Posology and method of administration: Betaloc ZOK prolonged release tablets are given once daily, preferably in the morning. The prolonged release tablets can be divided. They must not be chewed or crushed. The tablets should be swallowed together with at least half a glass of liquid. Concomitant intake of food does not influence the bioavailability. Dosage should be adjusted individually to avoid bradycardia.The following is valid as guidelines: Hypertension50-100 mg once daily. In patients not responding to 100 mg, the dose could be combined with other antihypertensive agents, preferably diuretics and calcium antagonists of the dihydropyridine type, or increased. Angina pectoris100-200 mg once daily. If needed, the dose can be combined with nitrates or increased. Therapy supplementary to ACE-inhibitors, diuretics and possibly digitalis in stable symptomatic heart failure. The patients should have a stable chronic heart failure, without acute failure for the last 6 weeks and an essentially unchanged basal therapy for the last 2 weeks.

Contraindications:-Cardiogenic shock.-Sick-sinus syndrome (provided there is no permanent pacemaker).-AV-block of second and third degree.-Patients with unstable, not compensated heart failure (pulmonary oedema, hypoperfusion or hypotension), and patients with continuous or intermittent inotropic therapy acting through beta-receptor agonism.-Symptomatic bradycardia or hypotension. Metoprolol should not be given to patients with suspected acute myocardial infarction as long as the heart rate is < 45 beats/min, the P-Q interval is > 0.24 sec or the systolic blood pressure is < 100 mm Hg.-In the indication heart failure, patients with repeated supine blood pressure below 100 mmHg should be re-evaluated before treatment is initiated.-Serious peripheral vascular disease with gangrene threat.-Hypersensitivity to the active substance, to other beta-blockers or to any of the excipients specified.

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