METOPROLOL SUCCINATE EVALUATION FOR FORMULARY INCLUSION AT THE UNIVERSITY HOSPITAL

Abstract

Objective: To evaluate the need for inclusion of oral metoprolol Therapy Form. Methods: We performed a literature review comparing beta-blockers metoprolol selected. According to the statement recorded in the National Health Surveillance Agency (ANVISA) was made to search the databases U.S. National Library of Medicine (PUBMED), Web of Science / Institute for Scientific Information (ISI), Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library (SCIELO) and Cochrane Library (BIREME). Inclusion criteria were studies: Clinical trials evaluating the efficacy of beta-blockers in the indications registered at ANVISA; studies with or without active control groups. Exclusion criterion was: clinical trial with retrospective non-randomized control. Were included in the safety assessment: Studies selected in the efficacy review that had data regarding adverse effects. The convenience was evaluated from information on the half-life of drugs and their dosage regimens. For the cost analysis, finally, there was a search in the website www. comprasnet.gov.br and www.consultaremedios.com where it´s possible to see the lowest prices in the region and by public bidding. Results and discussion: In the efficacy analysis, the studies included in heart failure showed no difference in benefit between carvedilol and metoprolol, with the exception of the COMET study that was favorable to carvedilol. However, it was not achieved the target dose of metoprolol in this study. For the treatment of IAM was not demonstrated superiority of atenolol, metoprolol and propranolol. We found similar efficacy between the beta- blockers to treat angina. For Hypertension, one study showed a better response in the control of heart rate in the atenolol group, in others there was no difference in benefit between the representatives. For the arrhythmias´ treatment studies showed a positive result with the use of atenolol and metoprolol. In the security analysis showed that no adverse effects have led to treatment discontinuation and were similar to the class. The convenience data favored the atenolol and metoprolol allowing once-daily administration. Finally, the analysis cost for treatment is unfavorable for metoprolol, which patent is protected. Conclusion: Based on the evaluation of all the steps for selecting is possible to conclude that the data is unfavorable for the inclusion of metoprolol in therapeutic form.