Betaloc ZOK 25 mg

Indication

Betaloc ZOK (Metoprolol succinate extended-release) is used for the treatment of hypertension, angina pectoris, and stable symptomatic heart failure (NYHA II–IV). It is a cardioselective beta-1 adrenoceptor blocker.

Ingredients

• Metoprolol succinate 25 mg (extended
• release)

Direction

Hypertension/Angina: 25–100 mg once daily; may be increased to 200 mg once daily. Heart failure: start with 12.5–25 mg once daily, doubling the dose every 2 weeks as tolerated to target dose of 200 mg. Swallow tablets whole; do not crush or chew. Can be taken with or without food.

Side effects

• Fatigue
• dizziness
• Bradycardia
• Cold extremities
• Dyspnoea
• bronchospasm (especially in asthmatics)
• Nausea
• diarrhoea
• abdominal pain
• Sleep disturbances
• nightmares
• Rare: heart block
• hypotension

Precautions

• Contraindicated in cardiogenic shock
• decompensated heart failure requiring inotropes
• sick sinus syndrome
• second
• or third
• degree AV block (without pacemaker)
• severe bradycardia (HR < 45 bpm)
• and severe peripheral arterial disease.
• Contraindicated in hypersensitivity to metoprolol or other beta
• blockers.
• Do not abruptly discontinue
• taper dose over at least 2 weeks
• especially in angina patients.
• Use with caution in asthma
• COPD
• diabetes (may mask hypoglycaemia signs)
• and thyrotoxicosis.
• Interactions: verapamil/diltiazem
• clonidine
• MAO inhibitors
• avoid concomitant use with other negative chronotropic agents.