Selomet 50 mg Tablet

Cardioselective beta-blocker for:

• High blood pressure
• Angina
• Heart failure (succinate extended-release form, with other treatment)
• After a heart attack (secondary prevention)
• Fast heart rhythms (atrial fibrillation rate control, supraventricular tachycardia)
• Migraine prevention; symptoms of overactive thyroid (palpitations, tremor)

Hypertension: 50–100 mg daily (tartrate in 1–2 doses, or succinate ER once daily); maximum 200–400 mg daily.

Angina: 50–100 mg two to three times daily (tartrate).

Heart failure (succinate ER): start 12.5–25 mg once daily, double every 2 weeks as tolerated to target 200 mg once daily.

After heart attack: 50 mg every 6 hours for 48 hours, then 100 mg twice daily (tartrate).

Arrhythmia: 50 mg two to three times daily.

Migraine: 100–200 mg daily.

• Take with or immediately after food; swallow ER tablets whole (may be halved if scored).
• Do not stop suddenly — taper over 1–2 weeks.

• Heart block (2nd/3rd degree), sick sinus syndrome, slow heart rate (< 50/min)
• Cardiogenic shock, uncontrolled heart failure needing IV support
• Severe low blood pressure, severe peripheral arterial disease
• Untreated phaeochromocytoma, metabolic acidosis
• Severe asthma

Common: tiredness, dizziness, headache, slow heartbeat, cold hands and feet, nausea, abdominal pain, shortness of breath on exertion.

Less common: sleep problems, nightmares, low mood, erectile difficulty, worsening heart failure at the start, weight gain.

Rare but serious: heart block, bronchospasm, masking of hypoglycaemia, worsening psoriasis, severe skin reactions.

• Asthma/COPD: caution (cardioselective but not completely).
• Diabetes: may hide low-sugar symptoms (except sweating).
• Thyrotoxicosis: may mask signs; do not stop suddenly.
• Tell the anaesthetist and cataract surgeon.
• Heart failure: increase dose slowly; weigh daily.

Can be used in pregnancy when needed (monitor baby's growth, and the newborn for slow heart rate and low sugar). Small amounts in milk — generally compatible with breastfeeding.

• Verapamil, diltiazem (heart block) — avoid together
• Clonidine (rebound hypertension)
• Amiodarone, digoxin (slow pulse)
• Fluoxetine, paroxetine, bupropion, quinidine, terbinafine (raise metoprolol — CYP2D6)
• Insulin, diabetes tablets (hidden hypoglycaemia)
• NSAIDs (reduced effect); rifampicin (lower levels)

Severe slow heartbeat, low blood pressure, heart failure, bronchospasm, seizures. Emergency care.

Store below 30°C, protected from moisture.