Presonil 50mg 10pcs

✔️ Mode of Action

Metoprolol is a selective beta1-blocker. Metoprolol diminishes or blocks the heart's response to catecholamines (released during physical and mental stress). This results in a reduction of the typical rise in heart rate, cardiac output, cardiac contractility, and blood pressure caused by the acute surge in catecholamines. Metoprolol has less impact on insulin secretion and carbohydrate metabolism compared to non-selective beta-blockers. Metoprolol affects the cardiovascular response to hypoglycemia much less than non-selective beta-blockers.

✔️ Pharmacology

Metoprolol is a specific beta1-blocker. Metoprolol diminishes or blocks the stimulatory effect of catecholamines on the heart (which are released during physical and mental stress). This implies that the typical rise in heart rate, cardiac output, cardiac contractility and blood pressure, caused by the sudden surge in catecholamines, is lessened by Metoprolol. Metoprolol has a lower impact on insulin release and carbohydrate metabolism compared to non-selective beta-blockers. Metoprolol also affects the cardiovascular response to hypoglycemia significantly less than non-selective beta-blockers.
Dosage & Administration of Presonil 50 mg
Oral- Hypertension: The total daily dosage of Metoprolol ranges from 100-400 mg, administered as a single or divided dose up to twice daily. The initial dose is 100 mg (two Metoprolol-50 tablets) daily. This may be increased by 100 mg per day at weekly intervals. If adequate control is not achieved with a single daily dose, a b. i. d. regimen should be started. Combination therapy with a diuretic or another anti-hypertensive medication may also be considered.

✔️ Angina:

Generally, Metoprolol is prescribed at 50 mg (one Metoprolol-50 tablet) to 100 mg (two Metoprolol-50 tablets) two to three times daily.

✔️ Cardiac arrhythmias:

Typically, Metoprolol 50 mg (one Metoprolol-50 tablet) is prescribed b. i. d. or t. i. d. to control the condition. If necessary, the dosage can be increased to a maximum of 300 mg per day in divided doses. Following the treatment of an acute arrhythmia with Metoprolol injection, oral treatment with Metoprolol tablets should begin 4-6 hours later. The initial oral dose should not exceed 50 mg t. i. d.

✔️ Hyperthyroidism:

The recommended dose is Metoprolol 50 mg (one Metoprolol-50 tablet) four times daily. The dosage should be reduced as the euthyroid state is achieved.

✔️ Myocardial infarction:

Therapy should start orally 15 minutes after the final injection, with an initial dose of 50 mg every 6 hours for 48 hours. For patients unable to tolerate the full intravenous dose, half of the suggested oral dose should be given. Maintenance – The common maintenance dose is 200 mg daily, divided into doses.

✔️ Elderly:

No specific dosage requirements exist for otherwise healthy elderly patients.

✔️ Dosage of Presonil 50 mg

Adult Doses

Oral Administration

Hypertension:

• Conventional tablets: Start with 100 mg daily, given as a single dose or divided into two doses. Weekly dose adjustments may be made up to 400 mg/day based on response. Maintenance dose: 100-200 mg/day.
• Extended-release tablets: Begin with 25-100 mg once daily, adjusting as needed.

Angina Pectoris:

• Conventional tablets: 50-100 mg twice or three times daily.
• Extended-release tablets: Start with 100 mg once daily, up to a maximum of 200 mg/day.

Cardiac Arrhythmias:

• 50 mg two to three times daily, increasing as needed up to 300 mg/day in divided doses.

Hyperthyroidism (as an adjunct):

• 25-50 mg four times daily.

Migraine Prophylaxis:

• Conventional tablets: 100-200 mg/day in divided doses.
• Extended-release tablets: 100 mg once daily.

Stable Symptomatic Heart Failure:

• Conventional tablets: Start with 12.5-25 mg once daily, increasing every two weeks to a target dose of 200 mg/day, as tolerated.
• Extended-release tablets: Start with 25 mg once daily (12.5 mg for severe heart failure) and titrate every two weeks to a target dose of 200 mg/day, as tolerated.

Intravenous Administration

Emergency Treatment of Cardiac Arrhythmias:

• Start with 5 mg given at a rate of 1-2 mg/min. Repeat every 5 minutes if needed, up to a total dose of 10-15 mg.

Arrhythmias During Induction of Anesthesia:

• Administer 2-4 mg as a slow injection. Repeat with 2 mg doses as needed, up to a maximum of 10 mg.

Early Management of Acute Myocardial Infarction (AMI):

• Within 12 hours of chest pain onset: Administer 5 mg every 2 minutes for a total dose of 15 mg, if tolerated.
• Transition to oral therapy: After 15 minutes, give 50 mg orally every 6 hours for 2 days. For patients who cannot tolerate the full IV dose, a reduced oral dose should be initiated when possible.
• Maintenance dose: 100 mg twice daily (oral).
• For patients who did not receive IV therapy: Start with 200 mg orally in 2-4 divided doses once their condition stabilizes.

Hepatic Impairment
Dose adjustments are necessary.

Dosing Considerations

• When switching from immediate-release to extended-release forms, the same total daily dose should be maintained.
• When converting between oral and IV formulations, an oral-to-IV dose ratio of 2.5:1 is recommended to achieve equivalent beta-blocking effects.

Pediatric Doses

Oral Administration

• Hypertension:
  • Conventional tablets (1-17 years): 1-2 mg/kg/day divided into two doses, with a maximum of 6 mg/kg/day or 200 mg/day.
  • Extended-release tablets (>6 years): 1 mg/kg once daily, with an initial maximum of 50 mg/day. Adjust based on patient response, not exceeding 2 mg/kg/day or 200 mg/day.

✔️ Contraindications

AV block, uncontrolled heart failure, severe bradycardia, sick sinus syndrome, cardiogenic shock, and severe peripheral arterial disease. Known hypersensitivity to Metoprolol or other beta-blockers. Metoprolol is also contraindicated when myocardial infarction is complicated by notable bradycardia, first-degree heart block, or systolic hypotension.

✔️ Pregnancy

Pregnancy Category C. There are no adequate and well-controlled trials in pregnant women. This medication should be administered during pregnancy only if necessary. Metoprolol is present in breast milk in very minimal amounts. Caution is advised when Metoprolol is given to nursing mothers.

✔️ Storage Conditions

Store in a cool, dry location, shielded from light.