Selomet SR 50 | 1 Strip

✔️ Side Effects of Selomet SR 50

Dizziness, Slow heart rate, Rash, Diarrhea, Tiredness, Shortness of breath

✔️ Indications:

Metoprolol is used in the management of high blood pressure (hypertension) and chest pain due to heart disease (angina pectoris). It is also effective in treating cardiac arrhythmias, especially supraventricular tachyarrhythmias, and serves as an adjunct therapy in hyperthyroidism. Early administration during acute myocardial infarction can reduce the size of the infarct and lower the risk of ventricular fibrillation. Additionally, Metoprolol can alleviate pain, potentially reducing the need for opioid analgesics. Its use in acute myocardial infarction has been associated with a reduction in mortality rates.

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✔️ Dosage & Administration

Oral Administration:

• Hypertension: 100–400 mg daily as a single dose or in two divided doses. Start with 100 mg daily and titrate up weekly if needed. It may be used alone or with a diuretic or another antihypertensive.
• Angina Pectoris: 50–100 mg two or three times daily.
• Cardiac Arrhythmias: Typically 50 mg twice or three times daily. The dose may be increased to a maximum of 300 mg/day. After IV treatment of arrhythmias, oral therapy should begin within 4–6 hours at a dose not exceeding 50 mg t.i.d.
• Hyperthyroidism: 50 mg four times daily. The dose should be reduced as thyroid function normalizes.
• Myocardial Infarction: Start oral therapy 15 minutes after last IV dose with 50 mg every 6 hours for 48 hours, followed by maintenance at 200 mg daily in divided doses. For those intolerant to full IV dosing, use half the oral dose.

Injection:

• Arrhythmias: 5 mg IV at a rate of 1–2 mg/min. May repeat every 5 minutes up to 10–15 mg total.
• During Surgery: 2–4 mg IV at induction or to manage anesthesia-related arrhythmias. Additional 2 mg doses may be given as needed (max 10 mg).
• Myocardial Infarction (within 12 hours): 5 mg IV every 2 minutes (up to 15 mg total), followed after 15 minutes by oral 50 mg every 6 hours for 48 hours, then 200 mg/day maintenance in divided doses.

Special Populations:

• Renal Impairment: No dose adjustment required.
• Hepatic Impairment: Usually no adjustment needed due to low protein binding. However, dose reduction should be considered in severe hepatic dysfunction (e.g., shunt-operated patients).

Elderly: No specific dose adjustment necessary.

✔️ Drug Interactions

Metoprolol levels may increase when taken with CYP2D6 inhibitors such as aspirin. Many other drugs, including antiarrhythmics, antihistamines, H2-blockers, antidepressants, antipsychotics, and COX-2 inhibitors, may also influence Metoprolol levels. Rifampicin can decrease its plasma concentration.

✔️ Side Effects

• Bradycardia
• Hypotension
• Bronchospasm
• Dizziness
• Headache
• Fatigue
• Sleep disturbances
• Visual changes
• Gastrointestinal discomfort

✔️ Metoprolol should not be used in patients with:

• Second- or third-degree AV block
• Sick sinus syndrome
• Significant hypotension
• Decompensated heart failure
• Sinus bradycardia
• Severe peripheral artery disease
• Cardiogenic shock
• Severe asthma or bronchospasm
• Untreated pheochromocytoma
• Prinzmetal's angina
• Metabolic acidosis

✔️ Pregnancy & Lactation

Metoprolol should only be used during pregnancy or breastfeeding if the potential benefit justifies the possible risk to the fetus or infant. Beta-blockers may cause bradycardia or other effects in the neonate, though exposure through breast milk is generally low at standard therapeutic doses.

✔️ Precautions & Warnings

If patients present with a heart rate below 40 bpm, PR interval >0.26 seconds, systolic BP <90 mmHg, or symptoms such as worsening dyspnea or cold sweats, further dosing should be avoided. Intravenous Verapamil-type calcium channel blockers must not be co-administered with beta-blockers. Close monitoring of hemodynamic status is essential following IV doses in patients with suspected or confirmed MI. Abrupt discontinuation should be avoided as it may worsen angina or lead to MI. Use caution in pregnant or lactating women or those undergoing major surgery.

✔️ Storage:

Store in a cool, dry place away from light and moisture. Keep out of reach of children.