Selomet 25 | 1 Strip

✔️ 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.