Corvitol® (Metoprolol) 50 mg, 50 tablets

Korvitol 50International unlicensed name: Metoprolol

Sostav
contains In 1 tablet Korvitola 50:
the operating medicinal substance: metoprolola of tartrate of 50 mg.
Auxiliary components: lactose × 1H2O, povidone, kroskarmelloza sodium salt, magnesium stearate, talc, silicon dioxide high-disperse.

Pharmacotherapeutic group
Cardioselective b1-adrenoblocker.
Code of automatic telephone exchange C07AB02.

Pharmacological action
Metoprolol is cardioselective b1-adrenoblocker without internal sympathomimetic activity and with mild membrane stabilizing action. Metoprolol possesses anti-anginal, hypotensive and antiarrhytmic action. Reduces the frequency and force of warm reductions, atrioventricular conductivity and activity of renin of blood plasma. As a result of blockade of b2-adrenoceptors metoprolol is able to raise a tone of smooth muscles.
After oral administration metoprolol almost completely (95%) it is soaked up from digestive tract. The bioavailability is 50%. The maximum contents it in plasma is reached 1.5-2 hours later.
Linking with proteins of plasma makes about 12%.
Metoprolol is almost completely metabolized in a liver.
In cirrhosis because of decrease in degree of a metabolization the maintenance of not changed metoprolol in plasma can increase.
Metoprolol and his metabolites are brought by kidneys approximately to 95%, from them about 10% - in not changed look. Elimination half-life makes 3-5 hours.

Indications
- arterial hypertension,
- prevention of attacks of stenocardia,
- functional pains from a cardiovascular system
(hyperkinetic syndrome of heart),
- supraventricular forms of tachycardias,
- an acute myocardial infarction and after the postponed myocardial infarction,
- prevention of attacks of migraine.

The route of administration and doses
recommend to establish the Dose of drug individually, first of all, depending on pulse rate or from a successful course of a course of treatment. This dosage is not allowed to be changed without medical prescription.
Recommendations about a dosage:
The increased arterial blood pressure (arterial hypertension) and stenocardia – on 1 tablet Korvitola 50 1-2 of time a day, if necessary a dose can be increased to 2 tablets 1-2 times a day.
Functional cardiovascular pains (hyperkinetic syndrome of heart) and tachycardic arrhythmias – the initial dose Korvitola 50 makes 1-2 tablets 1-2 times a day, if necessary the dose can be increased to 4 tablets (200 mg) a day.
Treatment of an acute myocardial infarction - in an acute myocardial infarction appoint 25-50 mg orally every 12 hours (on ½-1 to tablet Korvitola 50). If necessary the dose Korvitola 50 can be increased up to 100-200 mg of a metoprolol of tartrate a day: on 1-2 tablets Korvitola 50 2 of time a day under control of the electrocardiogram, arterial blood pressure and a condition of the patient.
The minimum duration of a course of treatment is 3 months, treatment is recommended to continue within 1-3 years.
Prevention of attacks of migraine – on 1-2 tablets Korvitola 50 2 of time a day.
In a liver failure the dose of drug has to be selected individually.
A pill is taken with a small amount of liquid, without chewing, after a meal. At one single dose Korvitol 50 it is necessary to accept in the mornings, at two single doses - in the morning and in the evening. The course of treatment is not limited to drug Korvitol 50 in time and the disease techechniya depends on features. It is allowed to interrupt a course of treatment or to change a dosage only according to doctor's instructions. In need of treatment cancellation the dose is reduced gradually (at least within 10 days) under observation of the doctor. Duration of treatment is established by the attending physician.

Side effects
Korvitol 50 it is usually well transferred, however, at the beginning of a course of treatment or at big dosages disorders from the central nervous system can be observed: fatigue, dizziness, depression, confusion of consciousness, slight headaches, perspiration, sleep disorders, strengthening of dreams or hallucinations. At decrease in dosages and the subsequent careful increase in a dose these symptoms pass.
Passing pains from digestive tract can sometimes be observed: nausea, vomiting, abdominal pain, constipation or diarrhea.
From respiratory organs: an asthma at loading, a bronchospasm.
From the central nervous system: feelings of numbness of skin and 'crawlings of goosebumps', cold sense in extremities are sometimes observed, it is rare - muscle weakness or myotonia. Strengthening of pain at patients with the significant disturbances of peripheral blood supply (Reynaud's syndrome and the alternating lameness) is possible.
From a cardiovascular system: orthostatic hypotonia, a pulse urezheniye, functional cardiac disturbances, atrioventricular blocks, strengthening of heart failure, pain in heart and heartbeat, bradycardia.
From sense bodys: conjunctivitis and reduction of secretion of a lacrimal gland are in rare instances possible dryness in a mouth (this circumstance needs to be considered at patients who carry contact lenses).
In some cases disorders of sexual desire (libido) and potency, increase in body weight, light sensitivity with the advent of skin rashes under the influence of light and also a hair loss, visual disturbances, hearing or sonitus can develop.
From skin and mucous covers: development of giperergichesky reactions (itching, erubescence, skin rash), allergic cold and anaphylactic reactions is in rare instances possible.
In some cases - changes of functional indicators of a liver, thrombocytopenia or a leukopenia.
The demonstration of latent diabetes or aggravation of symptoms of patients with the current diabetes is in rare instances possible.

Contraindications
- the demonstrating heart failure,
- atrioventricular block of II and III degree,
- shock,
- a sick sinus syndrome (Kisa-Flaka node),
- bradycardia (less than 50 beats per minute),
- arterial hypotension,
- acidosis,
- disturbances of a peripheral blood-groove,
- predisposition to bronchospasms (bronchial hyper reaction, bronchial asthma),
- simultaneous therapy by monoaminooxidase inhibitors, verapamil and diltiazem,
- hypersensitivity to a metoprolol and to other b-blockers.

Sick psoriasis Korvitol 50 recommends to appoint taking into account assessment of advantage and possible risk.
Especially careful medical control is necessary:
- at atrioventricular block of the I degree,
- at the significant fluctuations of sugar in blood at patients diabetes,
- at a long rigid diet (starvation) and considerable physical activity,
- at a pheochromocytoma (it is necessary to apply Korvitol 50 only after preliminary blockade of a-adrenoceptors),
- at the patients taking a course of the desensibilizing therapy (danger of excessive anaphylactic reaction)
- at patients with bounded function of a liver.

Pregnancy and a lactation
during pregnancy (especially in the first trimester) it is necessary to apply metoprolol only according to strict indications and taking into account assessment of a ratio of advantage and possible risk. Due to the possible development in the newborn of bradycardia, hypotension, a hypoglycemia and paralysis of breath the course of treatment Korvitolom 50 needs to be interrupted in 48-72 hours prior to the calculated term of childbirth. When it is impossible, it is necessary to provide strict observation of newborn children within 48-72 hours after the delivery.
Probability of receipt of a metoprolol with maternal milk in the quantities constituting danger to the baby is very small, however, babies have to be in such cases under special observation.

Prevention
Treatment of arterial hypertension Korvitolom 50 demands regular medical control. As a result of various individual sensitivity the ability in control of motor transport, especially at the beginning of a course of treatment can decrease.
Interactions with other means
At simultaneous use Korvitola 50 and:
- insulin or other hypoglycemic means their action can amplify or be prolonged, at the same time hypoglycemia symptoms (especially tachycardia and a tremor) can be disguised or weakened therefore it is necessary to carry out regular control of sugar to blood,
- tricyclic antidepressants, barbiturates, fenotiazin, nitroglycerine, diuretics, vazodilatator and other antihypertensives (for example, Prazozinum) the hypotensive effect can amplify,
- antagonists of calcium (type verapamil and diltiazem) or other antiritmik (for example, Disopyramidum) hypotension, bradycardia and cardiac conduction abnormalities can develop,
- cardiac glycosides, reserpine, alpha Methyldopum, a guanfatsin and a clonidine decrease in heart rate is possible,
- noradrenaline, adrenaline or other sympathomimetic means (for example, contained in eye drops or antibechics) increase in blood pressure is possible,
- indometacin and rifampicin hypotensive action of a metoprolol can decrease,
- lidocaine discharge of the last is at a loss,
- drugs the hypotensive effect amplifies, at the same time additive, negative inotropic action of both means is shown,
- peripheral muscle relaxants is possible strengthening of nervnomyshechny blockade therefore before operation, followed by an anesthesia, is necessary to inform the anesthesiologist that the patient accepts Korvitol 50
- alcohol is possible strengthening of the slowing-down action.
And the clonidine can be cancelled by the patient accepting at the same time Korvitol 50 only in several days after the termination of treatment Korvitolom 50.

Packaging: On 50 tablets in packing.

Storage conditions: To store at a temperature not higher than 25 wasps.
To store medicine out of children's reach!

Expiration date: 3 years.
After expiry date, medicine cannot be used.