Metoprolol belongs to the classic β receptor antagonist class antihypertensive drugs, clinical application of the preparation mainly include metoprolol tartrate tablets, metoprolol tartrate extended-release tablets and metoprolol succinate extended-release tablets, in addition to antihypertensive effect, metoprolol also has the effect of treating chronic heart failure, coronary heart disease, angina. It is also a commonly used clinical drug for the treatment of tachyarrhythmias.
hypertension
β receptor blockers such as metoprolol are particularly suitable for young and middle-aged hypertension with high blood pressure based on rapid heart rate, diastolic pressure and other sympathetic nervous system excitability enhancement, as well as hypertensive patients with coronary heart disease, tachyarrhythmia, and chronic heart failure.
coronary heart disease
β receptor blockers are used for coronary heart disease, myocardial infarction patients can relieve angina and improve myocardial ischemia, but also to prevent myocardial infarction recurrence and heart failure progression, improve quality of life, prolong survival, so β receptor blockers can both alleviate symptoms and improve prognosis, is the cornerstone of stable coronary heart disease patient drug treatment, as long as there are no contraindications should be used. In general, the initial use of a blocker begins with a normal metoprolol tablet, which facilitates the adjustment of the dose to the best target dose that the patient can tolerate, and long-term use of the recommended metoprolol extended-release dosage form, such as metoprolol succinate extended-release tablets or metoprolol tartrate extended-release tablets.
Heart failure
In the field of chronic heart failure with reduced ejection fraction, the main recommended are three β receptor blockers such as metoprolol succinate, bisoprolol, carvedilol, etc.,
Tachyarrhythmias
β receptor blockers have the effect of inhibiting myocardial contractility and slowing down the heart rate, so they can be used to treat rapid arrhythmias, most commonly metoprolol tartrate tablets.
。
Metoprolol succinate extended-release tablets need to pay attention to several points during use
1 dose
Metoprolol succinate extended-release tablets for the treatment of different diseases, the required dose is not the same, in the treatment of hypertension at a dose of 47.5-95 mg per day, if the dose is not effective to 95 mg / day, it is not recommended to increase the dose, but with other antihypertensive drugs such as amlodipine calcium channel blocker, hydrochlorothiazide and other diuretics, in the treatment of angina the dose should be larger should reach 95-190 mg per day, if necessary, can be combined with lipid nitrates, In the treatment of chronic heart failure with stable symptoms, depending on the severity of heart failure, the dose is also different, the cardiac function level 2 should start from a small dose of 23.75 / day, increase to 47.5 mg after two weeks, and then double the dose every 2 weeks thereafter, the target value of long-term treatment is 190 mg / day, and for patients with stable heart failure of cardiac function level 3-4, it should start from a smaller dose of 11.875 / day, gradually increase, until the target dose of 190 mg / day is reached. Because metoprolol succinate extended-release tablets have a long-term effect, so no matter what dosage is taken, it can be taken once a day, taken in the morning, before and after meals, and other types of extended-release tablets, metoprolol succinate extended-release tablets can be broken open due to the special preparation process used. But it should be noted that the opening should be along the dividing line, the current metoprolol succinate extended-release tablets have four specifications, namely 23.75mg, 47.5mg, 95mg, 190mg, should try to choose their own specifications, such as if you need to take 23.75mg dose, you should choose 23,75mg specifications to take one tablet or 47.5mg specifications to take half a tablet, rather than choose a larger dose of 95mg or 190mg specifications, otherwise you need to split into 1/4 or 1/8.
Adverse metoprolol countersuccinate extended-release tablets
Common adverse reactions of metoprolol succinate extended-release tablets are fatigue, dizziness, headache, bradycardia, acral chills, etc., contraindications are: cardiogenic shock, sick sinus syndrome, severe peripheral vascular disease with the risk of gangrene, patients with a heart rate of < 45 beats / min, systolic blood pressure < 100 mmHg of suspected acute myocardial infarction, 2-3 degrees AV block. Such drugs have adverse effects on blood glucose, blood lipid metabolism, dyslipidemia and diabetic patients with caution, metoprolol can not be abruptly discontinued, otherwise it will increase the risk of myocardial infarction and sudden death, and the drug should be gradually and slowly withdrawn.