BELOC ZOK (Metoprolol) 50MG

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BELOC ZOK   (Metoprolol) 50MG

METOPROLOL - ORAL EXTENDED RELEASE,(met-oh-PRO-lol) ,COMMON BRAND NAME(S): Toprol XL
This medication is a beta-blocker used to treat chest pain (angina), heart failure, and high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This results in a lowering of heart rate, blood pressure, and strain on the heart.
Generic Name Metoprolol
Search Name TOPROL XL Brand 50MG Tab
Supply Name BELOC ZOK
Brand Generic BRAND NAME
Presentation Blister in Box
Dosage Tab
USA Brand TOPROL XL
Manufacture Patent Holder
Strength 50MG
Search Terms TOPROL XL,BELOC ZOK ,Metoprolol
Origin TURKEY

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FOR THE CONSUMER

Along with its needed effects, metoprolol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking metoprolol:

More common:
-Blurred vision
-chest pain or discomfort
-confusion
-dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
-shortness of breath
-slow or irregular heartbeat
-sweating
-unusual tiredness or weakness

Less common:
-Bloating or swelling of the face, arms, hands, lower legs, or feet
-cough
-decreased urine output
-difficult or labored breathing
-difficulty with speaking
-dilated neck veins
-disturbed color perception
-double vision
-extreme fatigue
-fast, pounding, or racing heartbeat or pulse
-halos around lights
-headache
-inability to move the arms, legs, or facial muscles
-inability to speak
-irregular breathing
-loss of vision
-night blindness
-noisy breathing
-overbright appearance of lights
-pain, tension, and weakness upon walking that subsides during periods of rest
-paleness or cold feeling in the fingertips and toes
-rapid weight gain
-seeing, hearing, or feeling things that are not there
-short-term memory loss
-slow speech
-swelling of the face, fingers, feet, or lower legs
-tightness in the chest
-tingling of the hands or feet
-tingling or pain in the fingers or toes when exposed to cold
-troubled breathing
-tunnel vision
-unusual weight gain or loss

Rare:
-Bluish color skin of the fingers or toes
-chills
-clay-colored stools
-continuing loss of appetite
-continuing or severe abdominal or stomach pain
-continuing or severe nausea and vomiting
-dark urine
-difficulty with moving
-fever
-general tiredness and weakness
-hoarseness
-increased frequency of urination
-itching skin
-light-colored stools
-lower back or side pain
-muscle pain or stiffness
-numbness of the fingers or toes
-pain, swelling, or redness in the joints
-rash
-sore throat
-sores, ulcers, or white spots on the lips or in the mouth
-unpleasant breath odor
-unusual bleeding or bruising
-upper right abdominal or stomach pain
-vomiting of blood
-weakness
-yellow eyes and skin

Incidence not known:
-Black, tarry stools
-bleeding gums
-blood in the urine or stools
-burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
-cool, sweaty skin
-pinpoint red spots on the skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking metoprolol:

Symptoms of overdose:
-Bluish color of the fingernails, lips, skin, palms, or nail beds
-change in consciousness
-loss of consciousness
-no blood pressure or pulse
-stopping of heart
-unconsciousness
-very drowsy or sleepy

Some side effects of metoprolol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common:
-Belching
-bloated
-decreased interest in sexual intercourse
-difficulty having a bowel movement (stool)
-discouragement
-dry mouth
-excess air or gas in stomach or intestines
-feeling of constant movement of self or surroundings
-feeling of indigestion
-feeling sad or empty
-full feeling
-inability to have or keep an erection
-irritability
-loss in sexual ability, desire, drive, or performance
-loss of interest or pleasure
-nightmares
-pain in the chest below the breastbone
-passing gas
-redness or other discoloration of the skin
-runny nose
-sensation of spinning
-sneezing
-stuffy nose
-tiredness
-trouble concentrating
-trouble sleeping

Rare:
-Bone pain
-continuing ringing or buzzing or other unexplained noise in the ears
-dry eyes
-hair loss or thinning of the hair
-hearing loss
-increased sensitivity of the skin to sunlight
-pain of penis on erection
-severe sunburn

Incidence not known:
-Change in taste or bad, unusual, or unpleasant (after) taste
-fear or nervousness
-hives or welts
USUAL ADULT DOSE FOR ANGINA PECTORIS PROPHYLAXIS
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day.

USUAL ADULT DOSE FOR HYPERTENSION
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day.

USUAL ADULT DOSE FOR SUPRAVENTRICULAR TACHYCARDIA
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day.

USUAL ADULT DOSE FOR ANGINA PECTORIS
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 400 mg/day.
Extended release may be used at the same total daily dose given once a day.

USUAL ADULT DOSE FOR MYOCARDIAL INFARCTION
Early treatment:
IV: 3 bolus injections of 5 mg of metoprolol given at 2 minute intervals.
Oral: In patients who tolerate the full IV dose (15 mg), metoprolol tablets, 50 mg every 6 hours, should be initiated 15 minutes after the last IV dose and continued for 48 hours. Maintenance dose: 100 mg orally twice a day.
Patients who appear not to tolerate the full IV dose should be started on metoprolol tablets at 25 mg or 50 mg every 6 hours 15 minutes after the last intravenous dose or as soon as their clinical condition allows.

Late treatment:
Oral: 100 mg orally twice a day.
Patients with contraindications to treatment during the early phase of suspected or definite myocardial infarction, patients who appear not to tolerate the full early treatment, and patients in whom the physician wishes to delay therapy for any other reason should be started on metoprolol tablets as soon as their clinical condition allows.

USUAL ADULT DOSE FOR CONGESTIVE HEART FAILURE
Initial dose: 25 mg once daily (of the XL formulation) for two weeks in patients with NYHA class II heart failure and 12.5 mg once daily (of the XL formulation) in patients with more severe heart failure.
Maintenance dose: This dosage should then be doubled every two weeks to the highest dosage level tolerated or up to 200 mg.
If transient worsening of heart failure occurs, it may be treated with increased doses of diuretics, and it may also be necessary to lower the dose or temporarily discontinue treatment. The dose should not be increased until symptoms of worsening heart failure stabilize.
Initial difficulty with titration should not preclude later attempts to institute therapy. If heart failure patients experience symptomatic bradycardia, the dose of metoprolol should be reduced.

USUAL PEDIATRIC DOSE FOR HYPERTENSION
-Immediate release:
1 to 17 years:
Initial dose: 1 to 2 mg/kg/day, administered in 2 divided doses. Dosage should be adjusted based on patient response.
Maximum dose: 6 mg/kg/day (less than or equal to 200 mg/day)
-Extended release:
6 to 16 years:
Initial dose: 1 mg/kg orally once daily (not to exceed 50 mg once daily). The minimum available dose is one half of the 25 mg tablet.
Maintenance dose: Dosage should be adjusted according to blood pressure response. Doses above 2 mg/kg (or in excess of 200 mg) once daily have not been studied.

RENAL DOSE ADJUSTMENTS
No adjustment is usually recommended in patients with chronic renal failure.

LIVER DOSE ADJUSTMENTS
Metoprolol should be used with caution in patients with hepatic disease.

DOSE ADJUSTMENTS
The dosage may be increased at weekly (or longer) intervals until optimum blood pressure reduction is achieved or there is pronounced slowing of the heart rate. In general, the maximum effect of any given dosage level will be apparent after 1 week of therapy.
While once daily dosing is effective and can maintain a reduction in blood pressure throughout the day, lower doses (especially 100 mg) may not maintain a full effect at the end of the 24-hour period, and larger or more frequent daily doses may be required. This can be evaluated by measuring blood pressure near the end of the dosing interval to determine whether satisfactory control is being maintained throughout the day.
In general, a lower initial starting dose should be used in elderly patients given their greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Because metoprolol is metabolized by the liver, metoprolol blood levels are likely to increase substantially with poor hepatic function. Therefore, therapy should be initiated at doses lower than those recommended for a given indication; and doses should be increased gradually in patients with impaired hepatic function.

PRECAUTIONS
Safety and effectiveness of metoprolol immediate release has not been established in pediatric patients less than 2 years of age. Safety and effectiveness of metoprolol controlled release has not been established in pediatric patients less than 6 years of age.

DIALYSIS
A supplemental dose should be administered after hemodialysis. No supplemental dose is needed with peritoneal dialysis.

OTHER COMMENTS
Metoprolol should be taken with or immediately following meals.
Doses above 450 mg per day have not been studied for hypertension.
Myocardial Infarction therapy should be continued for at least 3 months. Although the efficacy of metoprolol beyond 3 months has not been conclusively established, data from studies with other beta blockers suggest that treatment should be continued for 1 to 3 years.
Doses above 400 mg per day have not been studied for angina pectoris.
Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with beta-blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.