Cardolax
(Metoprolol)




COMPOSITION

Each tablet contains metoprolol tartarate 25 mg or 50 mg or 100 mg.

THERAPEUTIC INDICATIONS

- Moderate-to severe arterial hypertension (monotherapy or in combination with other anti-hypertensive agents);
- Prevention of anginal attacks;
- Heart arhythmias (sinus tachycardia, ventricular and supraventricular arrhythmia, including paroxysmal tachycardia, supraventricular tachycardia, extrasystole, atrial flutter-fibrillation, atrial tachycardia);
- Secondary prevention after a myocardial infarction;
- Migraine prophylaxis.

CONTRAINDICATIONS

- AV-block of II and III degree;
- Bradycardia (heart rate <50 beats/min);
- Arterial hypotensy;
- Chronic cardiac failure of II-III class;
- Acute cardiac failure;
- Sick-sinus syndrome;
- Severe sinus bradycardia (heart rate <60 beats/min);
- Сardiogenic shock;
- Metabolic acidosis;
- Severe disturbances of peripheral circulation;
- Hypersensitivity to metoprolol or other beta-blockers (cross sensitivity between beta-blockers can occur).

ADVERSE EFFECTS

Transient effects include dizziness, lightheadedness, drowsiness, tiredness, diarrhea, unusual dreams, ataxia, trouble sleeping, depression, and vision problems. It may also reduce blood flow to the hands and feet, causing them to feel numb and cold; smoking may worsen this effect.
Serious side effects that are not to be tolerated for any length of time include symptoms of a very slow heartbeat (less than 50 bpm) (e.g. persistent dizziness, fainting, unusual fatigue), bluish discoloration of the fingers and toes, numbness/tingling/swelling of the hands or feet, sexual dysfunction, erectile dysfunction (impotence), hair loss, mental/mood changes, trouble breathing, cough, dyslipidemia, and increased thirst. Other highly unlikely symptoms include easy bruising or bleeding, persistent sore throat or fever, yellowing skin or eyes, stomach pain, dark urine, and persistent nausea. Symptoms of an allergic reaction include: rash, itching, swelling, and severe dizziness. Taking it with alcohol might cause mild body rashes and therefore is not recommended.

DOSAGE AND ADMINISTRATION

Cardolax tablets should be taken orally with or immediately following meals, washing out with enough water. The duration of treatment is established by a doctor. The dosage tablets should be individualized.
Hypertension:
The usual initial dosage of Cardolax tablets is 100 mg daily in single or divided doses. The dosage may be increased at weekly intervals until optimum blood pressure reduction is achieved. In general, the maximum effect of any given dosage level will be apparent after 1 week of therapy. The effective dosage range of Cardolax tablets is 100-450 mg per day.
Angina Pectoris:
The usual initial dosage of metoprolol tartarate tablets is 100 mg daily, given in two divided doses. The dosage may be gradually increased at weekly intervals until optimum clinical response has been obtained or there is pronounced slowing of the heart rate. The effective dosage range of Cardolax tablets is 100-400 mg per day. If treatment is to be discontinued, the dosage should be reduced gradually over a period of 1-2 weeks.
Secondary prevention after a myocardial infarction:

Treatment in the early phase should begin with the intravenous administration of metoprolol tartarate. Patients who tolerate the intravenous administration are shifted to per oral administration of the drug. Cardolax tablets should be initiated 15 minutes after the last intravenous dose and continued for 48 hours, 50 mg every 6 hours. Patients who appear not to tolerate the full intravenous dose should be started on Cardolax tablets 25 mg every 6 hours 15 minutes after the last intravenous dose. In the late phase of treatment Cardolax is given in dosage 100 mg twice daily.
In patients with severe intolerance, treatment with Cardolax should be discontinued.
Heart arrhythmias:
Daily dose is 100-200 mg, given in two or three divided doses. Dependant on the clinical condition, one dose 50 mg can be enough.
Migraine prophylaxis:
Administrated in dosage 100-200 mg daily.

DRUG INTERACTIONS

Catecholamine-depleting drugs (e.g., reserpine) may have an additive effect when given with beta-blocking agents. Both digitalis glycosides and beta blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
Some inhalation anesthetics may enhance the cardiodepressant effect of beta-blockers.
Potent inhibitors of the CYP2D6 enzyme may increase the plasma concentration of Cardolax. Strong inhibition of CYP2D6 would mimic the pharmacokinetics of CYP2D6 poor metabolizer. Caution should therefore be exercised when coadministering potent CYP2D6 inhibitors with Cardolax. Known clinically significant potent inhibitors of CYP2D6 are antidepressants such as fluoxetine, paroxetine or bupropion, antipsychotics such as thioridazine, antiarrhythmics such as quinidine or propafenone, antiretrovirals such as ritonavir, antihistamines such as diphenhydramine, antimalarials such as hydroxychloroquine or quinidine, antifungals such as terbinafine and medications for stomach ulcers such as cimetidine.
If a patient is treated with clonidine and Cardolax concurrently, and clonidine treatment is to be discontinued, Cardolax should be stopped several days before clonidine is withdrawn.

PREGNANCY AND LACTATION

The drug should be prescribed during pregnancy only if treatment efficacy justifies potential risk for the fetus. Cardolax crosses placental barrier. Cardolax is excreted in breast milk in a very small quantity therefore its administration during breast-feeding is not recommended.

MANUFACTURED FORM

30 tablets 100 mg in a box.
30 tablets 50 mg in a box.
30 tablets 25 mg in a box.

Cardiovascular System

All Products
Amlipin
Amlipin Tablet
Captopril
Cardolax
Carmetadin
Nebiworld
Nolaxen
Rosustar Tablet
Vasdilen
Venodiol

Home      |      Site Map      |      Terms of Use      |      Privacy Policy

2012 World Medicine. All Rights Reserved.