• bisoprolol – instructions for use, analogs, reviews and release form (tablets 2.5 mg, 5 mg and 10 mg) of the drug for the treatment of angina and reduce the pressure in adults, children and in pregnancy. The composition and the interaction with alcohol
Most popular brand: Zebeta
Active ingredient: Bisoprolol
Available dosage forms: 10, 5 mg
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Bisoprolol general information
There are lots of different medicines that could interact with hydrochlorothiazide and bisoprolol. Should you need to have any group of surgery, inform the surgeon in advance which you’re using bisoprolol. Bisoprolol is in many drugs called beta-blockers. It’s a member of a category of drugs called beta-adrenoreceptor blocking medications, sometimes generally known as beta-blockers. You definitely should not breast-feed while you’re using hydrochlorothiazide and bisoprolol.
Heart disease when pregnant encompasses a broad spectrum of disorders. It is quite important for women that have aorta disease to be evaluated by means of a cardiologist before arranging a pregnancy. Premature atrial or ventricular complexes are truly the most common arrhythmias when pregnant. Your pregnancy can likewise be affected in case you have had particular varieties of heart surgery. Don’t forget to speak with your doctor if you intend to turn into pregnant and follow any recommendations. The safety of bisoprolol hasn’t been established during pregnancy and ought not to be taken.
Using bisoprolol can allow it to be harder for you to really tell whenever you have low blood glucose. If you’re diabetic, review your blood sugar carefully. You might need to utilize blood pressure medication for the remainder of your whole life. Don’t halt the medication all on your own. Don’t offer this medication to anybody else, even if they got the very same symptoms as you do. Treatment is vital, however.
Several things can impact the dose of medication that someone requirements, including body weight, other health conditions, and other medications. It may be harmful that people take this medication if their doctor hasn’t prescribed it. Also, some forms of the medication might not be used for almost all of the conditions discussed here. This condition is usually due to rheumatic fever. Obstructive lesions reduce the quantity of blood circulate to the heart and also the human body’s major blood vessels. Without the 3rd leaflet, the valve can get narrowed or stiff.
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bisoprolol – instructions for use, analogs, reviews and release form (tablets 2.5 mg, 5 mg and 10 mg) of the drug for the treatment of angina and reduce the pressure in adults, children and in pregnancy. The composition and the interaction with alcohol
In this article, you can read the instructions for use of the drug bisoprolol. Presents reviews of visitors – users of the drug, as well as the opinion of medical specialists on the use of Bisoprolol in their practice. Most requested actively add their own reviews of the preparation: helped or did not help to get rid of the medicine from the disease, which were observed complications and side effects may not be claimed by the manufacturer in the summary. Analogs Bisoprolol if available structural analogues. Use for the treatment of angina and reduce the pressure in adults and children, as well as during pregnancy and lactation. The composition and interaction of the drug with alcohol.
bisoprolol – selective beta – blocker without its own sympathomimetic activity; It has antihypertensive, antiarrhythmic and antianginal effects. Blocking in low doses of beta1 – adrenergic receptors of the heart, reduces the formation of catecholamines stimulated cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP), decreases the intracellular current of calcium ions (Ca2 +), has a negative chrono -, Dromo -, Butman – and inotropic effect (uryazhaetsya heart rate reductions depresses conduction and excitability, reduces myocardial contractility).
If you increase the dose has beta2 – adrenoceptor blocking action.
The total peripheral vascular resistance at the beginning of the use of beta – blockers in the first 24 hours, increases (as a result of reciprocal increase in the activity of alpha – adrenoceptor stimulation and removal of beta2 – adrenergic receptors) that after 1 – 3 days back to the original, and prolonged appointment reduced.
The antihypertensive effect is associated with a decrease in cardiac output, sympathetic stimulation of peripheral vascular disease, decreased activity of the renin – angiotensin – aldosterone system (is more important for patients with initial hypersecretion of renin), restoring the sensitivity of baroreceptors of the aortic arch (not going to increase their activity in response to on the reduction of blood pressure), and the influence of the central nervous system. When hypertension effect occurs after 2 – 5 days, stable operation – after 1 – 2 months.
Antianginal effect is due to a decrease in myocardial oxygen demand as a result of deceleration in heart rate and decrease contractility, lengthening of diastole, improving myocardial perfusion. By increasing end-diastolic pressure in the left ventricle and increase the tension of the muscle fibers of the ventricles can increase myocardial oxygen demand, especially in patients with chronic heart failure (CHF).
In contrast, nonselective beta – blockers when administered at high therapeutic doses has a less pronounced effect on the organs containing beta2 – adrenergic receptors (pancreas, skeletal muscle, smooth muscle of the peripheral arteries, bronchi and uterus) and carbohydrate metabolism, causes delay sodium ions (Na +) in the body. When used in large doses it has a blocking effect on both subtypes beta – adrenergic.
Bisoprolol fumarate + auxiliaries.
bisoprolol almost completely absorbed from the gastrointestinal tract (80 – 90%). Food does not affect the absorption of the drug. The permeability of the blood-brain barrier and the placenta is low, the secretion of breast milk is low. It is metabolized in the liver. Excreted by the kidneys – 50% in an unmodified form, less than 2% – through the intestine.
- coronary heart disease (CHD) prevention of attacks of stable angina
The tablets of 2.5 mg, 5 mg and 10 mg.
Instructions for use and dosage
Inside, in the morning on an empty stomach, without chewing, with a small amount of liquid.
When hypertension and coronary heart disease (prevention of attacks of stable angina) is recommended to take 5 mg once daily. If necessary to increase the dose of 10 mg 1 time per day. The maximum daily dose – 20 mg.
In patients with impaired renal function (creatinine clearance less than 20 mL / min) or with severe liver problems, the maximum daily dose – 10 mg.
No dose adjustment in elderly patients is not required.
- “nightmarish” dream;
- confusion, or short-term memory loss;
- blurred vision;
- a decrease in the secretion of tear fluid;
- dry and sore eyes;
- hearing impairment;
- sinus bradycardia;
- a pronounced decrease in blood pressure;
- violation of AV – conduction;
- orthostatic hypotension;
- decompensation of chronic heart failure;
- peripheral edema;
- manifestation of vasospasm (strengthening of peripheral blood circulation, cooling of the lower extremities, Raynaud’s syndrome, paresthesia);
- chest pain;
- nausea, vomiting;
- dryness of the oral mucosa;
- stuffy nose;
- difficulty breathing when administered at high doses (loss of selectivity);
- in predisposed patients – laryngo – and bronchospasm;
- hyperglycemia (type 2 diabetes);
- hypoglycemia (type 1 diabetes);
- allergic rhinitis;
- increased sweating;
- flushing of the skin;
- exacerbation of psoriasis;
- muscle weakness;
- cramps in the calf muscles;
- thrombocytopenia, agranulocytosis;
- a violation of potency;
- syndrome “cancel” (increasing angina attacks, increased blood pressure).
- congestive heart failure or chronic heart failure decompensation (requires inotropic therapy);
- cardiogenic shock;
- atrioventricular block 2 and 3 degrees, without pacemaker;
- sinoatrial block;
- sick sinus syndrome;
- bradycardia (heart rate less than 60 beats / min);
- cardiomegaly (with no signs of heart failure);
- hypotension (systolic blood pressure less than 100 mm Hg);
- severe bronchial asthma and obstructive pulmonary disease;
- severe peripheral circulatory disorders, Raynaud’s syndrome;
- simultaneous reception of MAO inhibitors with the exception of MAO – B;
- hereditary lactose intolerance, lactase deficiency, glucose syndrome – galactose malabsorption;
- pheochromocytoma (without simultaneous application of alpha – blockers);
- metabolic acidosis;
- simultaneous reception floctafenine, sultopride;
- simultaneous intravenous administration of verapamil, diltiazem;
- the age of 18 years (effectiveness and safety have installed);
- hypersensitivity to bisoprolol, the components of the drug to other beta – blockers
Application of pregnancy and breastfeeding
Pregnancy is possible if the benefit to the mother outweighs the risk of side effects in the fetus.
Effect on the fetus: intrauterine growth retardation, hypoglycaemia, bradycardia, respiratory distress and possible (neonatal asphyxia) in infants.
If necessary, use bisoprolol during lactation breastfeeding should be discontinued as bisoprolol is excreted in breast milk.
Use in children
is contraindicated in children under the age of 18 years (effectiveness and safety have not been established).
Monitoring of patients taking bisoprolol should include monitoring of heart rate and blood pressure (at the beginning of treatment – daily, then 1 every 3 – 4 months), electrocardiogram (ECG), blood glucose concentrations in patients with diabetes mellitus (1 times 4 – 5 months). In elderly patients, it is recommended to monitor renal function (1 time in 4 – 5 months).
It is necessary to educate patients heart rate calculation method and instruct on the need of medical advice in heart rate less than 50 beats / min.
Before starting treatment recommended a study of external respiratory function in patients with a history of bronchopulmonary history.
Approximately 20% of patients angina beta – blockers are ineffective. The main reason – severe coronary atherosclerosis with a low threshold of ischemia (heart rate less than 100 beats / min) and increasing end-diastolic volume of the left ventricle that violates subendocardial blood flow. At the “smokers” efficacy of beta – blockers lower.
Patients who use contact lenses should bear in mind that during treatment may decrease the production of tear fluid.
In the application in patients with pheochromocytoma have a risk of paradoxical hypertension (if not previously reached effective alpha – adrenoblockade).
When bisoprolol thyrotoxicosis may mask certain clinical signs of hyperthyroidism (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated because the symptoms can increase.
In diabetes may mask tachycardia caused by hypoglycemia. In contrast, nonselective beta – blockers practically no increase insulin-induced hypoglycemia and delay recovery of blood glucose to normal values .
At the same time taking clonidine its reception can be terminated only after a few days after discontinuation of Bisoprolol.
Perhaps the increased severity of hypersensitivity reactions and the lack of effect of conventional doses of epinephrine (adrenaline) with aggravated allergic history.
In the case of the need for a planned surgical treatment abolition of the drug is carried out for 48 hours before general anesthesia. If the patient has taken the drug before surgery, he should choose the drug for general anesthesia with minimal negative inotropic effect.
Reciprocal activation of the vagus nerve can be eliminated by intravenous administration of atropine (1 – 2 mg).
The drugs that reduce stocks of catecholamines (eg, reserpine), may enhance the effect of beta – blockers, so patients taking such drug combinations should be under constant medical supervision in order to identify arterial hypotension or bradycardia.
Patients with bronhospasticheskimi diseases can assign cardioselective blocker in case of intolerance and / or ineffectiveness of other antihypertensive drugs, but should strictly follow the dosage. Overdosing is dangerous development of bronchospasm.
In the case of elderly patients increasing bradycardia (less than 50 beats / min), hypotension (systolic blood pressure below 100 mm Hg), AV blockade bronchospasm, ventricular arrhythmias, severe liver and kidney function should be reduced dose or stop treatment. It is recommended to discontinue therapy in the development of depression caused by the intake of beta – blockers.
Do not abruptly discontinue treatment because of – the danger of severe arrhythmias and myocardial infarction. Abolition are gradually reducing the dose for 2 weeks or more (reduce dose by 25% in 3 – 4 days).
It is necessary to cancel prior to the study in blood and urine catecholamines and Normetanephrine vanillylmandelic acid, antinuclear antibody titers.
Effects on ability to drive vehicles and management mechanisms
During the period of treatment must be careful when driving and occupation of other potentially hazardous activities; require high concentration and psychomotor speed reactions.
The allergens used for immunotherapy, or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol.
Phenytoin intravenous administration, drugs for inhalation general anesthesia (derivatives of hydrocarbons) increase the intensity of the action and likelihood of cardiodepressive reduce blood pressure.
Iodinated radiopaque diagnostic agents for intravenous administration increases the risk of anaphylactic reactions.
bisoprolol alters the effectiveness of insulin and hypoglycemic agents for oral, masking the symptoms of developing hypoglycemia (tachycardia, increased blood pressure).
The antihypertensive effect of weakening the non-steroidal anti-inflammatory drugs (delay sodium and kidney of prostaglandin synthesis blockade), corticosteroids, and estrogens (delay of sodium ions).
Cardiac glycosides, methyldopa, reserpine, guanfacine and increase the risk of developing or worsening bradycardia, atrioventricular block, cardiac arrest and heart failure.
are not recommended Bisoprolol combination with calcium channel blockers (verapamil, diltiazem, bepridil), when administered intravenously, due to the increasing negative impact on the inotropic function of the myocardium, AV – conductivity and BP.
The combined use of nifedipine and Bisoprolol may lead to a significant reduction in blood pressure.
With simultaneous use of bisoprolol and class 1 antiarrhythmic agents (disopyramide, quinidine, gidrohinidin) possible deterioration of atrio – ventricular conduction and negative inotropic effect (requires clinical surveillance and monitoring of electrocardiography).
With simultaneous use of bisoprolol and antiarrhythmics of class 3 (eg amiodarone) possible deterioration of conductivity intraatrial.
With the simultaneous use of the drug bisoprolol or other beta – blockers, including those contained in eye drops, possible synergism.
The simultaneous use of bisoprolol formulation with beta – adrenergic agonists (e.g., isoprenaline, dobunamin) may reduce the effects of both drugs.
The combination of Bisoprolol beta – and alpha – adrenergic agonists (eg, iorepinefrin, epinephrine), may enhance the vasoconstrictor effects of these agents arising from the participation of alpha – adrenergic receptors, resulting in increased blood pressure.
Diuretics, clonidine, sympatholytic, hydralazine and other antihypertensive drugs may lead to an excessive reduction in blood pressure.
With simultaneous use of bisoprolol and mefloquine increases the risk of bradycardia.
Simultaneous treatment with Bisoprolol floctafenine and sultopride contraindicated.
The action of non-depolarizing muscle relaxants and anticoagulant effect of coumarin during treatment with bisoprolol may be extended.
Three – and tetracyclic antidepressants, antipsychotics (neuroleptics), ethanol (alcohol), sedatives and sleeping medications increase central nervous system depression. Not recommended simultaneous application Bisoprolol with MAO inhibitors (except MAO – B) due to the significant increase in the hypotensive action. Break in treatment between receiving MAO inhibitors and Bisoprolol should not be less than 14 days.
Reduces clearance of lidocaine and xanthine (except diprofillina) and increases their concentration in the blood plasma, especially in patients with initially increased clearance of theophylline under the influence of smoking.
Bisoprolol sulfasalazine increases the concentration in the blood plasma.
Rifampicin shortens the half-life of Bisoprolol.
Analogues drug bisoprolol
The structural analogs of active material:
- Aritel Cor;
- bisoprolol OBL;
- bisoprolol meadows;
- bisoprolol Prana;
- Bisoprolol ratiopharm;
- Bisoprolol Sandoz
- Teva bisoprolol;
- Bisoprolol hemifumarate;
- Bisoprolol fumarate;
- Bisoprolol fumarate Farmaplant;
- Concor Cor;
In the absence of drug analogs of active material, it is possible to follow the links below on the disease, which makes it an appropriate drug and see the existing analogues for therapeutic impact.