What is the best time of day to take metoprolol? Learn about the proper dosage, side effects, and benefits of taking this common blood pressure medication.

Understanding Metoprolol: A Beta-Blocker with Multiple Uses

Metoprolol is a commonly prescribed medication that belongs to the class of drugs known as selective beta blockers. It is primarily used to treat hypertension (high blood pressure), angina (chest pain), and heart failure, often in combination with other blood pressure-lowering medications. Additionally, metoprolol may be prescribed to improve survival rates in individuals who have experienced a heart attack. The drug works by blocking the effects of the hormone epinephrine (adrenaline), which can help slow the heart rate, reduce the force of each heartbeat, and relax the blood vessels, ultimately leading to improved blood flow and lower blood pressure.

Dosage and Timing: When is the Best Time to Take Metoprolol?

The optimal time of day to take metoprolol can vary based on the individual’s needs and the specific condition being treated. Generally, it is recommended to take metoprolol exactly as prescribed by your healthcare provider, without taking more or less than the recommended dose. Metoprolol can be taken with or immediately after meals, as this may help minimize potential side effects such as dizziness or lightheadedness.

For those taking immediate-release metoprolol, the usual dose for high blood pressure is 100 mg per day, divided into multiple doses. For the extended-release formulation (Toprol XL), the typical dose ranges from 25 mg to 100 mg once daily. The maximum daily dose for metoprolol is 400 mg.

Why Night-Time May Be the Best Time to Take Metoprolol

While the timing of metoprolol administration is flexible, taking it at night may be preferable for some patients. This is because metoprolol can cause side effects such as dizziness, lightheadedness, and drowsiness, which may be more manageable if the medication is taken before bedtime. By taking metoprolol at night, these potential side effects may be less disruptive to daily activities.

Your healthcare provider may recommend starting with a nighttime dose to assess your individual response to the medication. If you do not experience significant side effects, you can then switch to taking metoprolol in the morning. It is important to space out the doses evenly throughout the day if you have been prescribed multiple daily doses.

Does Metoprolol Affect Sleep?

Metoprolol’s ability to slow the heart rate and promote relaxation can potentially have an impact on sleep patterns. Some studies have shown that metoprolol may help improve sleep, as the slowing of the heart rate can lead to feelings of drowsiness and fatigue. However, other research has suggested that metoprolol may worsen sleep quality in some individuals.

If you are experiencing sleep-related issues while taking metoprolol, it is important to discuss this with your healthcare provider. They may be able to adjust the dosage or recommend alternative beta-blockers that are more likely to have a positive effect on sleep.

Potential Side Effects and Interactions with Metoprolol

Like any medication, metoprolol can cause side effects. Some of the most common side effects include dizziness, lightheadedness, fatigue, and cold extremities. It is important to report any persistent or concerning side effects to your healthcare provider.

Metoprolol can also interact with other medications, including certain antidepressants, antifungal drugs, and some heart rhythm medications. It is crucial to inform your healthcare provider about all the medications, supplements, and herbs you are taking to minimize the risk of harmful interactions.

Consistency is Key: Maintaining Proper Metoprolol Use

Regardless of the time of day you choose to take metoprolol, it is essential to take it consistently as prescribed. Abruptly stopping metoprolol can lead to a rebound in blood pressure, chest pain, or even a heart attack. If you need to discontinue or change your metoprolol regimen, always consult with your healthcare provider first.

Remember, many people with high blood pressure do not experience any noticeable symptoms. It is crucial to continue taking metoprolol as directed, even if you feel well, to effectively manage your condition and reduce the risk of serious health complications.

What is the Best Time of Day to Take Metoprolol?

Written by
Juhi Modi

Medically reviewed by
HaVy Ngo-Hamilton, Pharm.D.
| Dec 20, 2022

Metoprolol is a commonly prescribed drug that is used with or without other blood pressure medications to treat hypertension (high blood pressure). It is also used to treat angina (chest pain) and heart failure, along with other medications. People who have suffered a heart attack are sometimes prescribed metoprolol to improve survival rates. There may be other uses of metoprolol, such as preventing migraine and treating thyrotoxicosis (excessive thyroid hormone).

This article will give you some important information about metoprolol, including how to take this medicine, the best time of day to take it, dosage, side effects, drug interactions, and more.

What is metoprolol? How does it work?

Metoprolol belongs to a group of drugs called selective beta blockers. Their effects occur due to the blocking of beta-1 receptors in the heart tissues. Therefore, a selective beta blocker like metoprolol works by slowing the heart rate while reducing the force of each beat and relaxing the blood vessels. This results in improved blood flow and lowering of blood pressure. 

Metoprolol is available as the active drug metoprolol tartrate in the form of immediate-release tablets and capsules (brand name: Lopressor). It is also available as the active drug metoprolol succinate in extended-release tablets (brand name: Toprol XL).

How to take metoprolol?

You should take metoprolol exactly as prescribed by your healthcare professional. Do not take this medicine more or less frequently than prescribed.

You can take metoprolol with meals or immediately after meals. Swallow the metoprolol tablets whole. Do not break, crush or chew the extended-release tablet or capsule. If you have trouble swallowing pills, you can open an extended-release capsule and sprinkle the contents on a small amount of soft food like applesauce. Do not store the mixture for more than 60 minutes.

Remember that many people with high blood pressure do not have any symptoms. It is important that you continue taking metoprolol even if you feel well. Metoprolol will control your blood pressure and reduce the risks of stroke and heart attacks. Do not suddenly stop taking this medicine without talking to your doctor first. Stopping metoprolol suddenly can lead to rebound hypertension, chest pain, or a heart attack. 

What is the dose of metoprolol for high blood pressure and other conditions?

• The usual dose of metoprolol for high blood pressure is 100 mg per day given in divided doses (immediate-release form) or 25 mg to 100 mg once a day (extended-release form). The maximum dose is 400 mg per day. 
• For chest pain, your doctor may prescribe immediate-release metoprolol, 50 to 100 mg to be taken 2 to 3 times a day
• For acute heart attack or heart failure, the initial metoprolol dose in adults is 25 mg (extended-release capsule) once daily for 2 weeks; the dose can be gradually increased as needed with the maximum dose of 400 mg. 

Why is it better to take metoprolol at night?

It doesn’t matter when you take this medication, as long as you remember to take this blood pressure consistently. You can take it in the morning or at night, but because this medicine can cause dizziness, lightheadedness, and drowsiness, it may be better to take metoprolol at night. Your doctor may advise you to take the first dose of metoprolol before going to bed to see how you feel. If the medicine does not make you feel dizzy or lightheaded, you can start taking single-dose metoprolol in the morning. If you have been prescribed metoprolol more than once a day, try to space out the doses evenly over the course of the day to get a consistent amount of the medication. Avoid drinking alcohol while on metoprolol, as this can make side effects like dizziness worse.

Can metoprolol help you sleep?

Metoprolol may help you sleep. Beta-blockers like metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol XL) work by slowing the heart. These drugs can therefore make you feel tired and drowsy. 

However, it is worth noting that some studies have shown metoprolol can lead to worsening sleep. On the other hand, other beta-blockers like nebivolol (Bystolic) are associated with improved sleep. 

If you have trouble sleeping, talk to your doctor about which beta blocker is the best choice for you.

What is the peak time for metoprolol?

Metoprolol starts working about 2 hours after you take a dose. However, it can take one week or longer to get the full benefits of this medicine. Call your doctor if you do not notice an improvement in your blood pressure numbers at home after 1-2 weeks of taking metoprolol.  

Keep in mind that you may not feel any different while on metoprolol tablets. Do not stop taking metoprolol without your doctor’s approval. This can lead to an increased risk of chest pain and heart attack. If you want to come off metoprolol, your doctor will give you instructions to decrease the dose slowly. 

What should I do in case of a missed dose of metoprolol?

If you miss a dose of metoprolol, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take the next dose according to your regular dosing schedule. Do not double up on the dose to make up for a missed dose.

What are the side effects of metoprolol?

Common side effects of metoprolol include lightheadedness or dizziness, unusual tiredness, dry mouth, blurred vision, depression, heartburn, stomach pain, gas, bloating, vomiting, constipation, rash, a cold feeling in the hands and feet, and runny nose.  

Tell your doctor if these side effects are severe or do not improve over time. Call your doctor immediately or seek emergency medical attention if you develop an allergic reaction. Signs and symptoms of allergic reactions include skin rash, hives, itching, swelling, and trouble breathing.

What should I avoid while taking metoprolol?

You should avoid taking certain other drugs while on metoprolol because there’s a risk of drug interactions. Some of the other medicines that can interact with metoprolol include:

• Other blood pressure medications like clonidine (Catapres) and reserpine
• Antidepressants like bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), and paroxetine (Paxil, Brisdelle)
• Medications used to treat an irregular heartbeat, such as propafenone (Rythmol) and quinidine
• Psychiatric medications like thioridazine
• h3  blockers like cimetidine
• Antihistamines like diphenhydramine (Benadryl)
• Antimalarials like hydroxychloroquine
• Antivirals like ritonavir (Norvir, in Kaletra)
• Antifungals like terbinafine (Lamisil)

Who should not take metoprolol?

Metoprolol may not be suitable for people with certain medical conditions. Give your doctor a complete medical history before starting metoprolol. Be sure to mention medical conditions like angina, ischemic heart disease (chest pain or previous heart attacks), hypotension (low blood pressure), circulation problems, severe bradycardia (very slow heartbeat), cardiogenic shock, heart block, sick sinus syndrome, decompensated heart failure, lung disease, pheochromocytoma, diabetes, hypoglycemia (low blood sugar), hyperthyroidism (overactive thyroid), liver disease, and Wolff-Parkinson-White syndrome (a rare heart condition associated with a very slow heartbeat). Also, tell your doctor if you have ever had an allergic reaction to any of the active or inactive ingredients in metoprolol tablets.
 

References:

1. https://medlineplus.gov/druginfo/meds/a682864.html
2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/019962s032lbl.pdf
3. https://pubmed.ncbi.nlm.nih.gov/18758699/

Metoprolol Definition & Meaning – Merriam-Webster

met·​o·​pro·​lol

me-ˈtō-prə-ˌlȯl -ˌlōl 

: a beta-blocker C₁₅H₂₅NO₃ used in the form of its succinate and tartrate especially to treat hypertension and angina pectoris

Example Sentences

Recent Examples on the Web

Beta blockers like metoprolol and propranolol are not very effective in people over 65, and are usually used only when there are other good reasons to use them, like in a person with heart disease or migraine.

—Dr. Keith Roach, oregonlive, 15 Mar. 2022

The metoprolol slows down the heart rate down, and methimazole prevents formation of thyroid hormone.

—Dr. Keith Roach, oregonlive, 24 Feb. 2022

This condition may also cause chest pain or discomfort especially on exercise, and metoprolol is the most common treatment.

—Dr. Keith Roach, oregonlive, 13 Dec. 2021

One is amlodipine, along with metoprolol and valsartan.

—Dr. Keith Roach, oregonlive, 29 Oct. 2021

ProvideGx, the new generic-drug venture, will begin supplying metoprolol in the middle of this month, according to executives at Premier Inc., which unveiled the subsidiary last month.

—Melanie Evans, WSJ, 4 Feb. 2019

But diltiazem was out of stock, and when two other drugs — adenosine and metoprolol — didn’t work, Mr. Alsina was admitted overnight.

—Katie Thomas, New York Times, 1 July 2018

Conversely, the blood pressure drug metoprolol went up about 70 percent, to 59 cents a pill from 35 cents.

—Charles Ornstein and Katie Thomas, New York Times, 8 Aug. 2017

Beta-blockers (e.g. Lopressor [metoprolol], Coreg (carvedilol], and Bystolic [nebivolol]) are used to treat high blood pressure and heart failure.

—Molly Kimball, OregonLive.com, 14 June 2017

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These examples are programmatically compiled from various online sources to illustrate current usage of the word ‘metoprolol. ‘ Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

Etymology

perhaps from methyl + -o- + propranolol

First Known Use

1974, in the meaning defined above

Time Traveler

The first known use of metoprolol was
in 1974

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Medical Definition

metoprolol

noun

met·​o·​pro·​lol

me-ˈtō-prə-ˌlȯl -ˌlōl 

: a beta-blocker C₁₅H₂₅NO₃ used in the form of its tartrate (C₁₅H₂₅NO₃)₂·C₄H₆O₆ or succinate (C₁₅H₂₅NO₃)₂·C₄H₆O₄ especially to treat hypertension, angina pectoris, and congestive heart failure

Note:
Metoprolol is marketed under the trademarks Lopressor and Toprol.

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Alternatives to bisoprolol: how to replace the drug?

Contents

• 1 What can replace bisoprolol?
  • 1.1 What is bisoprolol?
  • 1.2 When is bisoprolol prescribed?
  • 1.3 How does bisoprolol work?
  • 1.4 What problems can occur when taking bisoprolol?
  • 1.5 What alternatives to bisoprolol are available?
  • 1.6 What is carvedilol?
  • 1.7 When is carvedilol prescribed?
  • 1.8 How does carvedilol work?
  • 1.9 What problems can occur when taking carvedilol?
  • 1.10 What is metoprolol?
  • 1.11 When is metoprolol prescribed?
  • 1.12 How does metoprolol work?
  • 1.13 What problems can occur when taking metoprolol?
  • 1. 14 What is enalapril?
  • 1.15 When is enalapril prescribed?
  • 1.16 How does enalapril work?
  • 1.17 What problems can occur when taking enalapril?
  • 1.18 Related videos:
  • 1.19 Q&A:
    • • 1.19.0.1 What are the alternatives to bisoprolol?
      • 1.19.0.2 How do I choose the right alternative?
      • 1.19.0.3 What are the side effects of alternative drugs?
      • 1.19.0.4 Can bisoprolol be changed to another drug without consulting a doctor?
      • 1.19.0.5 How long does it take to find an alternative to bisoprolol?
      • 1.19.0.6 What other treatments are there for hypertension?
      • 1.19.0.7 Can herbal preparations be an alternative to bisoprolol?

What to choose instead of bisoprolol: analogues and other drugs for lowering blood pressure and treating cardiovascular diseases. Description of the effect, side effects and method of application.

Bisoprolol is a beta-blocker used to treat various diseases of the cardiovascular system. However, like any other drug, bisoprolol has its own side effects, which may be the reason for the need to replace this supplement.

There are alternatives to bisoprolol that can treat heart disease and rhythm disturbances without the risk of side effects. But before replacing the drug, it is necessary to consult a qualified doctor and not make a decision on your own in order to avoid negative health consequences.

Another drug can be prescribed to replace bisoprolol, for example, arbidol, valsartan, losartan, amladipine, convertal, etc. The use of alternative therapies, such as cardiac therapy, physiotherapy, massage, and others, may also be suggested.

What is bisoprolol?

Bisoprolol is a drug that primarily belongs to the group of beta-blockers.

It has the ability to slow down the heartbeat, regulate blood pressure and reduce the risk of developing cardiovascular disease.

Bisoprolol is prescribed according to individual patient indications, usually in the treatment of arrhythmias and tonsillitis, as well as in the treatment of a number of other diseases. It comes in a variety of forms, including tablets, injections, and solutions.

If you want to replace bisoprolol with another medicine, be sure to consult your doctor and follow all his recommendations.

When is bisoprolol prescribed?

Bisoprolol is a beta-blocker used to treat various diseases of the cardiovascular system.

The main indication for the appointment of bisoprolol is arterial hypertension. It lowers blood pressure levels by reducing heart rate and cardiac concentration power. In addition, bisoprolol is used for coronary heart disease, angina pectoris and control of arrhythmias.

Also, bisoprolol can be used as a prophylaxis for migraine, as well as to reduce the risk of complications after myocardial infarction. In some cases, bisoprolol may be used in the treatment of asthma and chronic obstructive pulmonary disease.

Only a doctor can prescribe bisoprolol, who will determine the dose and duration of treatment, depending on the individual characteristics of the patient and the nature of the disease.

How does bisoprolol work?

Bisoprolol is a selective beta-adrenergic antagonist. This means that it blocks the action of certain hormones that can lead to high blood pressure and heart rate.

Bisoprolol reduces the contractility of the heart and relaxes blood vessels, which helps to reduce pressure and reduce the workload on the heart. This makes it effective for treating hypertension and preventing recurrent heart attacks.

Bisoprolol reduces heart rate, reduces the force of contraction of the heart and reduces the heart’s need for oxygen. Also, this drug can improve blood flow to the heart and reduce the likelihood of arrhythmias.

Despite the effectiveness of bisoprolol, it can have side effects such as dizziness, sleep disturbances, depression and others. If these symptoms appear, you should consult a doctor.

What problems can occur when taking bisoprolol?

Bisoprolol is a drug often prescribed for the treatment of hypertension, angina pectoris and other cardiovascular conditions. However, some patients may have problems taking this drug.

• Lowering blood pressure: bisoprolol is a beta-blocker that can cause a decrease in blood pressure. Therefore, patients suffering from hypotension may experience an increase in the symptoms of this disease, such as dizziness, weakness, nausea, and even loss of consciousness.
• Dyspepsia: Some patients may experience dyspepsia, which is an indigestion that can manifest as nausea, vomiting, gas, abdominal pain, and tremors in the abdomen.
• Drowsiness and fatigue: bisoprolol may cause drowsiness and fatigue in patients, especially at the beginning of treatment or when the dose is increased. Therefore, it is not recommended to drive vehicles and engage in other hazardous activities that require increased attention until it is clear how the drug affects the patient’s body.
• Bronchospasm: Beta-blockers such as bisoprolol may cause bronchial constriction and worsen asthma symptoms. The use of bisoprolol is not recommended in patients with chronic obstructive pulmonary disease or other respiratory diseases.

If you experience any of the problems listed above, be sure to tell your doctor about your symptoms and do not take bisoprolol without his recommendation.

What alternatives to bisoprolol are available?

Bisoprolol is a beta-blocker used to treat hypertension, angina, and cardiac arrhythmias. However, if you have a contraindication to taking bisoprolol or if this drug is not effective, you have alternatives.

The doctor may prescribe other drugs instead of bisoprolol, including other beta-blockers, ACE inhibitors, calcium antagonists, etc. However, when taking a new drug, it is necessary to take into account the individual characteristics of the patient and contraindications, so the choice of a substitute should be made only by a doctor.

It is also possible to resort to alternative medicine methods, such as a nutritious diet combined with relaxation exercises, massage and yoga. But it should be remembered that these methods will not replace drug therapy and must be agreed with the doctor.

It is important to note that in no case should you cancel bisoprolol yourself and start taking a substitute, as this can lead to a deterioration in the condition and serious consequences. Only an experienced specialist will be able to choose the right replacement and control the treatment process.

What is carvedilol?

Carvedilol is a medicine used in cardiac practice for the treatment of cardiovascular diseases. It belongs to the group of beta-blockers with antioxidant activity and alpha-blocking properties.

Carvedilol acts on the heart by decreasing the heart rate, decreasing the force of the heart contraction, dilating the blood vessels. As a result, the load on the heart decreases and the pressure in the vessels decreases. This leads to an improvement in the blood supply to organs and tissues, a decrease in the manifestations of heart failure and arrhythmia.

Carvedilol is indicated for the treatment of various conditions such as:

• heart failure
• hypertension (high blood pressure)
• angina pectoris (chest pain on exertion)
• arrhythmias

9006 1

Carvedilol is effective and safe, but its use may be accompanied by some side effects such as dizziness, drowsiness, nausea and abdominal pain. Before you start taking carvedilol, be sure to consult your doctor and follow his recommendations.

When is carvedilol prescribed?

Carvedilol is a drug that belongs to the group of beta-blockers. It is used to treat cardiovascular diseases that are associated with an increase in the load on the heart, for example, in arterial hypertension, angina pectoris, chronic heart failure.

Carvedilol is indicated for:

• arterial hypertension;
• chronic heart failure;
• angina;
• myocardial infarction;
• heart rhythm disorders.

The drug can be prescribed when other methods of treatment have not given sufficient results, or if there are contraindications to the use of other drugs.

Carvedilol helps to restore a normal heart rhythm, reduce the workload on the heart, stabilize blood pressure and improve the general well-being of the patient.

How does carvedilol work?

Carvedilol is a beta-blocker used to treat cardiovascular conditions such as hypertension and angina pectoris. It works by blocking the action of adrenaline on β-receptors, which are found in the heart and blood vessels.

This mechanism of action reduces the strength and frequency of heart contractions, resulting in lower blood pressure and reduced workload on the heart. In addition, blockade of β-receptors reduces the contractile ability of the smooth muscle of blood vessels, which leads to their expansion and improved blood flow.

Carvedilol also has antioxidant properties and may improve vascular endothelial function, which reduces the risk of cardiovascular disease.

Carvedilol has a broader spectrum of action than many other beta-blockers, as it also blocks the α1 receptor, which is involved in the regulation of vascular tone. This mechanism of action reduces peripheral vascular resistance and reduces the workload on the heart.

Carvedilol is often prescribed as a substitute for bisoprolol when its use is contraindicated. It can also be used in combination with other drugs to achieve the best treatment effect.

What problems can occur when taking carvedilol?

1. Pressure reduction. Carvedilol is a drug that can lower blood pressure. It may cause dizziness, weakness, or even loss of consciousness. Therefore, it is important to monitor the value of blood pressure and contact a doctor immediately if such symptoms occur.

2. Deterioration of heart function. Possible deterioration in cardiac function may occur in patients with heart failure. Such patients should regularly visit a doctor and take the necessary tests. Also, with a decrease in vitality and weakness, it is recommended to stop taking carvedilol.

3. Refusal to take medication. Carvedilol must be taken daily and regularly without missing doses. Refusal to take the medicine can lead to a worsening of the condition and even to the development of serious complications. If you have problems taking the medicine, you should consult a doctor and find an alternative.

4. Negative interactions with other drugs. Some medicines may interfere with the effectiveness of carvedilol or cause it to be actively withdrawn from the body. Therefore, before taking other medicines, it is necessary to discuss this with your doctor and inform you that you are taking carvedilol.

5. Allergic reactions. Some patients may experience an allergic reaction to carvedilol. Symptoms may include hives, itching, swelling of the throat and face, respiratory problems, etc. In case of allergic reactions, you should stop taking carvedilol and consult a doctor.

What is metoprolol?

Metoprolol is a drug from the group of beta-blockers, which is used to treat various diseases of the heart and blood vessels. Beta-blockers block the action of epinephrine and norepinephrine on the beta-adrenergic receptors of the heart, which can reduce the heart rate, reduce the strength and speed of the heart rate, and reduce the oxygen demand of the heart.

Metoprolol is often used to treat hypertension, angina pectoris, myocardial infarction and heart failure. It can be used as monotherapy or in combination with other drugs.

Metoprolol is available in various forms: tablets, injection, long-acting tablets. The dosage and mode of taking the drug should be prescribed by a doctor, based on the health status of a particular patient.

Before you start taking metoprolol, you need to consult a doctor who will determine the optimal dose and choose an individual treatment regimen. Self-medication can be harmful to health and worsen the course of diseases of the cardiovascular system.

When is metoprolol prescribed?

Metoprolol is a drug that belongs to the group of beta-blockers. It is used to treat various diseases and conditions related to the cardiovascular system.

Metoprolol can be prescribed for:

• hypertension;
• angina;
• cardiac arrhythmias;
• myocarditis;
• myocardial infarction;
• prevention of recurrent myocardial infarction;
• chronic heart failure;
• other cardiovascular diseases.

The drug reduces the heart rate, reduces the force of contraction of the heart muscle and lowers blood pressure. This helps to improve the functioning of the cardiovascular system and reduce the risk of complications.

As with any drug, metoprolol should only be prescribed after a doctor’s examination and diagnostic measures.

There are various contraindications for which metoprolol should not be used. It is important to discuss all the risks and side effects of the drug with your doctor before starting treatment.

How does metoprolol work?

Metoprolol is a beta-blocker used to treat a variety of heart and blood vessel conditions. Its action is based on the fact that it blocks the action of adrenaline on the heart muscle and blood vessels.

The action of metoprolol is to reduce heart rate and blood pressure. Due to this, it reduces the load on the heart and vascular system.

Metoprolol benefits:

• decreased heart rate;
• lowering blood pressure;
• reducing the load on the heart and vascular system;
• improved quality of life in patients with diseases of the heart and blood vessels.

How to take metoprolol:

1. The dosage of metoprolol depends on the patient’s condition and is recommended to be prescribed by a doctor.
2. It is recommended to take metoprolol after meals and drink plenty of water.
3. It is not recommended to take metoprolol in the evening as it may cause insomnia.

Contraindications:

• Allergic reaction to metoprolol;
• Bronchial asthma;
• Arterial hypotension;
• Severe cardiovascular insufficiency.

What problems can occur when taking metoprolol?

Metoprolol is a beta-blocker used to treat high blood pressure, angina pectoris, myocardial infarction and other cardiovascular conditions. However, there may be some problems with its use that need to be taken into account.

Side effects: when taking metoprolol, various side effects may occur, such as dizziness, fatigue, drowsiness, sleep disturbance, insomnia, depression, bradycardia, bronchospasm and others.

Contraindications: metoprolol is contraindicated in individual intolerance, heart failure, bronchial asthma, low blood pressure, diabetes and other diseases. Before you start taking the drug, be sure to consult your doctor and read the instructions.

Interaction with other drugs: metoprolol may increase the toxicity of other drugs, such as antibiotics, antidepressants, anticancer drugs, etc. Therefore, before taking metoprolol, you should read the instructions in detail and consult your doctor.

Cancellation of the drug: when metoprolol is discontinued, the dosage should be gradually reduced to avoid lowering blood pressure, increasing heart rate, dizziness and other unpleasant symptoms.

In general, metoprolol is an effective drug for the treatment of cardiovascular diseases, however, before starting its use, it is necessary to consult a doctor and study the instructions in order to avoid problems.

What is enalapril?

Enalapril is a drug from the group of angiotensin converting enzyme inhibitors (ACE inhibitors). It is used to treat high blood pressure (hypertension), heart failure, and to prevent cardiovascular disease.

The drug is an effective means for lowering blood pressure, which helps to reduce the load on the heart muscle and improve blood circulation in the body. In addition to this, enalapril reduces the risk of developing cardiovascular diseases such as myocardial infarction and stroke.

The drug is available as tablets to be taken by mouth once or twice a day, usually with meals.

Important to know:

• Never take enalapril without a doctor’s prescription.
• Taking the drug requires regular monitoring of blood pressure and kidney function.
• Enalapril can interact with some drugs, so always tell your doctor about all the medicines you are taking.

When is enalapril prescribed?

Enalapril is a drug belonging to the group of ACE inhibitors (Angiotensin Converting Enzyme).

It is used to treat various diseases of the cardiovascular system:

• hypertension;
• chronic heart failure;
• after myocardial infarction;
• for kidney protection in diabetic nephropathy.

Enalapril can also be used as a prophylactic agent to prevent the development of cardiovascular diseases, especially in the presence of risk factors such as:

• obesity;
• alcohol abuse;
• diseases of diabetes mellitus;
• hereditary predisposition.

Enalapril may be given in combination with other drugs such as diuretics or beta-blockers to achieve the best therapeutic effect.

However, self-medication can lead to serious consequences, so the appointment of this drug should be carried out only under the supervision of a physician.

How does enalapril work?

Enalapril is a drug belonging to the group of angiotensin-converting enzyme inhibitors (ACE inhibitors). It acts on the renin-angiotensin-aldosterone system, which regulates blood pressure and is involved in the development of cardiovascular diseases.

The main action of enalapril is to block ACE inhibitors, which leads to a decrease in the conversion of angiotensin I to angiotensin II. Angiotensin II promotes vasoconstriction and increases blood pressure. Blocking its synthesis allows you to expand blood vessels and reduce the load on the heart.

In addition, enalapril reduces the release of aldosterone and reduces cardiac muscle remodeling. As a result, the likelihood of developing complications of the cardiovascular system, such as myocardial infarction, heart failure and mortality from cardiovascular diseases, is reduced.

Enalapril is used to treat hypertension, chronic heart failure, after myocardial infarction, to prevent cardiovascular complications in patients at increased risk and other conditions.

What problems can occur when taking enalapril?

Occurrence of side effects: Side effects may occur when taking enalapril, including dry mouth, dizziness, weakness, fatigue, loss of appetite, nausea, stomach pain, and problems with the absorption and elimination of fluid from the body. To prevent these side effects, it is important to take the drug exactly as directed by your doctor.

Contraindications: Enalapril is contraindicated in the presence of an allergy to this drug, as well as in certain heart conditions such as angina pectoris, heart attack and circulatory disorders in the brain.

Interactions with other drugs: Enalapril may interact with some other drugs, including pain medications, aseptic agents, furosemide, lithium, etc. It is important to tell your doctor about all the drugs you are taking.

Pressure change: Taking enalapril can lead to a decrease in blood pressure, so you should not stop the drug yourself. Be sure to tell your doctor about your blood pressure and health status.

Long-term use: Enalapril is taken for a long time as prescribed by a doctor. It is necessary to regularly undergo examinations and monitor pressure indicators and the effect of the drug on the body.

Edema: The use of enalapril may cause edema, especially in people with impaired renal function and a high salt diet. If swelling occurs, you should immediately consult a doctor.

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What are the alternatives to bisoprolol?

There are various alternatives: metoprolol, carvedilol, nebivolol, esmolol and other beta blockers, as well as other classes of antihypertensive drugs such as ACE inhibitors (lisinopril, ramipril), calcium antagonists (amlodipine, nifedipine) and diuretics (indapamide, furosemide).

How to choose the right alternative?

The choice of an appropriate alternative depends on many factors such as disease stage, comorbidities, side effects, cost, etc. It is better to discuss this issue with a doctor who will tell you the most appropriate drug in each case.

What are the side effects of alternative drugs?

Side effects may vary depending on the drug. For example, ACE inhibitors may have cough, calcium antagonists may have edema, and diuretics may have electrolyte disturbances. In any case, the doctor should warn the patient about possible side effects and monitor their manifestation while taking the drug.

Can bisoprolol be changed to another drug without consulting a doctor?

No, the replacement of the drug should take place only on the prescription of a doctor who takes into account the individual characteristics of the patient and additionally conducts an examination. Independent choice of drugs can lead to negative health consequences.

How long does it take to find an alternative to bisoprolol?

Alternative selection time may vary depending on the specific case. It depends on the degree of the disease, comorbidities, age and other factors. The selection of a new drug can take from several days to several weeks.

What other treatments are available for hypertension?

Non-pharmacological treatments are available, such as weight loss, regular physical activity, sodium and alcohol reduction, smoking cessation. It is also possible to use other types of drugs, including ACE inhibitors, calcium antagonists and others. However, the choice of treatment should be determined only by the doctor.

Can herbal preparations be an alternative to bisoprolol?

Herbal preparations can be used as an adjunct to the main treatment, but cannot be a complete alternative. For example, decoctions of medicinal herbs (melissa, motherwort) or dietary supplements can be used, but only when prescribed by a doctor.

Extrasystole heart rhythm disorders – causes and methods of treatment, diagnosis in St. Petersburg

Extrasystole is an extraordinary premature excitation of the heart or its departments that occurs in an ectopic (unusual) focus under the influence of a pathological impulse. Usually, extrasystoles are felt by the patient as a strong cardiac impulse with a “failure” or “fading” after it. Some extrasystoles may occur unnoticed by the patient.

Extrasystole is an extraordinary premature excitation of the heart or its departments that occurs in an ectopic (unusual) focus under the influence of a pathological impulse. Usually, extrasystoles are felt by the patient as a strong cardiac impulse with a “failure” or “fading” after it. Some extrasystoles may occur unnoticed by the patient. Extrasystoles can be found in more than 75% of people.

Extrasystole – causes of development

The reasons for the development of extrasystole can be both diseases of the heart itself: cardiosclerosis, myocardial infarction, inflammatory diseases of the heart muscle, heart defects, as well as diseases of other organs and systems. Extrasystoles can occur in diseases of the gastrointestinal tract, osteochondrosis of the spine, endocrine diseases, arterial hypertension. They are often the result of excessive consumption of coffee, alcohol, smoking. The appearance of extrasystoles when taking cardiac glycosides is one of the signs of an overdose of the drug taken. Diseases of the nervous system (neurocirculatory dystonia) can also contribute to the occurrence of these heart rhythm disturbances. Extrasystoles can also appear in a healthy person with excessive physical and mental stress.

Symptoms of extrasystoles

The patient may complain of “jolts” and strong heart beats due to energetic extraordinary ventricular systole after a compensatory pause, a feeling of “fading” in the chest, “somersaulting of the heart”, a feeling of a stopped heart. For patients suffering from extrasystole of a functional origin, symptoms of neurosis and dysfunction of the autonomic nervous system are more characteristic: anxiety, pallor, sweating, fear, a feeling of lack of air. With the organic origin of extrasystoles, manifestations are usually absent. Frequent (especially early and group) extrasystoles lead to a decrease in cardiac output, a decrease in cerebral, coronary and renal blood flow by 8-25%. Because of this, with stenosing atherosclerosecerebral and coronary vessels, transient cerebrovascular accidents and angina attacks may occur. The presence of ventricular extrasystoles with concomitant cardiac pathology can lead to ventricular tachycardia and become a threat to the patient’s life.

Diagnosis and types of extrasystoles

• ECG in 12 leads – allows you to identify the morphology and possible localization of the focus of extrasystole.

• Daily Holter monitoring (HM – continuous ECG recording) is the most reliable method for diagnosing transient cardiac arrhythmias per day of observation.

• EchoCG (ultrasound of the heart) – reveals the pathology of the myocardium, determines the state of the valvular apparatus of the heart.

When analyzing the ECG, it is possible to talk about single and group extrasystoles. A group of 5 extrasystoles can be regarded as an ectopic tachycardia.

According to the localization of the ectopic focus, they are distinguished:

• atrial,
• atrioventricular,
• ventricular extrasystoles.

Extrasystole – treatment

It is necessary to eliminate provoking factors and treat the underlying disease. Single extrasystoles without clinical manifestations are not treated.

Neurogenic extrasystoles are treated with the establishment of a work and rest regimen, dietary recommendations are given, regular sports are useful, psychotherapy, tranquilizers or sedatives (for example, valerian tincture) are used. Self-administration of drugs, self-medication by various methods is highly undesirable and not safe, since it can be life-threatening if the nature, mechanisms and causes of extrasystoles are not determined.

The choice of a method for treating extrasystole is carried out by a specialist, taking into account the clinical picture of the disease, the data of instrumental diagnostic studies and the current Russian and European recommendations.

By taking antiarrhythmic drugs, extrasystoles can be eliminated, but after discontinuation of the drugs, extrasystole resumes. In addition, the most important thing: in people with organic heart disease, against the background of effective treatment of extrasystole with antiarrhythmic drugs, an increase in mortality by more than 3 times was revealed! Only in the treatment of beta-blockers or amiodarone, there was no increase in the risk of mortality. However, a number of patients experienced complications, including life-threatening ones. The effectiveness and safety of the use of potassium and magnesium preparations or the so-called. “metabolic” drugs have not been definitively established.

A rather radical and effective method of treating extrasystole is catheter ablation (“cauterization”) of the focus of extrasystole.