Selomet 50 | 1 Strip

✔️ Patient Counseling Tips

• Always take Selomet at the same time daily with or without food.
• Do not stop abruptly without medical advice.
• Rise slowly from sitting or lying positions to avoid dizziness.
• Regularly monitor blood pressure and heart rate.
• May mask hypoglycemia signs in diabetic patients—monitor glucose closely.
• May impair ability to drive or operate machinery initially.

✔️ Mechanism of Action

Metoprolol selectively inhibits beta1-adrenergic receptors, primarily affecting the heart. It reduces heart rate and cardiac output, making the heart work more efficiently while lowering blood pressure. At therapeutic doses, it has minimal activity on beta2-receptors and lacks intrinsic sympathomimetic or membrane-stabilizing effects.

✔️ Side Effects | Selomet 50

Common (1–10%):

• Dizziness, headache, fatigue
• Bradycardia, orthostatic hypotension
• Nausea, diarrhea, constipation
• Rash, pruritus, cold extremities
• Dyspnea, wheezing, dry mouth, heartburn
• Depression, decreased libido
• Rare: Heart failure, bronchospasm, vision changes

Less Common / Frequency Not Defined:

• Raynaud's phenomenon, exercise intolerance
• Increased triglycerides, reduced HDL, and insulin resistance

✔️ Dosage & Administration : Oral Administration

Hypertension: Start with 100 mg/day (single or divided doses); may be increased weekly up to 400 mg/day.

Angina: 50–100 mg two to three times daily.

Arrhythmias: 50 mg twice or three times daily; maximum 300 mg/day in divided doses.

Hyperthyroidism: 25–50 mg four times daily.

Migraine prophylaxis: 100–200 mg/day (divided doses or extended-release).

Heart failure (stable): Start with 12.5–25 mg once daily; gradually increase to 200 mg/day if tolerated.

Intravenous Use (Acute Settings)

Arrhythmias: 5 mg IV over 1–2 minutes; may repeat every 5 minutes (max 15 mg).

MI (early management): 5 mg IV every 2 minutes (total 15 mg), followed by oral 50 mg every 6 hours for 2 days, then 100 mg twice daily.

Anesthesia-related arrhythmia prophylaxis: 2–4 mg IV; repeat 2 mg doses up to 10 mg if needed.

Note: Dosing adjustments may be needed in hepatic impairment. No adjustment required for renal impairment.

✔️ Pediatric Use | Selomet 50

• Conventional tablets (ages 1–17): 1–2 mg/kg/day divided twice daily; do not exceed 6 mg/kg/day or 200 mg/day.
• Extended-release tablets (>6 years): Start with 1 mg/kg once daily; max 2 mg/kg/day or 200 mg/day.

✔️ Drug Interactions

• Additive bradycardia or conduction block with cardiac glycosides or non-dihydropyridine calcium channel blockers
• Increased plasma levels with CYP2D6 inhibitors (e.g., bupropion, cimetidine)
• Reduced effect when combined with NSAIDs (e.g., indomethacin) or rifampicin
• Increased risk of hypotension with general anesthetics
• May blunt response to sympathomimetics like epinephrine
• Caution with vasodilators (e.g., hydralazine) in uremic patients

✔️ Use in Pregnancy & Lactation

Pregnancy Category C: Should be used only if clearly needed.

Lactation: Metoprolol is excreted in small amounts in breast milk. Use caution if administered to nursing mothers.

✔️ Selomet 50 should not be used in patients with:

• Severe bradycardia, 2nd/3rd degree AV block, or sick sinus syndrome
• Hypotension or cardiogenic shock
• Severe peripheral arterial disease
• Acute decompensated heart failure
• Severe asthma or bronchospasm
• Untreated pheochromocytoma
• Metabolic acidosis
• Known hypersensitivity to Metoprolol

✔️ Caution is advised in:

• Patients with bronchospastic conditions or myasthenia gravis
• Those undergoing major surgery (risk of anesthesia complications)
• Individuals with diabetes or thyroid disorders may mask symptoms like tachycardia.
• Patients with hepatic impairment, AV conduction issues, or minimal cardiac reserve
  Avoid abrupt discontinuation to prevent rebound effects like angina, myocardial infarction, or thyroid storm.

✔️ Storage:

Store in a cool and dry place, protected from light.