Betaloc Zok tablets are contraindicated in the following conditions:
- Atrioventricular block of second or third degree
- Non-compensated heart failure
- Marked clinically relevant sinus bradycardia
- Sick sinus syndrome
- Cardiogenic shock
- Severe peripheral arterial circulatory disorder
Because of lack of experience Betaloc Zok is not indicated in myocardial infarction patients with a heart rate of <45 beats per minute, a P-Q interval of >0.24 sec, a systolic blood pressure of <100 mm Hg, and / or severe heart failure.
Betaloc Zok is also contraindicated in case of known hypersensitivity to metoprolol and related derivatives.
Betaloc Zok – Drug Warnings
- Generally when treating hypertensive patients with asthma, concomitant therapy with a β2-stimulant may (tablet and/or aerosol) should be administered. The dosage of β2-stimulants may require adjustment when treatment with Betaloc Zok is started. The risk of Betaloc Zok interfering with β2-receptors is however less than conventional tablet formulations of β1-selective β-blockers.
- During treatment with Betaloc Zok, the risk of interfering with carbohydrate metabolism or masking hypoglycemia seems to be less than during treatment with conventional tablet formulations of β1-selective β-blockers and much less than non-selertive Betaloc Zok. In labile and insulin dependent diabetes, it is necessary to adjust the hypoglycemic therapy.
- Patients suffering from heart failure should have their decompensation treated both before and during treatment with Betaloc Zok. Digitalization and/or diuretic therapy should also be considered for patients with a history of heart failure.
- Very rarely, a pre-existing A-V conduction disorder of moderate degree may become aggravated (possibly leading to A-V block).
- Betaloc Zok may aggravate the symptoms of peripheral arterial circulatory disorders, mainly due to a blood pressure lowering effect.
- When Betaloc Zok is prescribed for a patient known to be suffering from pheochromocytoma, an alpha-blocker should be given concomitantly.
- The bioavailability of metoprolol may be increased in the presence of liver cirrhosis.
- The anesthetist should be informed prior to surgery that the patient is receiving Betaloc Zok.
- Abrupt interruption of the medication is to be avoided. When possible, Betaloc Zok should be withdrawn gradually over a period of 10 days in diminishing doses. During its withdrawal especially patients with known ischemic heart disease should be kept under close surveillance.
- Anaphylactic shock assumes a more severe form in patients taking β-blockers.
- Betaloc Zok Side Effects and Drug Interactions
- Contraindications and Drug Warnings
- Use During Pregnancy & Lactation
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