rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2010-6-3-370-375rpcardio-881Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИWHAT DOES PROVIDE A CLINICAL EFFICACY OF METOPROLOL?ЧТО ОБЕСПЕЧИВАЕТ КЛИНИЧЕСКУЮ ЭФФЕКТИВНОСТЬ МЕТОПРОЛОЛА?КулешоваЭ. В.KuleshovaE. V.

д.м.н., профессор, главный научный сотрудник лаборатории ИБС 

197341 Санкт-Петербург, ул. Аккуратова, 2

Akkuratova ul. 2, Saint-Petersburg, 197341

kuleshova@yandex.ruФедеральный центр сердца, крови и эндокринологии им. В.А. АлмазоваРоссияFederal Center of Heart, Blood and Endocrinology named after V.A. AlmazovRussian Federation20101901201663370375Copyright © Kuleshova E.V., 20162016Кулешова Э.В.Kuleshova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/881

Relationship of metoprolol clinical efficacy with its different salts (tartrate, succinate, fumarate) as well as its presentations (tablets with immediate, controlled or sustained release) is analyzed. It is highlighted that pharmacodynamic properties depend on metoprolol molecule only. These properties do not change after modification of drug presentation or metoprolol plasma concentration which depends on velocity of drug release from the tablet. Data of randomized clinical trials are discussed in regard to development of evidence base for use of different metoprolol presentations in treatment of patients with arterial hypertension, unstable angina, myocardial infarction, heart failure. Indications for tartrate and succinate salts of metoprolol are presented. Results of clinical studies on efficacy of metoprolol tartrate in long-acting drug presentations are analyzed.

Обсуждается связь различных солей метопролола (тартрата, сукцината и фумарата) и его лекарственных форм (с немедленным, контролируемым и замедленным высвобождением препарата) с клинической эффективностью. Подчеркивается, что фармакодинамический эффект препарата зависит только от молекулы метопролола. Этот эффект не изменяется при модификациях лекарственной формы и концентрации метопролола в плазме крови, обусловленной скоростью высвобождения действующего соединения. Анализируются данные рандомизированных клинических исследований, составивших доказательную базу для применения различных лекарственных форм метопролола при лечении больных артериальной гипертензией, нестабильной стенокардией, инфарктом миокарда, сердечной недостаточностью. Приводятся показания к применению метопролола тартрата и сукцината. Обсуждаются результаты исследований клинической эффективности метопролола тартрата пролонгированного действия.

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The authors declare that there are no conflicts of interest present.