List B. The drug should be stored out of the reach of children at a temperature of 15 ° to 25 ° C.

- 3 years.
Pharmacy sales terms
The drug is available on prescription.