"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, 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 of release and composition of the medicinal product

The drug refers to beta-blockers. Produced in the form of white tablets, which have a flat-cylindrical round shape, facet and one-sided risk. Produced 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 the instructions for use.

Pharmacology and pharmacodynamics

"Corvitol" is a cardioselective beta-adrenoblocker, which does not show sympathomimetic activity and does not have membrane-stabilizing qualities. It has antihypertensive, antiarrhythmic, anti-anginal properties.

It inhibits the β1-adrenergic receptor of the heart in a small amount, reduces the catecholamine-activated formation of CAMP from ATP, weakens the intracellular current of calcium ions. It has negative batmo-, chrono-, dromo-, and inotropic influences.

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, ultimately, 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, 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.

Antianginal qualities of the drug are determined by a decrease in the demand for myocardium in oxygen because of a decrease in 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 in the removal of arrhythmogenic manifestations, a decrease in excitation of sinus and ectopic rhythm, as well as inhibition of AV conduction. In cases of supraventricular tachycardia, the appearance of atrial fibrillation and the detection of sinus tachycardia associated with heart disease and hyperthyroidism, the drug reduces the heart rate. Sometimes restores sinus rhythm. It alleviates the state of migraine and prevents its occurrence in the future.

When used 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-adrenergic receptors.

Metoprolol is absorbed 95% from the stomach and intestines. The maximum concentration in the blood plasma is observed after 1-2 hours. Because of 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" is connected 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% is released unchanged.

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

Indications for the use of medicine

"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 chosen 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 years, and people with increased sensitivity to metoprolol, additional substances in the composition of the drug.

With special care take a medical product for diabetes, 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 for psoriasis and elderly patients.

During pregnancy, tablets "Corvitol" are prescribed only in cases of acute necessity, when the fetus has bradycardia, arterial hypotension, hypoglycemia. In this case, the treatment process should 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 child 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 a specialist should prescribe a medication and a dosage 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.

With functional disorders in the heart, provoking the emergence 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 a 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

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.

The acute degree of overdose with the drug "Corvitol" (analogs 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 the stomach and prescribed adsorption drugs. If there was a sharp drop in blood pressure, then the person is laid in the Trendelenburg position. If the pressure drops 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 a bronchospasm occurs, 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

Constant reception of the drug "Corvitol" (tablets) can provoke from the central nervous system a 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 abdomen, 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 there was hypoglycemia and hypothyroid condition. 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 should be a special control over the frequency of heartbeats, blood pressure and glucose, especially in patients with diabetes. In the latter case, the dose of the drug is selected in accordance with the picture of the disease.

It is necessary to teach the patient how to calculate the heart rate and instruct him about the need to consult a doctor 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.

It is possible to increase the severity of reactions of hypersensitivity (against a background of a burdened allergic anamnesis) and the absence of the effect of the administration of usual doses of "Epinephrine".

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

Cancellation of treatment is made 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 pectoris, the dose is selected so that the heart rate is 55-60 beats / min, and when 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, since this will only aggravate the course of the disease.

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

Elderly people when taking medication should constantly monitor the functions of the kidneys, as well as patients with kidney failure.

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

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

During treatment, you should wear closed clothing, since the drug is capable of causing photosensitization.

How to replace "Corvitol"?

In some cases, the drug can cause a lot of 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 a metoprolol tartrate. They are quite popular and are sold in almost every pharmacy, and the price of some of them barely reaches 50 rubles.

Further, the analogs with the same active component can be substituted for "Corvitol":

• Betalok.
• "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 efficiently as the original drug, which has passed a number of tests and a lot of studies.

The cost of the drug, reviews

Can "Corvitol" analogues always replace? The patient's comments 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 experience has shown that 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.