"Corvitol": analogues, reviews, instructions for use. How to replace "Corvitol 50" and "Corvitol 100"?

Cardiovascular diseases are the most common. In order to quickly reduce blood pressure, reduce the number of heartbeats, relieve the condition with angina pectoris, migraines, take the drug "Corvitol".Analogues are also appointed quite often for one reason or another. The drug has contraindications, so before using it, you need to consult a doctor.

Form release and formulation of the drug

The drug refers to beta-blockers. Produced in the form of white tablets that have a flat-cylindrical round shape, a facet and one-sided risk. It is available in two dosages:

• "Corvitol 100".Contains 100 mg of active ingredient metoprolol tartrate.
• "Corvitol 50".It contains 50 mg of active ingredient metoprolol tartrate.

Additional ingredients for both forms of release are the same and are represented by lactose monohydrate, magnesium stearate, povidone K30, croscarmellose sodium, silicon dioxide, colloidal talc.

Tablets are packed in aluminum blisters for 10 pieces. In the package can be from 3 to 10 blisters. The medication is accompanied by instructions for use.

Pharmacology and pharmacodynamics

"Corvitol" is a cardioselective beta-blocker that does not show sympathomimetic activity and does not have membrane-stabilizing properties. It has antihypertensive, anti-arrhythmic, anti-anginal properties.

Brakes a small number of β1-adrenoreceptors of the heart, reduces catecholamine-activated formation of CAMP from ATP, weakens the intracellular current of calcium ions. Provides negative batmo-, chrono-, dromo- and inotropic effects.

OPSS at the start of the use of beta-blockers increases, and after a few days of drug use returns to the baseline level, with continued use decreases.

The antihypertensive property is due to a decrease in cardiac output and renin synthesis, inhibition of renin-angiotensin and central nervous system activity, restoration of the sensitivity of the aortic arch baroreceptors and, as a result, a decrease in peripheral sympathetic influences. Reduces blood pressure at rest and with physical, nervous and mental stress.

A hypotensive result is achieved in a matter of minutes. So, the systolic blood pressure decreases in fifteen minutes, maximum in two hours. The effect lasts for six hours. Diastolic blood pressure changes more slowly. Its stabilization can be achieved only after several weeks of taking the drug.

Antiangial qualities of the drug are determined by the reduction in myocardial oxygen demand due to a decrease in the heart rate. The susceptibility of the myocardium to the influence of sympathetic innervation decreases, the number and severity of angina attacks. Increases physical endurance.

Antiarrhythmic properties are manifested with the removal of arrhythmogenic manifestations, a decrease in excitation of sinus and ectopic rhythm, as well as inhibition of AV conduction. With manifestations of supraventricular tachycardia, the appearance of atrial fibrillation and the detection of sinus tachycardia associated with heart disease and in hyperthyroidism, the medication reduces the heart rate. Sometimes restores sinus rhythm. It alleviates the state of migraine and prevents its occurrence in the future.

When applied at average therapeutic doses, in contrast to non-selective beta-blockers, it exerts a less pronounced effect on organs containing β2-adrenoreceptors and on carbohydrate metabolism. When used in large doses( more than 100 mg per day) has a blocking effect on both subtypes of β-adrenoreceptors.

Metoprolol is absorbed 95% from the stomach and intestines. The maximum concentration in the blood plasma is observed after 1-2 hours. Due to active metabolism, when the drug is first taken, bioavailability is 50%.With subsequent use of the drug, it increases to 70%.Eating food increases bioavailability every 20-40%.

"Corvitol" connects with blood proteins by 10%, Vd - 5.5 l / kg. Passes through the BBB and the placenta barrier. It is excreted in breast milk in small doses.

The drug is almost completely metabolized in the liver. The two main metabolites of the three are characterized by a beta-adrenoblocking property. The cytochrome P450 isoenzyme( CYP 2D6) is involved in the metabolism of the drug. Excretion lasts about 3.5 hours. The drug is excreted in the urine, and 5% comes out unchanged.

Kidney disease inhibits the metabolism of metoprolol. Significantly increases the bioavailability in cirrhosis. The active substance is not released from the body during hemodialysis.

Indications for the use of medication

"Corvitol" should be used strictly according to the doctor's prescription for arterial hypertension. It is used as a monotherapy or in combination with other antihypertensive agents. Indication for use is tachycardia, ischemic heart disease, myocardial infarction. Often used "Corvitol 100", analogs to prevent attacks of angina and in violation of the heart rate, for the prevention of migraine.

Contraindications

"Corvitol 50", as well as the drug in a dosage of 100 mg can not be taken with cardiogenic shock. Contraindication is AV-blockade II and III degree, as well as sinoatrial blockade. Do not take the drug in the syndrome of a weak sinus node, pronounced bradycardia. The ban is peripheral circulatory failure and heart failure. Tablets do not drink with stenocardia, acute myocardial infarction and arterial hypotension.

You can not combine the medication "Corvitol 50"( the analogues can be selected by the attending physician if necessary) with the use of monoamine oxidase inhibitors and with intravenous injections of "Verapamil".

The drug is not prescribed during the breastfeeding of a child, persons under the age of eighteen, and people with increased sensitivity to metoprolol, additional substances in the composition of the drug.

With special care take a medical product for diabetes mellitus, bronchial asthma, pulmonary emphysema, metabolic acidosis, chronic bronchitis in an obstructive form. Only under the supervision of a doctor people with peripheral vascular diseases, kidney and liver failure should use the medicine. Caution with the use of tablets "Corvitol" should be patients with myasthenia gravis, AV-blockade I degree, as well as with pheochromocytoma, depressive state and with thyrotoxicosis. With caution appoint it with psoriasis and elderly patients.

During pregnancy, tablets "Corvitol" are prescribed only in cases of acute necessity, when the fetus has a bradycardia, arterial hypotension, hypoglycemia. In this case, the treatment process must be under close supervision of the doctor. In the future, continuous supervision of the newborn is carried out for 48-72 hours after delivery.

The impact of metoprolol on the baby of the first days of life has not been studied, so the ladies using the drug are advised to stop breastfeeding.

"Corvitol": use, recommended doses

The therapeutic course for each patient is determined by the doctor and depends on the course of the illness. Only an expert should prescribe a dose and a medication dose of the drug "Corvitol".Instructions for use( analogues of medicines from Russian manufacturers are much cheaper) describes only the classical regimens for certain diseases.

So, with arterial hypertension and angina, the drug is ingested 100 mg once a day or 50 mg twice a day. If necessary, the amount of the drug is increased to 100 mg, taken twice a day. The maximum possible daily dose is 200 mg.

In case of functional disorders in the heart, provoking the occurrence of tachycardia, the initial reception is prescribed in an amount of 50-100 mg per day. This volume can be divided into two. As necessary, the daily dose is increased to 200 mg.

To prevent migraine, the drug is prescribed for 100 mg once a day or 50 ml in the morning and in the evening. When the therapeutic effect is achieved, the dose should be reduced. This process should be slow and under the close supervision of the doctor.

In elderly people with kidney disease and for hemodialysis, the daily dose is not reduced. If there is a malfunction in the liver, the daily amount of the drug is reduced, focusing on the patient's condition.

In all of the above cases, "Corvidol" is used orally, after eating and washed down with a small amount of water. Tablets should be swallowed without chewing. If the drug is drunk once a day, then it should be taken in the morning. When twice taken, tablets are taken in the morning and in the evening.

Overdose

The medication "Corvitol" in case of an overdose immediately stop taking. Symptoms of substance abuse are sinus bradycardia, nausea, dizziness, lowering of arterial pressure, gag reflex, cyanosis, arrhythmia, bronchospasm, syncope, ventricular extrasystole.

Acute degree of overdose with the drug "Corvitol"( analogues in Russia can be bought in any pharmacy from 30 rubles and above) is manifested in the form of cardiogenic shock, coma, AV blockade, loss of consciousness, cardialgia. As a rule, the first signs of excessive use of the drug occur after 20 minutes - 2 hours after ingestion.

First, the patient is washed with a stomach and prescribed adsorption drugs. If there was a sharp drop in blood pressure, then the person is placed in the Trendelenburg position. If the pressure falls to a critical level and there is heart failure, a bradycardia, intravenous beta-adrenostimulators are injected intravenously at intervals of 2-5 minutes. The procedure is carried out to a positive result. Intravenous injection can be made in a dose of 0.5-2 mg of "Atropine sulfate".

If the desired effect is not achieved, then drugs such as "Dopamine", "Norepinephrine", "Noradrenaline" or "Dobutamine" are used. Sometimes 1-10 mg of "Glucagon" is prescribed or a transvenous intracardiac electrostimulator is installed. When there is bronchospasm, beta-adrenostimulators are injected into the vein. If there are convulsions, then slowly inject a "Diazepam" into the vein. Hemodialysis in this case does not work.

Adverse events

Permanent intake of the drug "Corvitol"( tablets) can trigger from the central nervous system headache, muscle weakness, excessive fatigue, dizziness, cause inhibition of mental and physiological reactions, paresthesia of hands and feet. Depressive state, feelings of anxiety and fear are manifested, concentration of attention is disturbed. Drowsiness, negative dreams, sleeplessness, confusion of thoughts, short-term loss of memory disturbs. Asthenic syndrome may occur.

"Corvitol" and its analogs can cause vision impairment, dry eyes and soreness, a decrease in the production of tear fluid. In rare cases, there is conjunctivitis, rhinitis. There is a noise in the ears.

The drug can cause disruption of the cardiovascular system in the form of a sinus type bradycardia, increased heart rate, a sharp decrease in pressure, orthostatic hypotension. In rare cases, there is a decrease in myocardial contractions, aggravation of heart failure, arrhythmia, angiospasm. The patency of the myocardium is violated. There is cardialgia.

With regular medication, there were violations of the functions of the gastrointestinal tract, which manifested itself in the form of nausea, vomiting reflex, pain in the abdominal region, diarrhea, dry mouth. Some patients noted a change in taste preferences, an increase in the vital activity of hepatic enzymes. In rare cases, there was hyperbilirubinemia.

As a result of therapy, dermatological reactions were also observed. This psoriasis and its aggravation, hyperemia, exanthema. Excessive sweating, alopecia of reversible type and photodermatosis were noted.

Side effects of the respiratory system occurred in the form of shortness of breath and nasal obstruction. Some patients suffered from shortness of breath.

Sometimes hypoglycemia and hypothyroid status occurred. Thrombocytopenia, leukopenia and agranulocytosis worried patients. There was an allergy in the form of itching, hives and rashes. There were pains in the back( joints), weight gain, loss of libido, potency.

Special instructions

When using the drug, you should maintain special control over heart rate, blood pressure and glucose, especially in patients with diabetes mellitus. In the latter case, the dose of the drug is selected in accordance with the picture of the disease.

The patient should be taught how to calculate the heart rate and instructed about the need for a doctor's consultation at a heart rate of less than 50 beats per minute.

If high doses are prescribed( from 200 mg per day), then cardioselectivity decreases. In patients with heart failure, therapy is performed during the compensation period.

There may be an increase in the severity of reactions of hypersensitivity( against a background of a weighed allergic anamnesis) and the absence of the effect of the administration of usual doses of "Epinephrine".

Against the background of taking the drug, the symptoms of peripheral arterial circulation may worsen.

Cancellation of treatment is carried out gradually, reducing the dose to a minimum for ten days. You can not abruptly cancel taking the drug, as there can be an attack of angina and an increase in blood pressure.

In patients with angina, the dose is chosen so that the heart rate is 55-60 beats / min, and with physical activity does not exceed 110 beats / min.

People with contact lenses should know that during the therapy with beta-blockers, the production of tear fluid may decrease.

Metoprolol in some cases masks the manifestations of thyrotoxicosis. Patients with thyrotoxicosis are contraindicated for the abrupt withdrawal of the drug, as this will only aggravate the course of the disease.

Patients with diabetes mellitus can not immediately detect tachycardia, provoked by hypoglycemia."Corvitol" does not increase insulin-induced hypoglycemia and does not delay the restoration of blood glucose to normal levels.

Elderly people should always monitor kidney function while taking medication, as well as patients with kidney failure.

With caution, people with a depressive condition should take medicine, since tablets can increase the severity of the disease.

During the period of therapy, one should refrain from driving a vehicle and stop activities related to concentration, requiring quick response.

During treatment, it is necessary to wear closed clothing, since the drug is capable of causing photosensitization.

How to replace "Corvitol"?

In a number of cases, the drug can cause many side effects or simply do not fit your actions, so the doctor can replace "Corvitol".Analogs have similar properties, give the same therapeutic effect and have metoprolol tartrate in the composition. They are quite popular and are sold in almost every pharmacy, and the price of some of them barely reaches 50 rubles.

The following are available to replace "Corvitol" analogs with the same active component:

• "Betaloc".
• "Egilok".
• "Metozok".
• Metoprolol.
• "Serdol".
• "Vazocardine".
• "Lidalok".

The following drugs have a similar effect: Aritel, Estecor, Bisomor, Binelol, Atenolol, Cordinorm, Betak, Biol, Nebilet, Bisogamma and other medications.

When replacing one medication with another, it should be remembered that the analogue does not always act as effectively as the original drug, which has passed a series of tests and a lot of studies.

The cost of the drug, reviews of

Is it always possible to replace "Corvitol" analogues? Patients' opinions say that it is difficult to find a drug with the same long-term effect, despite the fact that many products containing exactly the same active substance are produced. The medicine is often more expensive than the substitutes, but, as experience has shown, the analogs are less effective. Testimonials indicate that "Corvitol" effectively reduces blood pressure and prevents the development of migraine.

50 tablets of 100 mg will cost 250-300 rubles, the same amount in a dosage of 50 mg is about 220-250 rubles.