Egilok - what are these tablets for, how to take them? Correct dosage of the antihypertensive drug Egilok.

Egilok is an effective remedy for the treatment of diseases of the cardiovascular system. It refers to beta1-adrenergic blocking drugs, the main active ingredient of which is metoprolol. Due to its presence in this medication, it has antiarrhythmic, antianginal and blood pressure-lowering effects, for which reason Egilok is used in the treatment of myocardial infarction, angina pectoris and arterial hypertension.
Egilok blocks beta1-adrenergic receptors, thereby reducing the excitatory effect of the sympathetic nervous system on the heart muscle, heart rate, and blood pressure. The hypotensive effect of using this drug persists for a long period of time due to a gradual decrease in peripheral vascular resistance. During long-term treatment with this medication, with high blood pressure, the mass of the left ventricle decreases, as a result of which it relaxes better in the diastolic phase.

This is interesting! It has been officially registered that Egilok helps reduce mortality from pathologies of the cardiovascular system in males with a moderate increase in blood pressure.

The effect of this drug is similar to the effect of its analogues, since Egilok helps reduce the heart's need for oxygen while lowering blood pressure and decreasing the heart rate. The result of this is a lengthening of diastole - the time during which the heart can rest, which improves its blood supply and absorption of oxygen in the blood. A similar effect that occurs as a result of taking Egilok reduces the frequency of angina attacks and improves the patient’s physical condition. Moreover, the use of this medicine normalizes the ventricular heart rate during ventricular extrasystole, atrial fibrillation and supraventricular tachycardia.

What are Egilok tablets prescribed for?

This medication is prescribed for arterial hypertension, both in combination with other antihypertensive drugs and in monotherapy.
This medicine successfully fights coronary heart disease. It is used as a prophylactic against angina attacks and myocardial infarctions.
Egilok eliminates heart rhythm disturbances, so it is prescribed for supraventricular tachycardia and ventricular extrasystole.
This medication treats functional cardiac disorders that are accompanied by tachycardia.
This medicine is prescribed as part of complex therapy for hyperthyroidism.
Doctors recommend taking Egilok to prevent migraine attacks.

Directions for use and dosage

This medicinal drug should be taken orally regardless of the time of eating. Its dosage and regimen are set strictly individually depending on the patient’s well-being, his age and type of disease, therefore drinking Egilok without prior medical consultation is prohibited. The maximum permissible daily dosage of this drug is 200 mg. To achieve a positive effect, regular, systematic use is of great importance.

To lower blood pressure, doctors recommend taking 25–50 mg. medicines morning and evening.
To treat angina, you need to drink 25–50 mg. 2 – 3 times a day. If the drug does not have a positive effect, the dosage can be increased to 200 mg. per day.
For cardiac arrhythmias, the initial dosage is 25-50 mg. 2-3 times a day, if it is insufficiently effective, it should be increased to 200 mg. per day or add another antiarrhythmic drug to the treatment regimen.

Remember that treatment with this medication should also be completed correctly, gradually reducing the dosage, since abrupt withdrawal of this medication can negatively affect the patient’s condition.

Egilok is a cardioselective b-adrenergic receptor blocker that does not have membrane stabilizing and internal sympathomimetic activity. This drug has antiarrhythmic, antianginal and antihypertensive effects, for which Egilok is used in the treatment of many different diseases. Take this medication correctly, in accordance with your doctor's recommendations, and be healthy!

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Egilok ® (Egilok ®)

Latest update of the description by the manufacturer 11.09.2014

Show all release forms (14)

tablets (14)

tablets 25 mg; bottle (bottle) of brown glass 60, cardboard pack 1; EAN code: 5995327166193; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 50 mg; bottle (bottle) of brown glass 60, cardboard pack 1; EAN code: 5995327166223; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 100 mg; bottle (bottle) of brown glass 60, cardboard pack 1; EAN code: 5995327166261; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 100 mg; brown glass bottle (bottle) 30, cardboard pack 1; EAN code: 5995327114620; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

Egilok ®

tablets 50 mg; brown glass bottle (bottle) 30, cardboard pack 1; EAN code: 5995327114217; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 25 mg; blister 20, cardboard pack 3; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 50 mg; blister 15, cardboard pack 4; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 100 mg; brown glass bottle (bottle) 30, cardboard pack 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 100 mg; plastic bag (bag) 12.8 kg, polypropylene container 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 50 mg; brown glass bottle (bottle) 30, cardboard pack 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 50 mg; plastic bag (bag) 12.8 kg, polypropylene container 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 25 mg; brown glass bottle (bottle) 30, cardboard pack 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary) Egilok ®

tablets 25 mg; plastic bag (bag) 14.3 kg, polypropylene container 1; No. P N015639/01, 2009-03-17 from EGIS Pharmaceuticals PLC (Hungary)

Egilok

Compound

Tablets of 25, 50, 100, 200 mg.

One tablet of Egilok, Egilok Retard contains 25, 50, 100 mg of active substance ( metoprolol tartrate ) respectively.

For one tablet of Egilok S, the active substance (metoprolol succinate ) account for 23.75, 47.5, 95, 190 mg, respectively .

Excipients for Egilok, Egilok Retard: povidone . sodium carboxymethyl starch . Magnesium stearate, microcrystalline cellulose, colloidal anhydrous silicon dioxide.

Excipients for Egilok S: ethylcellulose, microcrystalline cellulose, corn starch, metalcellulose, glycerol, magnesium stearate.

Release form

Packed in a cardboard box of 1, 2 and 3 blisters, 10 pcs. each for 25 mg, 50 mg, 100 mg, 200 mg tablets.

Packaged in a dark glass bottle: 30 and 60 pcs. for 25 mg, 50 mg and 100 mg tablets.

Round, biconvex tablets, white or almost white. Without smell. Volume: 25 mg, 50 mg, 100 mg.

On a tablet Egilok 25 mg on one side there is a cross-shaped dividing line with a double bevel, on the other side there is an engraving E435.
On a tablet Egilok 50 mg on one side there is a mark, on the other side there is an engraving E434.
On a tablet Egilok 100 mg on one side there is a mark, on the other side there is an engraving E432.

Egilok Retard

White, biconvex, round tablets with a score on both sides. Volume 50 mg and 100 mg.

Biconvex, oval, white film-coated tablets. On both sides of the risk. Volume: 25 mg, 50 mg, 100 mg, 200 mg.

pharmachologic effect

Develops hypotensive, antiarrhythmic, antianginal and beta1-adrenergic blocking stimulation. Causes a rapid decrease in contractions in the heart muscle.

When sinus tachycardia on the background hyperthyroidism and functional heart problems, as well as atrial fibrillation And supraventricular tachycardia the medicine can significantly slow down the heart rate until sinus rhythm is restored.

Unlike non-selective beta blockers, the effect metoprolol on carbohydrate metabolism and insulin production is less significant.

Pharmacodynamics and pharmacokinetics

The drug has a high rate of absorption in the gastrointestinal tract. Within 1.5-2 hours after administration, Cmax in blood plasma is achieved. Under the influence of the active substance, the increased activity of the sympathetic system in relation to the heart is suppressed. What causes Egilok tablets when used regularly? lower cholesterol levels in blood serum. The bioavailability of the drug increases by 30-40% if taken metoprolol along with food.

Impaired kidney and liver function has virtually no effect on the excretion and absorption of the active substance. However, with severe liver dysfunction ( cirrhosis . placed portacaval shunt ) bioavailability increases significantly, and with chronic renal failure the risk of unwanted side effects increases. In old age, the pharmacokinetics of the drug cannot be significantly changed.

After use, the medicine undergoes full absorption. Egilok has weak binding to proteins in blood plasma (no more than 10%). The drug is excreted from the body mainly in the form of metabolites, only 5% is excreted by the kidneys.

Indications for use of Egilok

prophylactic prevention of attacks migraine ;
high blood pressure;
impaired functional cardiac activity;
angina pectoris ;
abnormal heart rhythm (supraventricular tachycardia and bradycardia with ventricular extrasystoles and atrial febrillation);
myocardial infarction .

Indications for the use of tablets also apply to people over 60 years of age.

Contraindications

SSSU;
cardiogenic shock ;
pronounced bradycardia (less than 50 beats per minute);
lactation period ;
simultaneous use of MAO inhibitors;
age under 18 years;
hypersensitivity to the components of the drug in particular, or to beta-blockers in general;
sinoatrial block;
severely impaired peripheral circulation;
bronchial asthma in severe form;
AV block - 2nd or 3rd degree block.

Side effects

In relation to the central nervous system: increased threshold for fatigue (very common), headaches and dizziness (often); infrequently - convulsions . weakened attention, depressive state, increased heart failure . nightmares; rarely – nervous excitability, anxiety . sexual dysfunction . hallucinations . memory impairment.
In relation to the senses (rarely): blurred vision .
In relation to the digestive system (rarely): stomach ache . diarrhea . constipation . dryness in the mucous membrane of the mouth.
In relation to the respiratory system: shortness of breath during physical exertion (often), rhinitis (rarely).
In relation to the skin (not often): rash . increased sweating .

Instructions for use of Egilok

The tablets are taken orally, washed down with a small amount of water. Reception is allowed both during meals (recommended) and on an empty stomach.

Instructions for Egilok Retard And Egilok. the dose is divided into two doses per day, morning and evening.

Instructions for Egilok S. Take 1 time per day, in the morning.

How to take the medicine (final dose size and number of doses) is determined by the doctor individually. Maximum dose 200 mg. In case of impaired renal function and in old age, redistribution of the volume of medication consumed is not required.

Heart failure with compensation: 25 mg per day.
Hyperthyroidism : 50-200 mg per day.
Arrhythmia : 50-200 mg per day.
Angina pectoris : 50 mg per day.
Migraine attacks (prevention): 100-200 mg per day.
Tachycardia : 50-200 mg per day.
Myocardial infarction (secondary prevention): 200 mg per day.

Find a doctor for treatment

Overdose

Excessive use of the drug and inconsistent with the doctor leads to an overdose, the most obvious symptom of which is a reaction from the cardiovascular system: slow heart rate, heart failure. In some cases, when using the medicine by persons under 18 years of age, a negative reaction from the central nervous system is also possible: increased fatigue, seizures, excessive sweating, and fatigue.

In case of overdose, one or more of the above symptoms occur within 20-120 minutes, depending on the characteristics of the body. High concentration metoprolol in the body, depending on the nature of the symptoms, is eliminated by gastric lavage, symptomatic therapy, and the administration of adsorbents, atropine sulfate . gluconate . dopamine . norepinephrine .

Using Egilok with other medications

The list of prohibited drugs for simultaneous use with Egilok is wide. Therefore, you should be especially careful when combining this drug with third-party medications.

When mixed with verapamil can cause cardiac arrest.

When mixed with beta blockers ( estrogens . theophylline . indomethacin ) the hypotensive property of metoprolol is reduced.

When mixed with ethanol, the pumping effect on the central nervous system increases.

When mixed with oral hypoglycemic drugs and insulin the likelihood of occurrence increases hypoglycemia .

When mixed with barbiturates (pentobarbital ) under the influence of enzyme induction, the metabolism of metoprolol is accelerated.

Catad_pgroup Beta blockers

Egilok tablets - official* instructions for use

*registered by the Ministry of Health of the Russian Federation (according to grls.rosminzdrav.ru)

Registration number: P No. 015639/01 03/17/2009

Trade name: Egilok ®

International nonproprietary name: metoprolol

Dosage form: pills

Compound: each tablet contains 25 mg, 50 mg or 100 mg of the active substance metoprolol tartrate. Excipients: microcrystalline cellulose 41.5/83/166 mg, sodium carboxymethyl starch (type A) 7.5/15/30 mg, colloidal anhydrous silicon dioxide 2/4/8 mg, povidone (K-90) 2/4/ 8 mg, magnesium stearate 2/4/8 mg.

Description: 25 mg tablets: White or off-white, round, biconvex tablets with a cross-shaped dividing line and a double bevel (double snap shape) on one side and engraved E 435 on the other side, odorless.

Tablets 50 mg: White or almost white, round, biconvex tablets, scored on one side and engraved E 434 on the other side, odorless.

Tablets 100 mg: White or almost white, round, biconvex tablets, bevelled, scored on one side and engraved E 432 on the other side, odorless.

Pharmacotherapeutic group: selective beta1-blocker

ATX code:С07АВ02

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics:

Mechanism of action:

Metoprolol suppresses the effects of increased sympathetic system activity on the heart and also causes a rapid decrease in heart rate, contractility, cardiac output and blood pressure.

At arterial hypertension metoprolol reduces blood pressure in patients in the standing and lying position. 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 diastolic function. In men with mild or moderate hypertension, metoprolol reduces mortality from cardiovascular causes (primarily sudden death, fatal and non-fatal heart attack and stroke).

Like other beta-blockers, metoprolol reduces myocardial oxygen demand by reducing systemic blood pressure, heart rate and myocardial contractility. A decrease in heart rate and a corresponding prolongation of diastole when taking metoprolol ensures improved blood supply and oxygen uptake by the myocardium with impaired blood flow. Therefore, for angina pectoris, the drug reduces the number, duration and severity of attacks, as well as asymptomatic manifestations of ischemia, and improves the patient’s physical performance. In myocardial infarction, metoprolol reduces the mortality rate by reducing the risk of sudden death. This effect is primarily associated with the prevention of episodes of ventricular fibrillation. A reduction in mortality can also be observed with the use of metoprolol in both the early and late phases of myocardial infarction, as well as in high-risk patients and patients with diabetes mellitus. Use of the drug after myocardial infarction reduces the likelihood of non-fatal recurrent infarction. In chronic heart failure against the background of idiopathic hypertrophic obstructive cardiomyopathy, metoprolol tartrate, taken starting from low doses (2x5 mg/day) with a gradual increase in dose, significantly improves heart function, quality of life and physical endurance of the patient.

In case of supraventricular tachycardia, atrial fibrillation and ventricular extrasystoles, metoprolol reduces the frequency of ventricular contractions and the number of ventricular extrasystoles.

At therapeutic doses, the peripheral vasoconstrictor and bronchoconstrictor effects of metoprolol are less pronounced than the same effects of non-selective beta-blockers.

Compared with non-selective beta-blockers, metoprolol has less effect on insulin production and carbohydrate metabolism. It does not increase the duration of hypoglycemic attacks.

Metoprolol causes a slight increase in triglyceride concentrations and a slight decrease in serum free fatty acid concentrations. There is a significant decrease in total serum cholesterol concentrations after several years of taking metoprolol.

Pharmacokinetics:

Metoprolol is quickly and completely absorbed from the gastrointestinal tract. The drug is characterized by linear pharmacokinetics in the therapeutic dose range. The maximum concentration in blood plasma is achieved 1.5-2 hours after oral administration. 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 regular use.

Taking with food can increase the bioavailability of metoprolol by 30-40%. Metoprolol is slightly (~ 5-10%) bound to plasma proteins. The volume of distribution is 5.6 l/kg.

Metoprolol is metabolized in the liver by cytochrome P-450 isoenzymes. Metabolites do not have pharmacological activity.

Half-life (t 1/2) on average 3.5 hours (from 1 to 9 hours). The total clearance is approximately 1 l/min.

Approximately 95% of the administered dose is excreted by the kidneys, 5% as unchanged metoprolol. In some cases this value can reach 30%.

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 (glomerular filtration rate less than 5 ml/min), a significant accumulation of metabolites is observed. However, this accumulation of metabolites does not increase the degree of beta-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 overall body clearance may decrease. After portacaval shunt, the total clearance of the drug from the body is approximately 0.3 L/min, and the area under the concentration-time curve increases approximately 6 times compared with that in healthy volunteers.

INDICATIONS FOR USE

Arterial hypertension (in monotherapy or (if necessary) in combination with other antihypertensive drugs); functional disorders of cardiac activity, accompanied by tachycardia.

Coronary heart disease: myocardial infarction (secondary prevention - complex therapy), prevention of angina attacks.

Heart rhythm disturbances (supraventricular tachycardia, ventricular extrasystole). Hyperthyroidism (complex therapy). Prevention of migraine attacks.

CONTRAINDICATIONS

Hypersensitivity to metoprolol or any other component of the drug, as well as other beta-blockers; atrioventricular block (AV) II or III degree; sinoatrial block; sinus bradycardia (heart rate less than 50/min), sick sinus syndrome; cardiogenic shock; severe peripheral circulatory disorders; heart failure in the stage of decompensation, age under 18 years (due to the lack of sufficient clinical data), simultaneous intravenous administration of verapamil, severe bronchial asthma and pheochromocytoma without simultaneous use of alpha-blockers.

Due to insufficient clinical data, Egiolok ® is contraindicated in acute myocardial infarction, accompanied by a heart rate below 45 beats/min, with a PQ interval of more than 240 ms, and systolic blood pressure below 100 mm Hg.

CAREFULLY

Diabetes mellitus, metabolic acidosis, bronchial asthma, chronic obstructive pulmonary disease (COPD), renal/liver failure, myasthenia gravis, pheochromocytoma (with simultaneous use with alpha-blockers), thyrotoxicosis, AV block of the first degree, depression (including medical history), psoriasis, obliterating diseases of peripheral vessels (intermittent claudication, Raynaud's syndrome), pregnancy, lactation, old age, in patients with a burdened allergic history (a decrease in response is possible when using adrenaline).

USE IN PREGNANCY AND LACTATION

The use of the drug is not recommended during pregnancy. The use of the drug is possible only when the benefit to the mother outweighs the potential risk to the fetus. If taking the drug is necessary, you should carefully monitor the fetus and then the newborn for several days (48 - 72 hours) after birth, as bradycardia, respiratory depression, decreased blood pressure and hypoglycemia may develop.

Although only small amounts of the drug are excreted into breast milk when taking therapeutic doses of metoprolol, the newborn should be kept under observation (bradycardia is possible). The use of the drug during lactation is not recommended. If it is necessary to use the drug during lactation, it is recommended to stop breastfeeding.

METHOD OF APPLICATION AND DOSES

Egilok ® tablets are taken orally. The tablets can be taken with food or without regard to meals. If necessary, the tablet can be broken in half. The dose should be adjusted gradually and individually to avoid excessive bradycardia. The maximum daily dose is 200 mg. Recommended doses:

Arterial hypertension

For mild or moderate arterial hypertension, the initial dose is 25-50 mg twice a day (morning and evening). If necessary, the daily dose can be gradually increased to 100-200 mg/day or another antihypertensive agent can be added.

Angina pectoris

The initial dose is 25-50 mg two to three times a day. Depending on the effect, this dose can be gradually increased to 200 mg per day or another antianginal drug can be added.

Maintenance therapy after myocardial infarction

The usual daily dose is 100 - 200 mg/day, divided into two doses (morning and evening).

Heart rhythm disturbances

Initial dose is 25 to 50 mg two or three times daily. If necessary, the daily dose can be gradually increased to 200 mg/day or another antiarrhythmic agent can be added. Hyperthyroidism

The usual daily dose is 150-200 mg per day in 3 to 4 doses.

Functional heart disorders accompanied by palpitations The usual daily dose is 50 mg 2 times a day (morning and evening); if necessary, it can be increased to 200 mg in two doses.

Preventing migraine attacks

The usual daily dose is 100 mg/day in two divided doses (morning and evening); if necessary, it can be increased to 200 mg/day in 2 divided doses.

Special patient groups

If renal function is impaired, no change in dosage regimen is required.

In liver cirrhosis, a dose change is usually not required due to the low binding of metoprolol to plasma proteins (5-10%). In case of severe liver failure (for example, after portacaval shunt surgery), it may be necessary to reduce the dose of Egilok ®.

In elderly patients, no dose adjustment is required.

SIDE EFFECTS

Egilok ® is usually well tolerated by patients. Side effects are usually mild and reversible. 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. The frequency of side effects listed below is defined as follows: very common: > 10%), common: 1-9.9%, uncommon: 0.1-0.9%, rare: 0.01-0.09%, very rarely (including isolated messages):< 0,01 %.

From the nervous system: very often - increased fatigue; often - dizziness, headache; rarely - increased excitability, anxiety, impotence/sexual dysfunction; uncommon - paresthesia, convulsions, depression, decreased concentration, drowsiness, insomnia, nightmares; very rarely - amnesia/memory impairment, depression, hallucinations.

From the cardiovascular system: often - bradycardia, orthostatic hypotension (in some cases, syncope is possible), coldness of the lower extremities, palpitations; uncommon - temporary increase in symptoms of heart failure, cardiogenic shock in patients with myocardial infarction, first degree atrioventricular block; rarely - conduction disturbances, arrhythmia; very rarely - gangrene (in patients with peripheral circulatory disorders). From the digestive system: often - nausea, abdominal pain, constipation or diarrhea; infrequently - vomiting; rarely - dryness of the oral mucosa, impaired liver function.

From the skin: infrequently - urticaria, increased sweating; rarely - alopecia; very rarely - photosensitivity, exacerbation of psoriasis. From the respiratory system: often - shortness of breath with physical effort; uncommon - bronchospasm in patients with bronchial asthma; rarely - rhinitis.

From the senses: rarely - blurred vision, dryness and/or irritation of the eyes, conjunctivitis; very rarely - ringing in the ears, disturbance of taste. Other: infrequently - weight gain; very rarely - arthralgia, thrombocytopenia. Taking Egilok ® should be discontinued if any of the above effects reaches a clinically significant intensity, and its cause cannot be reliably determined.

OVERDOSE

Symptoms: marked decrease in blood pressure, sinus bradycardia, atrioventricular block, heart failure, cardiogenic shock, asystole, nausea, vomiting, bronchospasm, cyanosis, hypoglycemia, loss of consciousness, coma. The symptoms listed above may increase with the simultaneous use of ethanol, antihypertensive drugs, quinidine and barbiturates.
The first symptoms of overdose appear 20 minutes -2 hours after taking the drug.

Treatment: Careful monitoring of the patient is necessary (monitoring blood pressure, heart rate, respiratory rate, renal function, blood glucose concentration, serum electrolytes) in the intensive care unit. If the drug has been taken recently, gastric lavage with activated charcoal may reduce further absorption of the drug (if lavage is not possible, vomiting can be induced if the patient is conscious).

In case of excessive decrease in blood pressure, bradycardia and the threat of heart failure - intravenously, at intervals of 2-5 minutes, beta-adrenergic agonists - until the desired effect is achieved or intravenously 0.5-2 mg of atropine. If there is no positive effect, dopamine, dobutamine or norepinephrine (norepinephrine). For hypoglycemia - administration of 1-10 mg of glucagon, installation of a temporary pacemaker. For bronchospasm, beta2-agonists should be administered. For convulsions - slow intravenous administration of diazepam. Hemodialysis is ineffective.

INTERACTIONS WITH OTHER MEDICINES

The antihypertensive effects of Egilok ® and other antihypertensive drugs are usually enhanced. To avoid hypotension, careful monitoring of patients receiving combinations of these drugs is necessary. However, the summation of the effects of antihypertensive drugs can be used, if necessary, to achieve effective blood pressure control.

The simultaneous use of metoprolol and blockers of “slow” calcium channels such as diltiazem and verapamil can lead to increased negative inotropic and chronotropic effects. Intravenous administration of calcium channel blockers such as verapamil should be avoided in patients receiving beta-blockers.

Caution should be exercised when taken concomitantly with the following drugs:

Oral antiarrhythmic drugs (such as quinidine and amiodarone) - risk of bradycardia, atrioventricular block.

Cardiac glycosides (risk of bradycardia, conduction disorders; metoprolol does not affect the positive inotropic effect of cardiac glycosides).

Other antihypertensive drugs (especially the guanethidine, reserpine, alpha-methyldopa, clonidine and guanfacine groups) due to the risk of hypotension and/or bradycardia.

Stopping the simultaneous use of metoprolol and clonidine should definitely begin by stopping metoprolol, and then (after a few days) clonidine; If clonidine is first discontinued, a hypertensive crisis may develop.

Some drugs acting on the central nervous system, such as hypnotics, tranquilizers, tri- and tetracyclic antidepressants, antipsychotics and ethanol, increase the risk of arterial hypotension. Anesthesia (risk of cardiac depression).

Alpha and beta sympathomimetics (risk of arterial hypertension, significant bradycardia; possibility of cardiac arrest). Ergotamine (increased vasoconstrictor effect). Beta-2 sympathomimetics (functional antagonism).

Nonsteroidal anti-inflammatory drugs (for example, indomethacin) may weaken the antihypertensive effect.

Estrogens (possibly reducing the antihypertensive effect of metoprolol). Oral hypoglycemic agents and insulin (metoprolol may enhance their hypoglycemic effects and mask the symptoms of hypoglycemia). Curare-like muscle relaxants (increased neuromuscular blockade). Enzyme inhibitors (for example, cimetidine, ethanol, hydralazine; selective serotonin reuptake inhibitors, for example, paroxetine, fluoxetine and sertraline) - enhance the effects of metoprolol due to an increase in its concentration in the blood plasma. Enzyme inducers (rifampicin and barbiturates): the effects of metoprolol may be reduced due to increased hepatic metabolism.

Concomitant use of sympathetic ganglion blockers or other beta blockers (eg eye drops) or monoamine oxidase inhibitors requires careful medical monitoring.

SPECIAL INSTRUCTIONS

Monitoring of patients taking beta-blockers includes regular measurement of heart rate (HR) and blood pressure, blood glucose concentration in patients with diabetes mellitus. If necessary, for patients with diabetes mellitus, the dose of insulin or hypoglycemic agents for oral administration should be selected individually. The patient should be taught how to calculate heart rate and instructed about the need for medical consultation if the heart rate is less than 50 beats/min. When taking a dose above 200 mg per day, cardioselectivity decreases.

In case of heart failure, treatment with Egilok ® begins only after reaching the stage of compensation of cardiac function.

There may be an increase in the severity of hypersensitivity reactions and a lack of effect from the administration of usual doses of epinephrine (adrenaline) in patients with a burdened allergic history.

Anaphylactic shock may be more severe in patients taking Egilok ® . May increase symptoms of peripheral arterial circulation disorders. Abrupt discontinuation of Egilok ® should be avoided. The drug should be discontinued gradually by reducing doses over approximately 14 days. Abrupt withdrawal may worsen angina symptoms and increase the risk of coronary events. When discontinuing the drug, special attention should be paid to patients with coronary artery disease. For exertional angina, the selected dose of Egilok ® should ensure the heart rate at rest is within 55-60 beats/min, and during exercise - no more than 110 beats/min. Patients who use contact lenses should take into account that during treatment with beta-blockers, tear production may decrease. Egilok may mask some clinical manifestations of hyperthyroidism (for example, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated as it can increase symptoms.

In diabetes mellitus, it can mask tachycardia caused by hypoglycemia. Unlike non-selective beta-blockers, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentrations to normal levels. When prescribing Egilok ® to patients with diabetes mellitus, the concentration of blood glucose should be monitored and, if necessary, the dose of insulin or oral hypoglycemic agents should be adjusted (see section “Interaction with other drugs”).

If necessary, beta2-adrenergic stimulants are prescribed to patients with bronchial asthma; for pheochromocytoma - alpha-blockers.

If surgical intervention is necessary, it is necessary to warn the surgeon/anesthesiologist about the therapy being performed (choosing a general anesthesia agent with minimal negative inotropic effect); discontinuation of the drug is not recommended. Drugs that reduce catecholamine levels (for example, reserpine) may enhance the effect of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision to detect an excessive decrease in blood pressure or bradycardia.

In elderly patients, regular monitoring of liver function is recommended. Correction of the dosage regimen is required only if an elderly patient develops increasing bradycardia (less than 50 beats/min), a pronounced decrease in blood pressure (systolic blood pressure below 100 mm Hg), atrioventricular block, bronchospasm, ventricular arrhythmias, severe liver dysfunction , sometimes it is necessary to stop treatment. In patients with severe renal failure, monitoring of renal function is recommended.

Special monitoring should be carried out for the condition of patients with depressive disorders taking metoprolol; in case of development of depression caused by taking beta-blockers, it is recommended to discontinue therapy.

If progressive bradycardia occurs, the dose should be reduced or the drug discontinued.

Due to the lack of sufficient clinical data, the drug is not recommended for use in children.

Impact on the ability to drive vehicles and complex equipment.

Caution must be exercised when driving vehicles and when engaging in potentially hazardous activities that require increased concentration (risk of dizziness and fatigue).

RELEASE FORM

Tablets 25 mg: 60 tablets in a brown glass bottle with a PE cap with an accordion shock absorber, with first opening control. 1 bottle along with instructions for use is packed in a cardboard box. Or 20 tablets in a blister made of PVC/PVDC//al. foil. 3 blisters along with instructions for use are packed in a cardboard box.

The drug Egilok (the active ingredient is metoprolol tartate) is a beta-blocker.

It is used to treat hypertension, heart failure and angina.

The clinical pharmacokinetics of Egilok is described by the fact that metoprolol is largely absorbed by the intestine, and more than 95% of the oral therapeutic dose is usually excreted in the urine in the form of metabolites. The remaining 5% is excreted as unchanged metoprolol.

Since food can increase the bioavailability of metoprolol, it is advisable to take the drug during or after meals.

The drug is distributed very quickly between the blood and various extravascular (extravascular) areas, and only 1 to 2% of the total amount of drug in the body is localized in the blood. Serum protein binding is about 10%.

The drug easily penetrates the placenta and the concentration in the umbilical cord and maternal venous blood is approximately the same. Despite the 3-to-4-fold accumulation of Egilok in breast milk, adverse reactions when breastfeeding a child seem unlikely if the child’s liver function is not highly developed.

Impaired renal function has little effect on the bioavailability of metoprolol, but affects the excretion of metabolites from the body through the kidneys. However, approximately 50% of the metabolites are cleared from the body of patients with a removed or absent kidney during the 5-hour dialysis period. Liver cirrhosis increases the bioavailability and reduces the total clearance of metoprolol.

The β-blocking effect is linearly dependent on the dose and plasma concentration of the drug. The rate of decline in effect can be slowed by administering the drug in the form of controlled-release preparations (for example, Egilok Retard).

The principle of action of Egilok: the active component of the drug reduces the need for oxygen in the myocardium (heart muscle) by reducing intravascular blood pressure, heart rate and myocardial contractility. Due to this, the period of relaxation of the heart muscle during heartbeat when taking Egilok is extended, and this, in turn, improves blood supply and oxygen uptake by the myocardium with impaired blood flow.

Medicine Egilok: indications and contraindications

The drug Egilok is sold in the form of biconvex round white tablets of 25, 50 and 100 mg, intended for oral administration.

The drug is indicated for the following conditions: high blood pressure, chest pain after a heart attack, migraine prevention, symptoms caused by an overactive thyroid gland (thyrotoxicosis), myocardial infarction (as secondary prevention in complex therapy), coronary heart disease, ventricular extrasystole and supraventricular tachycardia.

You should not take Egilok medicine for those who:

is allergic to metoprolol or any of the other components of this drug;
has severe heart failure;
suffers from blocked blood vessels, which can cause blueness or tingling in the fingers and toes;
suffered a heart attack complicated by a significant slowdown in heart rate;
suffers from chest pain during rest (Prinzmetal's angina);
suffers from untreated pheochromocytoma (high blood pressure due to a tumor near the kidneys);
suffers from increased blood acidity (metabolic acidosis);
has low blood pressure;
has or has had in the past breathing difficulties or asthma, including chronic obstructive pulmonary disease;
suffers from diabetes with frequent episodes of low blood sugar (hypoglycemia);
has liver or kidney disease;
has difficulty urinating;
has a low level of potassium (hypokalemia; in this case, you should use Kalinor) or sodium (hyponatremia) in the blood;
has high calcium levels (hypercalcemia);
suffers from gout due to high levels of uric acid (hyperuricemia), the crystals of which settle in the joints of the hands or feet, causing pain;
is taking other medications to lower blood pressure by injection, especially medications such as verapamil, diltiazem, or disopyramide.

You should consult a cardiologist or physician before using Egilok if the patient has diabetes (blood sugar levels are less controlled due to Egilok), pheochromocytoma, psoriasis, slow heart rate, liver cirrhosis, myasthenia gravis.

Egilok drug: drug interactions and possibility of taking during pregnancy

Drugs that may interact with Egilok include those listed below.

Reserpine and monoamine oxidase (MAO) inhibitors. May increase the effects of metoprolol. They may also increase feelings of dizziness or slow your heart rate further. MAO inhibitors include: Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine.

Drugs to normalize heart rhythm. Taking digitalis (Lanoxin) with metoprolol may slow your heart rate too much.

Calcium channel blockers. Like metoprolol, these drugs are taken by hypertensive patients and people with various heart problems. When combined with metoprolol, calcium channel blockers can reduce heart contractions and slow down the heart rate. Doctors sometimes use this combination, but only under close supervision. These drugs include: Amlodipine, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Nisoldipine, Verapamil.

Drugs that are processed in the body by the same organs as metoprolol. Their combination with metoprolol can increase the level of metoprolol in the body. The most common: Fluoxetine, Paroxetine, Sertraline, Bupropion, Clomipramine, Desipramine, Aminazine, Fluphenazine, Haloperidol, Thioridazine.

Alpha blockers. Lower blood pressure and may lower blood pressure too much when combined with metoprolol. Alpha blockers include: Guanethidine, Reserpine, Clonidine, Prazosin.

Stopping Clonidine while taking metoprolol may cause a sharp rise in blood pressure.

Many pregnant women with hypertension are concerned about the question: is it possible to take Egilok while pregnant? Metoprolol is a Category C drug. This means two things: animal studies have shown adverse effects on the fetus when the mother takes the drug. However, there have not been enough human studies of Egilok. Admission is justified only when the benefits to the mother are higher than the risks to the fetus.

If you are pregnant and have high blood pressure, talk to your doctor about other treatment options during pregnancy.

Metoprolol passes into breast milk and can be passed into the newborn's body if the mother is breastfeeding. This can lead to the child developing bradycardia (slow heart rate). Therefore, if it is impossible to discontinue the drug, it is recommended to stop breastfeeding. Children aged 1-17 years are recommended to choose a different drug.

How long can you take Egilok, side effects and correct dosage of the drug

The most common side effects of Egilok are presented below.

Fatigue. Metoprolol slows the heart rate by blocking the effect of adrenaline. As a result, blood does not flow to the brain as quickly as usual. This may make you feel tired. This side effect usually goes away after the first few days of taking metoprolol, as soon as the body gets used to its effects.

Slight dizziness. By lowering blood pressure, Egilok may cause mild dizziness, especially with sudden movements. This side effect often goes away once the body gets used to the dosage. However, in some cases, metoprolol may lower your blood pressure too much, causing dizziness to become unbearable and require medical attention.

Diarrhea or constipation. Metoprolol can block nerve signals from the brain to the intestines. This can speed up or slow down digestion in the intestines. Rapid digestion causes diarrhea; slow - constipation.

Breathing problems. Metoprolol can block signals from the brain to the muscles that form the walls of the bronchioles. This prevents the bronchioles from relaxing, causing symptoms such as shortness of breath, coughing and wheezing.

Slowing your heart rate(bradycardia) due to the slowing of nerve impulses that travel from the brain to the heart.

In men, metoprolol may interfere with the part of the brain that signals an erection. Egilok sometimes leads to decreased potency and difficulty achieving orgasm in both men and women.

An allergic reaction to metoprolol can cause various types of skin rashes, along with itching.

Serious side effects of Egilok that require emergency medical attention include:

low blood pressure (hypotension);
coldness and soreness in the arms and legs;
very slow heart rate (severe bradycardia);
extreme fatigue;
serious depression. Some studies have shown a clear association between metoprolol use and depression, while others have shown no association. If the patient already had depression, this drug may make it worse.

How long can you take Egilok and the correct dosage

Egilok can be taken indefinitely if there are no contraindications. However, the exact course, as well as the dosage, is calculated only by the attending physician, and not by the patient himself.

Dosage for adults (ages 18-64) usually starts at 50 mg, twice daily. It is gradually adjusted if necessary.

The extended-release formulation often starts at 25 mg once daily or more. This dose is also gradually increased if necessary.

The dosage for people under 18 years of age has not been established, since Egilok is not prescribed to them.

The dosage for people 65 years of age and older may be lower than for adults because their bodies metabolize the drug more slowly.

Overdose symptoms:

low blood pressure (with fatigue and dizziness);
slow pulse;
cardiac conduction problems;
heart failure;
shock caused by heart problems;
dyspnea;
loss of consciousness;
coma;
bluish skin tone;
low blood sugar and high blood potassium levels.

Egilok and Egilok S are practically the same medicine, only the first contains the active ingredient - metoprolol tartate, and the second - metoprolol succinate. Egilok S is available in the form of extended-release tablets (lasting slightly longer), Egilok - in the form of regular tablets.

How long can you take Egilok S? Unlimitedly long, like Egilok.

Concor has different active ingredients (beta-blocker bisoprolol and calcium channel blocker amlodipine) than Egilok. It is a more selective and more effective drug, but has its contraindications. You cannot switch from Egilok to Concor without your doctor’s approval.

Concor, like Egilok, can be taken indefinitely.

Patients mostly respond well to Egilok. This remedy is praised for its quick effect on tachycardia and hypertension, low price, and lack of addictive effect. Negative effects often include headache and allergic reaction, and sometimes depression (apathy, despondency). In addition, the product is not suitable for asthmatics and hypotensive patients.

Pills white or almost white, round, biconvex, with a cross-shaped dividing line and a double bevel (“double step” shape) on one side and an engraving “E435” on the other side, odorless.

Excipients: microcrystalline cellulose – 41.5 mg, sodium carboxymethyl starch (type A) – 7.5 mg, colloidal anhydrous silicon dioxide – 2 mg, povidone K90 – 2 mg, magnesium stearate – 2 mg.

20 pcs. – blisters (3) – cardboard packs.

Pills white or almost white, round, biconvex, with a mark on one side and an engraving “E434” on the other side, odorless.

Excipients: microcrystalline cellulose – 83 mg, sodium carboxymethyl starch (type A) – 15 mg, colloidal anhydrous silicon dioxide – 4 mg, povidone K90 – 4 mg, magnesium stearate – 8 mg.

15 pcs. – blisters (4) – cardboard packs.
60 pcs. – dark glass jars (1) – cardboard packs.

Pills white or almost white, round, biconvex, chamfered, with a mark on one side and engraved “E432” on the other side, odorless.

Excipients: microcrystalline cellulose – 166 mg, sodium carboxymethyl starch (type A) – 30 mg, colloidal anhydrous silicon dioxide – 8 mg, povidone K90 – 8 mg, magnesium stearate – 8 mg.

30 pcs. – dark glass jars (1) – cardboard packs.
60 pcs. – dark glass jars (1) – cardboard packs.