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Selomet 25 | 1 Strip
Selomet is used in the management of:
- Hypertension
- Angina pectoris
- Cardiac arrhythmias (especially supraventricular tachyarrhythmias)
- Hyperthyroidism (as adjunct therapy)
- Acute myocardial infarction: Early administration can help reduce infarct size, lower the risk of ventricular fibrillation, and reduce the need for opioid analgesics. Clinical data also shows a reduction in mortality in acute MI patients.
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✅ Description:
Metoprolol is a selective beta1-adrenergic receptor blocker that diminishes the effects of catecholamines (e.g., adrenaline) on the heart. It reduces heart rate, myocardial contractility, and blood pressure, particularly during stress. Unlike non-selective beta-blockers, metoprolol has minimal interference with insulin secretion and less effect on hypoglycemia-induced cardiovascular responses, making it safer for diabetic patients.
Overdosage Symptoms: Severe hypotension, AV block, bradycardia, cardiogenic shock, coma, bronchospasm, hypoglycemia.
Management: Supportive care, activated charcoal if recent ingestion, use of sympathomimetics (e.g., dopamine, norepinephrine), atropine, glucagon (1–10 mg IV), pacing, and β2 agonists for bronchospasm. Hemodialysis is ineffective.
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✔️ Side Effects
- Common: Fatigue, dizziness, depression, shortness of breath, headache, bradycardia
- GI: Nausea, dry mouth, constipation, heartburn
- Others: Blurred vision, musculoskeletal pain, decreased libido, sleep disturbances, rash, pruritus
✔️ Dosage & Administration
Film-Coated Tablet:
- Hypertension: 100–400 mg/day, either as a single dose or divided. Initial dose: 100 mg/day, titrated weekly.
- Angina: 50–100 mg two or three times daily.
- Arrhythmias: 50 mg 2–3 times daily, up to 300 mg/day if needed.
- Hyperthyroidism: 50 mg four times daily; adjust as thyroid function normalizes.
- Myocardial Infarction: 50 mg every 6 hours for 48 hours, then maintenance of 200 mg/day in divided doses.
Extended-Release Tablet:
- Hypertension: 25–100 mg once daily.
- Angina: Start with 100 mg/day, adjusted as needed.
- Heart Failure (NYHA Class II-IV): Start with 12.5–25 mg/day; titrate weekly. Discontinue gradually.
Intravenous (IV) Injection:
- Arrhythmias: 5 mg IV over 1–2 minutes; repeat after 5 minutes (max 10–15 mg).
- Surgery: 2–4 mg IV at induction or intraoperatively.
- Myocardial Infarction: 5 mg IV every 2 minutes (max 15 mg), then 50 mg orally every 6 hours for 48 hours.
✔️ Drug Interactions
Increased effects with catecholamine-depleting drugs (e.g., reserpine, MAO inhibitors).
CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine) may raise metoprolol levels.
Co-administration with digoxin or clonidine increases the risk of bradycardia or rebound hypertension.
✔️ Contraindications
- AV block
- Severe bradycardia or sick sinus syndrome
- Uncontrolled heart failure
- Cardiogenic shock
- Severe peripheral arterial disease
- Hypersensitivity to Metoprolol or other beta-blockers
- Hypotension or significant heart failure during MI
✔️ Special Advise
Hepatic Impairment: Dose adjustment may be necessary.
Pediatric Use: Not established for children <6 years.
Geriatric Use: Generally well tolerated; no significant dosage adjustments needed.
✔️ Pregnancy & Lactation
Pregnancy Category C: Use only if needed.
Lactation: Small amounts are excreted in breast milk; use with caution in breastfeeding women.
✔️ Precautions & Warnings
- Bronchospastic Disorders: Use cautiously; beta1-selectivity is beneficial.
- Surgery: Beta-blocker withdrawal before surgery is controversial; caution is advised.
- Diabetes: May mask signs of hypoglycemia.
- Peripheral Vascular Disease: May worsen symptoms.
- Calcium Channel Blockers: Combined use may intensify bradycardia and AV block.
✔️ Storage:
Store in a cool, dry place, protected from light. Keep out of reach of children.
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
