Pregnancy and lactation
During pregnancy, it is prescribed according to strict indications, taking into account the benefit / risk ratio (due to the development of the fetus bradycardia, arterial hypotension, hypoglycemia). In this case, close monitoring is carried out, especially for fetal development. Strict monitoring of newborns is necessary within 48-72 hours after delivery.
The effect of metoprolol on a newborn, while breastfeeding has not been studied, therefore, women taking metoprolol should stop breastfeeding.
Allergens used for immunotherapy or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving metoprolol. Order Toprol XL 100 mg, 50 mg, 25 mg (Metoprolol) Over The Counter Iodine-containing radiopaque drugs for intravenous administration increase the risk of anaphylactic reactions. Phenytoin with iv administration, drugs for inhalation general anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressive effect and the likelihood of lowering blood pressure. Changes the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, increased blood pressure). It reduces the clearance of lidocaine and xanthines (except diphillin) and increases their plasma concentration, especially in patients with initially increased theophylline clearance under the influence of smoking. The antihypertensive effect is weakened by NSAIDs (Na + retention and blockade of Pg synthesis by the kidneys), GCS and estrogens (Na + retention). Cardiac glycosides, methyldopa, reserpine and guanfacine, BMKK (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV block, heart failure and heart failure. Nifedipine can lead to a significant decrease in blood pressure. Diuretics, clonidine, sympatholytics, hydralazine and other hypotensive drugs can lead to an excessive decrease in blood pressure. It lengthens the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins. Tri- and tetracyclic antidepressants, antipsychotic drugs (antipsychotics), ethanol, sedative and hypnotic drugs increase CNS depression. The simultaneous use with MAO inhibitors is not recommended due to a significant increase in the antihypertensive effect, the break in treatment between taking MAO inhibitors and metoprolol should be at least 14 days. Non-hydrogenated ergot alkaloids increase the risk of peripheral circulatory disorders.
Indications for use
Metoprolol is used to treat diseases: moderate and moderate arterial hypertension (monotherapy or in combination with other antihypertensive drugs), coronary heart disease, hyperkinetic cardiac syndrome, cardiac arrhythmias (sinus tachycardia, ventricular and supraventricular tachycardia, paroxysmal tachycardia and tachycardia, and atrial fibrillation, atrial tachycardia), hypertrophic cardiomyopathy, mitral valve prolapse, myocardial infarction a (prevention and treatment), migraine (prevention), thyrotoxicosis (complex therapy); treatment of akathisia caused by antipsychotics.