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Metoprolol CR (BETAZOK) is intended for once daily treatment and can be taken with or without food. The Metoprolol CR (BETAZOK) tablet should be swallowed with liquid. The tablets and the divided halves should not be chewed or crushed.
Hypertension: The recommended dosage in patients with mild to moderate hypertension is 50 mg Metoprolol CR (BETAZOK) given once daily. In patients not responding to 50 mg the dose could be increased to 100-200 mg once daily and/or combined with other antihypertensive agents.
Long-term antihypertensive treatment with metoprolol in daily doses of 100-200 mg has been shown to reduce total mortality, including sudden cardiovascular death, stroke, and coronary events in hypertensive patients.
Angina pectoris: The recommended dosage is 100-200 mg Metoprolol CR (BETAZOK) given once daily. If needed, Metoprolol CR (BETAZOK) can be combined with other anti-anginal agents.
Cardiac arrhythmias: The recommended dosage is 100-200 mg Metoprolol CR (BETAZOK) given once daily.
Maintenance treatment after myocardial infarction: Long-term treatment with metoprolol in doses of 200 mg given once daily has been shown to reduce the risk of death (including sudden death), and to reduce the risk of reinfarction (also in patients with diabetes mellitus).
Functional heart disorders with palpitations: The recommended dosage is 100 mg once daily. If needed, the dose can be increased to 200 mg.
Migraine prophylaxis: The recommended dosage is 100-200 mg once daily.
Impaired renal function: Dose adjustment is not needed in patients with impaired renal function.
Impaired hepatic function: Dose adjustment is normally not needed in patients suffering from liver cirrhosis because metoprolol has a low protein binding (5-10%). When there are signs of serious impairment of liver function (e.g. shunt-operated patients), a dose reduction should be considered.
Elderly: Dose adjustment is not needed in the elderly.
Children and adolescents: The recommended initial dosage in hypertensive patients ≥6 years is 1.0 mg/kg Metoprolol CR (BETAZOK), not exceeding 50 mg, once daily given approximated by dose strength. In patients not responding to 1.0 mg/kg, the dose can be increased to a maximum daily dose of 2.0 mg/kg. Doses above 200 mg once daily have not been studied in children and adolescents.
Efficacy and safety of use in children < 6 years have not been studied.
23.75 mg: Chronic heart failure: The dose of Metoprolol CR (BETAZOK) should be individually adjusted in patients with chronic heart failure stabilised on other heart failure treatment. A recommended initial dose during the first two weeks is a 25 mg tablet once daily. It is recommended that patients with NYHA functional classes III-IV begin with half a 25 mg tablet once daily the first week. It is recommended that the dose then be doubled every second week up to a maximum target dose of 200 mg Metoprolol CR (BETAZOK) once daily (or to the highest tolerated dose). During long-term treatment, the aim should be to reach 200 mg Metoprolol CR (BETAZOK) once daily (or the highest tolerated dose).
At each dose level the patient should be carefully evaluated with regard to tolerability. In case of hypotension, decrease in concomitant medication may be necessary. Initial hypotension does not necessarily mean that the dose cannot be tolerated in chronic treatment but the patient should be kept at the lower dose until stabilised.
