Presonil 50

Indications

Presonil is used for managing hypertension and angina pectoris, as well as treating cardiac arrhythmias, particularly supraventricular tachyarrhythmias. It serves as an adjunct in hyperthyroidism treatment and has been shown to reduce infarct size and the risk of ventricular fibrillation when administered early during acute myocardial infarction. Additionally, it can provide pain relief, potentially decreasing the need for opiate analgesics and reducing mortality in acute myocardial infarction cases.
Consult a registered physician for advice on medication use.

Pharmacology

Metoprolol, a selective beta-1 blocker, decreases the heart’s response to catecholamines—hormones released during stress—thereby lowering heart rate, cardiac output, contractility, and blood pressure. Unlike non-selective beta-blockers, Metoprolol has minimal effects on insulin release and carbohydrate metabolism, making it a safer option for patients with diabetes.

Dosage & Administration

Film-coated Tablet

• Hypertension: Starting dose is 100 mg daily, adjustable to 100-400 mg. If control is insufficient with a single daily dose, consider a twice-daily regimen.
• Angina: 50-100 mg taken twice or thrice daily.
• Cardiac Arrhythmias: 50 mg taken two to three times daily, with a maximum of 300 mg.
• Hyperthyroidism: 50 mg taken four times daily.
• Myocardial Infarction: Begin with 50 mg every 6 hours after intravenous administration.

Extended-Release Tablet

• Hypertension: Start with 25-100 mg once daily.
• Angina: Typically starts at 100 mg once daily.
• Heart Failure: Initiate with 25 mg once daily, adjusting as needed.

IV Injection

• Arrhythmias: Up to 5 mg by IV, repeated as necessary.
• Surgery: Administer 2-4 mg slowly during induction.

Consult a registered physician for advice on medication use.

Interactions

Use caution with catecholamine-depleting drugs and CYP2D6 inhibitors, as they can increase Metoprolol levels. Co-administration with digitalis may heighten the risk of bradycardia.

Contraindications

Do not use in cases of AV block, uncontrolled heart failure, severe bradycardia, or significant hypersensitivity to Metoprolol.

Side Effects

Common side effects include tiredness, dizziness, depression, and gastrointestinal disturbances. Serious adverse effects are rare.

Pregnancy & Lactation

Pregnancy Category C. Use during pregnancy only if essential. Metoprolol appears in breast milk; caution is advised for nursing mothers.

Precautions & Warnings

Monitor patients with bronchospastic diseases and consider risks associated with major surgery and diabetes.

Use in Special Populations

Exercise caution in patients with hepatic impairment. Safety in children under 6 has not been established.

Overdose Effects

Overdose can cause severe hypotension and bradycardia. Treatment involves monitoring and supportive care, potentially including glucagon for severe cases.

Storage Conditions

Store in a cool, dry place away from light.