Betaloc ZOK, 100 mg, delayed-release, film-coated tablets, 30 pcs.

pharmachologic effect

Manufacturer: Astra Zeneca, Sweden
Release form: extended-release tablets

Active ingredient: Metoprolol

Synonyms: Egilok Retard, Metoprolol Retard, Metoprolol KRKA

Betaloc ZOK is a selective beta-1 adrenergic blocker, that is, it blocks mainly beta-1 adrenergic receptors, reducing cardiac output, slowing the rhythm, facilitating myocardial stimulation during physical and mental stress, preventing reflex tachycardia. The drug inhibits the activity of the renin-angiotensin system, restores the sensitivity of baroreceptors, which, together with a decrease in cardiac output, causes a rapid hypotensive effect.

By reducing the frequency and strength of myocardial contractions, as well as its need for oxygen, Betaloc ZOK has an antianginal (anti-ischemic) effect.

The drug slows down the sinus rhythm and the rate of propagation of excitation through the atrioventricular node, inhibits the automaticity of the heart, lengthens the refractory period, and reduces the force of heart contractions. Thanks to these effects, the drug has an antiarrhythmic effect.

Since in therapeutic doses the drug does not affect beta-2 adrenergic receptors, bronchospasm, decreased sugar and constriction of peripheral vessels do not occur.

Betaloc lowers blood pressure, but is not a diuretic.

Betaloc ZOK - instructions for use

The medicine should be taken every morning, swallowed whole and washed down, regardless of meals. You can split the tablet in half, but do not chew or suck it.

Doses are selected individually, depending on the disease, ranging from 12.5 to 200 mg per day. Often combined with other antihypertensive or antianginal drugs.

Before using the drug, you should carefully read the instructions for use of Betaloc ZOK for contraindications and drug interactions.

Analogues of Betalok ZOK

The main analogues and substitutes for Betaloc ZOK are its synonyms and other adrenergic blockers, which can be divided into groups:

1. Non-selective beta-blockers - Anaprilin, Sotahexal.
2. Selective beta1-blockers - Metoprolol, Nebilet, Atenolol.
3. Alpha and beta blockers – Carvedilol.

Analogs of Betalok ZOK with prices are presented in the table.

Betaloc Zok tab p/o 25 mg N14 (AstraZeneca)

Metoprolol is a substrate of CYP2D6, and therefore drugs that inhibit CYP2D6 (quinidine, terbinafine, paroxetine, fluoxetine, sertraline, celecoxib, propafenone and diphenhydramine) may affect the plasma concentrations of metoprolol. Combinations to avoid Barbituric acid derivatives: barbiturates increase metabolism metoprolol, due to enzyme induction (the study was conducted with phenobarbital). Propafenone: when propafenone was prescribed to 4 patients treated with metoprolol, an increase in plasma concentrations of metoprolol was observed by 2-5 times, while 2 patients experienced side effects characteristic of metoprolol. This interaction was confirmed in a study on 8 volunteers. The interaction is likely due to propafenone's inhibition, like quinidine, of the metabolism of metoprolol via the CYP2D6 isoenzyme. Taking into account the fact that propafenone has beta-blocker properties, co-administration of metoprolol and propafenone does not seem advisable. Verapamil: the combination of beta-blockers (atenolol, propranolol and pindolol) and verapamil can cause bradycardia and lead to a decrease in blood pressure. Verapamil and beta-blockers have a complementary inhibitory effect on AV conduction and sinus node function. Combinations that may require dose adjustment Betaloc® ZOK Class I antiarrhythmic drugs: when combined with beta-blockers, the negative inotropic effect may be additive, resulting in serious development hemodynamic side effects in patients with impaired left ventricular function. This combination should also be avoided in patients with SSSS and impaired AV conduction. The interaction is described using the example of disopyramide. Amiodarone: combined use with metoprolol can lead to severe sinus bradycardia. Taking into account the extremely long T1/2 of amiodarone (50 days), a possible interaction should be considered long after discontinuation of amiodarone. Diltiazem: Diltiazem and beta-blockers mutually enhance the inhibitory effect on AV conduction and sinus node function. When metoprolol was combined with diltiazem, cases of severe bradycardia were observed. NSAIDs: NSAIDs weaken the antihypertensive effect of beta-blockers. This interaction has been reported in combination with indomethacin and is likely not to be observed in combination with sulindac. Negative interactions were noted in studies with diclofenac. Diphenhydramine: Diphenhydramine reduces the biotransformation of metoprolol to α-hydroxymetoprolol by 2.5 times. At the same time, an increase in the effect of metoprolol is observed. Epinephrine (adrenaline): 10 cases of severe arterial hypertension and bradycardia were reported in patients taking non-selective beta-blockers (including pindolol and propranolol) and receiving epinephrine. The interaction was also observed in the group of healthy volunteers. It is assumed that similar reactions can be observed when epinephrine is used together with local anesthetics if it accidentally enters the vascular bed. This risk appears to be much lower with the use of cardioselective beta-blockers. Phenylpropanolamine: Phenylpropanolamine (norephedrine) in a single dose of 50 mg may increase diastolic blood pressure to pathological values ​​in healthy volunteers. Propranolol mainly prevents the increase in blood pressure caused by phenylpropanolamine. However, beta-blockers may cause paradoxical hypertension reactions in patients receiving high doses of phenylpropanolamine. Several cases of hypertensive crisis have been reported with the use of phenylpropanolamine. Quinidine: Quinidine inhibits the metabolism of metoprolol in a special group of patients with rapid hydroxylation (in Sweden approximately 90% of the population), causing mainly a significant increase in plasma concentrations of metoprolol and increased beta-adrenergic receptor blockade . It is believed that such an interaction is also typical for other beta-blockers, in the metabolism of which the CYP2D6 isoenzyme is involved. Clonidine: hypertensive reactions with abrupt withdrawal of clonidine may increase while taking beta-blockers. When used together, if it is necessary to discontinue clonidine, discontinuation of beta-blockers should begin several days before discontinuation of clonidine. Rifampicin: Rifampicin may increase the metabolism of metoprolol, reducing its concentration in the blood plasma. Patients simultaneously taking metoprolol and other beta-blockers (eye drops) or MAO inhibitors should be closely monitored. While taking beta-blockers, inhaled anesthetics increase the cardiodepressive effect. While taking beta-blockers, patients receiving oral hypoglycemic agents may dose adjustment of the latter is required. Plasma concentrations of metoprolol may increase when taking cimetidine or hydralazine. Cardiac glycosides, when used together with beta-blockers, can increase AV conduction time and cause bradycardia.

Betalok or Betalok ZOK – which is better, the difference

Manufacturer: Astra Zeneca, Sweden
Release form: tablets and solution for internal use

Active ingredient: Metoprolol

Synonyms: Egilok, Metoprolol Teva, Metoprolol KRKA, Serdol, Metocard

The Betalok analogue differs from Betalok ZOK in the technology of tablets and the release of the active substance from them. Betaloc ZOK is available in the form of tablets with prolonged release, that is, the active substance gradually, in small portions, penetrates the bloodstream and has a uniform effect throughout the day.

Simple Betaloc is produced in the form of regular 100 mg tablets. Therefore, it is taken twice a day for the same indications, only the daily dose is divided into two doses.

Composition and release form

The medicine belongs to the category of selective beta-blockers, the main active ingredient is metoprolol tartrate. Available in the form of tablets and solution for intravenous administration, additional components and concentration of the active component depend on the form of release.

The use of the drug reduces the risk of developing myocardial infarction and other complications in case of serious heart failure.

If symptoms of myocardial infarction appear, intravenous administration of Betaloc should be started as early as possible, optimally in the first 24 hours.

The mechanism of action of Betalok is based on blocking certain receptors that have a negative effect on the heart during physical and nervous stress.

The medicine prevents an increase in heart rate, an increase in myocardial contractility and an increase in blood pressure. The active substance normalizes heart function, reduces the likelihood of atrial fibrillation and flutter, which can lead to serious consequences.

Betalok ZOK or Concor – which is better?

Manufacturer: Merck, Germany
Release form: film-coated tablets

Active ingredient: Bisoprolol

Synonyms: Biprol, Biol, Bisogamma, Coronal, Niperten

An analogue of Betaloc ZOK, the drug Concor also selectively blocks beta-1 adrenergic receptors, providing hypotensive, antianginal and antiarrhythmic effects.

The medication slowly and gradually reduces blood pressure, the maximum effect occurs after two weeks.

Concor is used to treat hypertension, stable angina and chronic heart failure.

Therapeutic doses vary from 2.5 to 10 mg and are selected individually. When replacing, it should be taken into account that Concor 5 mg will be an approximate analogue of Betaloc ZOK 100 mg, but you should not change the dose yourself; be sure to consult your doctor.

For chronic heart failure, the dose is taken starting from 1.25 mg, gradually increasing to 5 or 10 mg per day.

Patient reviews are positive when using both drugs.

Let's sum it up

The most common and cheapest analogue of Betaloc is Metoprolol - a drug with this name is produced by different manufacturers, so choosing a suitable product will not be difficult. Bisoprolol is no less popular, but its cost is much higher than that of metoprolol.

Table of Betalok analogues

All analogues of Betalok and Betalok ZOK belong to the category of beta-blockers - drugs that have a positive effect on the activity of the cardiovascular system, reduce the risk of heart attack and other serious complications. However, they have significant differences in the mechanism of action, the list of side effects and contraindications.

The appropriate drug must be selected depending on the clinical course of the disease, the severity of symptoms and the characteristics of the patient’s body. The cost of the medicine in this case plays a secondary role, since the wrong choice can lead to unpleasant health consequences. Before taking Betaloc, Betaloc ZOK and their substitutes, you should definitely consult your doctor.

Betaloc ZOK or Metoprolol – which is better?

Manufacturer: Vertex, Ozone, Pranafarm, Russia / Hemofarm, Serbia
Release form: tablets

Active ingredient: Metoprolol

Synonyms: Egilok, Metoprolol Teva, Metoprolol KRKA, Serdol, Metocard

Metoprolol is the active substance of Betaloc ZOK and all its synonyms, as well as its international non-proprietary name. In addition, there are many domestic drugs whose trade name is the same as the generic one.

The analog Metoprolol has the same properties - antihypertensive, antianginal and antiarrhythmic effects. According to doctors, the effectiveness of domestic analogues is no lower than that of imported drugs.

Betaloc ZOK or Bisoprolol - which is better, comparison

Manufacturer: Rapharma, Izvarino, Atoll, Russia
Release form: film-coated tablets

Active ingredient: Bisoprolol

Synonyms: Concor, Biprol, Biol, Bisogamma, Coronal, Niperten

You can replace Betaloc ZOK with Bisoprolol, which also selectively blocks beta-1 adrenergic receptors, reduces the volume and force of cardiac output, reduces myocardial oxygen demand, and reduces heart rate.

Analogue Bisoprolol is the active component and international non-proprietary name of many drugs that have antianginal, antiarrhythmic and anti-ischemic properties. The half-life of Bisoprolol allows you to take the medicine once a day.

Reviews from cardiologists indicate the high effectiveness of the drug, regardless of the manufacturer and trade name, in the treatment of chronic heart failure, as well as stable angina and hypertension.

Egilok or Betalok ZOK – which is better, what’s the difference

Manufacturer: Egis, Hungary
Release form: tablets

Active ingredient: Metoprolol

Synonyms: Metoprolol Teva, Metoprolol KRKA, Serdol, Metocard

A substitute for Betalok ZOK, the drug Egilok is produced in the form of regular and retard forms. Egilok Retard is a complete synonym for Betalok ZOK, since it is also a prolonged release form of the active substance.

Egilok is taken twice a day, Egilok retard is taken once. The drug has the same effect as Betaloc ZOK; it is used for hypertension, arrhythmia, angina pectoris, and for maintenance after myocardial infarction.

The use of Egilok's analogue reduces the risk of mortality in patients after a heart attack.

Indications and contraindications

Indications for the use of Betaloc include supraventricular tachycardia, ischemia of the heart muscle, tachycardia and pain syndrome during myocardial infarction. The use of the drug reduces the severity of symptoms, prevents the risk of necrosis and limits the area of ​​tissue damage.

Contraindications to the use of the drug include severe cardiac disorders (sick sinus syndrome, decompensated heart failure, etc.), arterial hypotension, and circulatory disorders in peripheral vessels.

Nebilet

Manufacturer: Berlin Hemi, Germany
Release form: tablets

Active ingredient: Nebivolol

Synonyms: Binelol, Bivotenz, Nebivolol Sandoz

The Nebilet analogue is the same selective beta-1 adrenergic blocker as Betaloc ZOK. It has hypotensive, anti-ischemic and antiarthmic effects.

The analogue Nebilet is used for hypertension and angina pectoris in doses of 2.5-5 mg once a day. If we compare doses, the analogue of Betaloc ZOK 25 mg is Nebilet 2.5 mg.

Analogues and substitutes

Betaloc is difficult to classify as an inexpensive drug, so many patients are interested in cheap substitutes and analogues of the drug. Modern pharmacology offers many drugs that have similar effects, but the list of contraindications and features of their effects may be different.

Egilok

Egilok is a drug that is most often prescribed to patients as a substitute for Betalok and Betalok ZOK. Its active substance is metoprolol tartrate, that is, the therapeutic effect is similar to Betaloc. Egilok is prescribed for disorders of cardiovascular activity (arrhythmia, extrasystole), arterial hypertension, migraines, coronary artery disease, and sometimes for dysfunction of the thyroid gland. The list of additional components of drugs differs slightly, so people with an increased tendency to allergic reactions need to carefully choose the drug.

Bisoprolol

The main active ingredient of the drug is Bisoprolol, which is considered a classic beta-blocker and has been used to treat cardiovascular disorders for more than 40 years. It has an antiarrhythmic and antihypertensive effect, reduces the severity of cardiovascular disorders and prevents the risk of heart attack.

All Betalok analogues are potent drugs and are therefore sold in pharmacies with a prescription.

Despite the similar list of indications, the mechanism of action of metoprolol and bisoprolol is different. Betaloc has a wider list of indications and is less likely to cause unwanted reactions in the body.

The most common side effect when using Betaloc is increased fatigue and decreased performance, and Bisoprolol most often causes bradycardia and decreased blood pressure.

Metoprolol

The drug is a complete analogue of Betaloc, since its mechanism of action is based on metoprolol tartrate. The list of indications, contraindications and side effects for the drugs is also the same, but when purchasing Metoprolol you should pay attention to additional components, the content of the active substance and the manufacturer. The drug is produced by different companies, both Russian and foreign - the former are cheaper, and the latter are considered safer and of higher quality.

Concor

The main active ingredient of the popular product Concor is bisoprolol fumarate. They belong to the same pharmacological group and are used for the treatment and prevention of cardiac disorders, but there are significant differences in the characteristics of their effects.

If Bisoprolol is considered the “gold” standard in the treatment of heart diseases, then Metoprolol, according to patient reviews, is better tolerated by the body.

Concor has a long-lasting therapeutic effect that lasts for 12 hours. The duration of action of Betalok is 4 hours, so the dose must be repeated 2 or 3 times a day.

The side effects of the drugs also differ, which must be taken into account in the presence of concomitant diseases.

1. Concor
   can cause serious mental disorders, hearing and vision impairment - a particularly common reaction is a decrease in lacrimation, which should be taken into account by people who wear contact lenses;
2. Metoprolol
   does not affect the organs of vision and hearing, but quite often provokes allergic reactions, which are manifested by rash, itching and hives.

When choosing a drug, you should also take into account the fact that Concor is considered a potent drug, while Bisprolol has a gentle effect on the body.

Implicor

Implicor is a combination drug of French origin, and it contains two components - metoprolol and ivabradine. The latter refers to substances that can slow down the heart rate and regulate heart rate. Implicor is a new pharmacological agent, but has already earned positive reviews as an effective drug. Thanks to the content of two components, it has a quick effect and relieves symptoms of cardiovascular disorders.

At the same time, Implicor has a fairly wide list of contraindications and side effects, so it must be used with extreme caution. Betaloc and Betaloc ZOK have a gentler effect on the body, cause side effects less often, and their cost is much lower, but if there are appropriate medical indications, it is better to give preference to Implicor.

Logimax

A Swedish combination drug that includes the calcium antagonist felodipine and the beta blocker metoprolol. They complement each other’s effects, due to which the product has a pronounced prolonged effect. It is enough to take Logimax once a day, which distinguishes it from Betaloc, which requires two or three doses.

The disadvantage of this product is that, like all combination drugs containing several components, it has a fairly wide list of contraindications and side effects. In addition, Betaloc and Betaloc ZOK are considered the drugs of choice for cardiac disorders, and Logimax is used primarily to reduce arterial hypertension.