Metoprolol: The Risk of the Drug That Include the Side Effects
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These include the diuretics, calcium channel blockers, ACE inhibitors, and angiotensin-receptor blockers. These four plus beta blockers are often used in combination, two or more at a time. Indeed, many people with high blood pressure will require two or more high blood pressure medicines to bring their blood pressure down to a normal and healthy range. Although they are used primarily to treat people with high blood pressure, they are also used to treat other heart conditions. These include angina (heart or chest pain), abnormal heart rhythms, coronary artery blockages, and heart failure. They are also used, along with other treatments, to help prevent repeat heart attacks in people who have already had one, to prevent migraine headaches, and to treat performance or stage-fright anxiety. High blood pressure is one of the most significantly and persistently under-diagnosed and under-treated medical conditions. It raises your risk of heart disease, heart attack, heart failure, stroke, dementia, vision loss, and kidney failure. In most who have high blood pressure, it is a lifelong condition. Yet studies show that only 30% of people with high blood pressure getting the medicines, care, and blood pressure control they need. Uncontrolled high blood pressure is a leading cause of death. Because it has no symptoms and often goes undetected, high blood pressure is often called the nation’s leading “silent killer.” Beta-blockers work by blocking adrenaline in the heart and blood vessels. Adrenaline speeds up the heart rate, makes the heart muscle contract more strongly, and constricts arteries throughout the body. All these raise blood pressure. In blocking adrenaline, beta-blockers slow down the heart and reduce its workload. That helps to decrease blood pressure.
Multidrug efflux transporters such as P-glycoprotein (P-gp, ABCB1) were first described as one of the causes of chemotherapy resistance in tumors. P-glycoprotein is expressed in many tissue barriers such as intestine, liver, kidney, and blood–brain barrier, and in the placenta, testis, lymphocytes, and tumor cells, and extrudes predominantly lipophilic connections/bindings from inside the cell via the apical membranes of epithelial or endothelial cells. Inhibition of this efflux transporter could therefore help to overcome chemoresistance. P-gp-mediated efflux transport also contributes to reducing the responsiveness of lymphocytes to HIV protease inhibitors. Ritonavir, which causes many side effects at high doses, simultaneously inhibits P-gp and also the drug-metabolizing cytochrome P450 3A4 (CYP3A4). The fixed combination of ritonavir with, for example, 200 mg lopinavir improves the bioavailability of the protease-inhibiting substance and the efflux of lopinavir out of the lymphocytes, thus reducing the breakdown in the liver. So far, however, the attempt to overcome the chemoresistance of tumors by inhibiting efflux transporters, especially by means of P-glycoprotein, has been unsuccessful (Rocha A, Coelho EB, 2010).
The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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