A.T Bisoprolol 2.5mg An Thien Treatment of Chronic heart failure (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Bisoprolol
Ingredient An Thien DP Joint Stock Company

Ingredient

Composition information	Content
Bisoprolol	2.5mg

Uses

Indications

Bisoprolol 2.5mg drugs are indicated in the following cases:

Hypertension.

Chronic stable angina.

Treatment of chronic heart failure stabilized with reduced left ventricular systolic function in combination with enzyme inhibitors, diuretics and heart glycosides.

Pharmacy

Pharmacological Group

Beta, selective drugs. Bisoprolol is a strong Adrenoceptor Beta 1 receptor, which has no intrinsic stimulating effects and has no relevant membrane stability. It only shows low affinity with the beta 2 receptor of bronchial muscles and vessels as well as beta 2 receptors related to metabolic regulation. Therefore, Bisoprolol is often not expected to affect the airway resistance and the metabolic effect through beta 2.

Bisoprolol is used to treat hypertension and angina. Like other Beta-1 prevention drugs, the method of effects in hypertension is unclear. However, it is known that Bisoprolol reduces plasma renin activity.

Anti -angina mechanism: Bisoprolol by inhibiting the beta receptor in the heart should inhibit the response to sympathetic activation. That leads to a decrease in heart rate and contraction in this way that reduces the oxygen needs of the heart muscle.

In acute treatment in patients with coronary heart disease without chronic heart failure, Bisoprolol reduces heart rate and stroke volume and thus the supply of heart and oxygen consumption. In chronic treatment, the initial peripheral resistance will decrease.

pharmacokinetic

absorption

Bisoprolol is absorbed almost completely through the digestive tract. Along with the very small metabolic effect in the liver, this leads to high bioavailability of about 90%.

Distribution

Bisoprolol's

binding to plasma proteins is about 30%. The distribution volume is 3.5L/kg.

Metabolism and elimination

Bisoprolol Fumarate 2.5mg is eliminated in two ways, 50% converted in the liver into non -activity metabolites and then excreted through the kidneys. 50% of the maintenance dose is excreted by the kidney in the form of constant. Total clearance of about 15l/h. Selling waste time in plasma (10 - 12 hours) is effective for 24 hours after use once a day. Because the elimination takes place in the kidneys and liver at the same level, there is no need to adjust the dosage for patients with impaired liver or kidney failure.

Before taking A.T Bisoprolol 2.5mg An Thien Treatment of Chronic heart failure (10 blisters x 10 tablets)

How to use

Take medicine with lots of water, should take the drug in the morning when hungry or breakfast. Do not chew.

Dosage

Dosage recommended in each specific patient. Should start treatment with minimum doses. In some patients, the dose of 5mg per day is sufficient. The usual dose is 10mg once daily and the maximum dose is recommended for 20mg daily.

Dose adjustment phase

The dose adjustment in the following steps: 1.25mg 1 time per day for 1 week, if tolerated well, increase the dose to 2.5mg 1 time per week of the next week, if the tolerance is good, increase the dose to 3.75mg 1 time per day of the next week, if the tolerance is good, increase the dose to 5mg per day for the next 4 weeks, if the tolerance is good, increase the dose to 7.5mg per day, if the dose is good, increase the dose.

maintenance dose 10mg once a day.

The maximum dose is recommended for 10mg, 1 time daily.

Dose reduction

If the patient is not tolerated with the maximum dose recommended, the dose should be reduced. If the drug is discontinued, the dosage should be reduced, due to the sudden stopping of the drug can make the patient's condition worse. Dosage should gradually reduce the dose per week.

Patients with renal failure

In patients with severe renal function (creatinine purification

Patients with severe liver failure

Should carefully monitor, the dose of bisoprolol should not exceed 10mg daily.

Older patients

No need to adjust the dosage, recommend starting with the minimum dose.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? There are a few data that Bisoprolol cannot be separated.

Slow heart rate: Atropine intravenous injection. If the response is incomplete, caution can be used with isoproterenol or another drug that increases the heart rate. In some cases, temporary pacemaker places to stimulate the rhythm.

Hypotension: Intravenous fluid and use of hypertension drugs. Can be intravenously glucagon intravenously.

Heart Block (Ill or ILL): Careful monitor the patient and Isoproterenol infusion or pacemaker placing.

SECRETING HEART: Take common measures (use digitalis, diuretics, medications that increase muscle contraction, vasodilators).

Bronchospasm: use bronchodilators such as isoproterenol and or aminophylin.

Hypoglycemic blood glucose: glucose intravenous injection.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Bisoprolol 2.5mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Body: weakness (in patients with chronic heart failure), fatigue.

Nervous system disorders: dizziness, headache.

Heart disorders: worsen heart failure (in patients with chronic heart failure).

Vascular disorders: Cold or numbness, hypotension, especially in patients with heart failure. gastrointestinal disorders: nausea, vomiting, diarrhea, constipation.

Uncommon, 1/1000

Body: weakness (in hypertension patients or angina).

musculoskeletal and connective tissue disorders: muscle weakness and cramps.

Respiratory disorders, chest and mediastinum: bronchospasm in patients with bronchial asthma or a history of airway obstruction.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Bisoprolol 2.5mg contraindicated drug in the following cases:

acute heart failure or in loss of loss of heart failure need to be treated with intravenous medication.

Cardiococci.

The second or third AV block (without a pacemaker).

Sinus syndrome.

Sinus block.

Symptomatic bradycardia.

Symptomic hypotension.

Severe bronchial asthma or severe chronic obstructive pulmonary disease.

The final stage of peripheral artery disease and Raynaud syndrome.

Non -treated phagocytes.

Metabolic acidosis.

Hypersensitivity to the active ingredient or any excipients of the drug.

Precautions when used

drugs containing bisoprolol ingredients are used to treat chronic heart failure. Be careful when using Beta-Blockers in this indication and should start with a reserved dose.

Bisoprolol combination with amiodarone is not recommended by the risk of automatic disorders in muscle contraction and transmission. Bisoprolol must be used carefully in bronchial spasm.

Sometimes an increase in airway resistance can occur in asthma patients, so an increase in sympathetic medicine should be increased. Before starting treatment, it is recommended to conduct respiratory function.

Simultaneous treatment with anesthetic, respiratory anesthetic.

diabetes with a large fluctuating blood sugar level. Symptoms of hypoglycemia may be obscured. During the treatment of Bisoprolol 2.5mg should monitor blood sugar.

Thyroid poisoning - When treating bisoprolol, symptoms may be obscured.

Strict fasting.

As other beta-blockers, bisoprolol can increase both sensitivity to raw allergies and the severity of hypersensitivity reactions. Adrenalin usually does not work Block A-V.

Prinzmetal angina: B-blockers may increase the number and time of angina in patients with Prinzmetal angina. Selective B-Blockers can be used in medium forms and only used in combination with vasodilators.

Peripheral artery disease such as Raynaud's syndrome and other non -recovery, these diseases may be worse, especially during the beginning of treatment.

Patients with chromium skin tumors in the adrenal marrow, only use Bisoprolol Fumarate 2.5mg after selecting Alpha receptors.

Patients with psoriasis or have a history of psoriasis, should only use Bisoprolol only after careful consideration of benefits and risks.

Starting for treatment with Bisoprolol needs to be monitored regularly, especially in older patients. Do not stop the drug suddenly unless indicated clearly. There is a risk of myocardial infarction and sudden death if the drug suddenly stops in patients with myocardial ischemia.

The ability to drive and operate machinery

Due to the various effects of the drug, the ability to drive and operate machinery may be impaired. Especially this condition usually occurs at the beginning of treatment and when there is a change in the medication as well as when used with alcohol.

Pregnancy

Bisoprolol 2.5mg has pharmacological effects that can cause damage to pregnant women or fetus/infant. It is recommended to consider the effects of damaging pregnant women or fetal fetuses. Always consult a doctor before taking the drug during pregnancy.

Breastfeeding period

It is not known whether the drug is secreted in breast milk or not, so it is not advisable to breastfeed during treatment with bisoprolol.

Medicinal interaction

Medicines for treating cardiovascular diseases (Calcium channel blockers such as Verapamil, Diltiazem, Nifedipine): due to it can increase the hypotension effect of Bisoprolol 2.5mg.

Treatment of depression, Parkinson's disease (Monoamine Oxidase inhibitors, except IMAO-B): Bisoprolol's hypotension can be stronger but there is also a sudden increased risk of blood pressure.

Clonidine -containing drugs: Hypertension can occur as well as overcurrent heart rate and heart transmission.

anti -arrhyths (disopyramid, quinidine or amiodaron): The effect on heart transmission and heart rate can be strengthened.

Some drugs containing parasympathetic enhancers (including tacrin): heart transmission systems may be affected.

Beta options, including eye drops.

diabetes (insulin or oral diabetes): Signs of blood sugar that are too low may be covered (such as fast vascular signs).

Me (used during surgery): Due to the activity of the heart may be impaired during anesthesia.

Medicines containing glycosides of Digitalis group: Heart rate and cardiac transmission system may be affected.

Pain or anti -inflammatory (Prostaglandin inhibitors): Due to the reduced hypotension effect.

Ergotamine derivatives: Peripheral blood supply may be reduced.

Sympathetic enhancement (eye drops, nose, cough pills): may lose the effect of bisoprolol.

Other blood pressure treatments.

Barbiturat, psychotropic drugs (3 -round antidepressant, phenothiazin) increase the hypotension effect of bisoprolol.

rifampicin: affecting the acting time of bisoprolol but often do not need to adjust the dose.

Mefloquin: Increases the effect of Bisoprolol's heart rate.

Storage

Where dry, less than 30 ° C.

Other drugs

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