Bihasal 2.5 Hasan treatments for hypertension, angina, and stable heart failure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Bisoprolol
Ingredient Heart failure, high blood pressure, angina

Ingredient

Composition information	Content
Bisoprolol	2.5mg

Uses

indications

Bihasal 2.5 drugs are indicated in the following cases:

Hypertension.

The recognized effect of the drug in patients with chronic heart disease is to reduce the abnormal activity of the sympathetic nervous system, causing adverse consequences on the heart (increasing heart rate). Bisoprolol Fumarat 2.5 mg has been shown to reduce heart rate, so it has a long -term heart protection effect.

In clinical trials, Bisoprolol shows more benefit when taken with diuretics and/or yeast inhibitors.

Dynamic pharmacokinetics

absorption and bioavailability

Absolute bioavailability after taking the dose of Bisoprolol Fumarat 10 mg is about 80%. The absorption is not affected by food.

Distribution

Links to serum protein about 30%. Achieving plasma peaks within 2 - 4 hours after the dose of 2.5 - 20 mg and the average peak concentration value varies from 9.0 ng/ml (at a dose of 2.5 mg) to 70 ng/ml (at a dose of 20 mg).

In both young people and the elderly, the accumulation in low plasma, the accumulation coefficient from 1.1 - 1.3.

Metabolism and elimination

The first liver metabolism of Bisoprolol Fumarat is about 20%. Bisoprolol Fumarat is not metabolized by Cytochrom P450 2D6 (Debrisoquin hydroxylase).

Semi -selling time in plasma from 9 - 12 hours and slightly longer in elderly patients, partly due to their reduced kidney function.

In patients with creatinine clearance below 40 ml/min, the sale time in plasma increases approximately 3 times compared to healthy people.

In cirrhosis patients, the excretion of Bisoprolol Fumarat has a more change and significantly slower than healthy people, with a semi -discharged time in plasma from 8 to 22 hours.

Bisoprolol Fumarat is eliminated through the kidneys and does not pass the same kidney with about 50% of the dose appears in the form of unchanged urine, the rest is in the form of non -active metabolites. Under 2% of the dose is discharged through feces.

Before taking Bihasal 2.5 Hasan treatments for hypertension, angina, and stable heart failure (3 blisters x 10 tablets)

How to use

oral medication. Take medicine with plenty of water, should take medicine in the morning when hungry or breakfast. Do not chew.

Do not stop using the sudden use of Bihasal 2.5 nor do not change the dose unless the doctor is clearly indicated by the doctor.

Dosage

Dosage should be determined depending on the individual and calibrated depending on the response of the disease and the patient's tolerance.

Hypertension or angina

The usual starting dose of Bisoprolol Fumarat is 2.5 - 5 mg/time/day. The maximum recommended dose is 20 mg/day/day.

Stable chronic heart failure

Bihasal 2.5 is often used in combination with some other drugs prescribed by a doctor. The starting dose is 1.25 mg/time/day. If tolerated well, the dose doubled after 1 week, then increased gradually after 1-4 weeks until the maximum tolerance is reached, no more than 10 mg/time/day. Specific dosage as follows:

1.25 mg/day/time, for a week, if the tolerance is good, increase the dose.

2.5 mg/day/time, in the next week, if the tolerance is good, increase the dose.

3.75 mg/day/time, the next week, if the tolerance is good, the dose increases.

5 mg/day/time, in the next 4 weeks, if the tolerance is good, the dose increases.

7.5 mg/day/time, in the next 4 weeks, if the tolerance is good, the dose increases.

Maintenance dose of 10 mg/day.

Unnecessary dose adjustment in older patients except for significant liver and kidney dysfunction.

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?

symptoms

Signs of overdose due to beta blockers include slow heart rate, hypotension, heart block, congestive heart failure, bronchial spasm and hypoglycemia.

There have been reports on some cases of overdose with bisoprololfumarat (maximum of 2000 mg), the most common is slow heart rate and/or hypotension.

How to handle

Stop using bisoprolol immediately, supportive treatment and symptoms. There are a few data that Bisoprolol Fumarat 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. Can be intravenously glucagon intravenously.

heart block (degree II or III)

Careful monitor patient and Isoproterenol infusion or pacemaker.

SECRETING HEART

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

Bronchospasm

Use bronchodilators such as isoproterenol and/or aminophylin.

Hypoglycemia

Intravenous glucose.

What to do when forgetting 1 dose?

Side Effects

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

The drug is well tolerated in most patients. Most of the side effects are light and transient.

Common

diarrhea, vomiting, rhinitis, weakness, fatigue, cold or numbness in the limbs, digestive disorders.

Central nervous system: Perception, irritation, drowsiness, anxiety, restlessness, reduced capacity/memory.

Automatic nervous system: dry mouth.

Cardiovascular: Slow heart rate, nervousness, arrhythmia, cold head, balance, hypotension, chest pain, congestive heart failure, shortness of breath.

Mental: Di dream, insomnia, depression. digestive: stomach pain, gastritis, indigestion, constipation.

Neuropathy: muscle/joint pain, back/neck pain, abdominal spasms, convulsions/tremor. skin: rash, eczema, skin irritation, itching, redness, sweating, hair loss, angioedema, peeling skin. sensory: visual disorders, eye pain/eye pain, tearing eyes, tinnitus, ear pain, abnormal taste.

Metabolism: Gout.

Respiratory: Asthma, bronchitis, cough, shortness of breath, sore throat, rhinitis, sinusitis. Urinary - genital: Reduce sexual activity, cystitis, kidney cramps. Hematology: rash.

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

Bihasal 2.5 contraindications in the following cases:

Hypersensitivity to bisoprolol or beta blockers or one of the other ingredients of the drug.

acute heart failure, loss of loss of heart failure is in need of intravenous infusion of medications causing myocardial shrinkage.

Shock due to heart (shock due to reduced cardiac amount with very low blood pressure symptoms (systolic blood pressure below 90 mmHg), loss of orientation, and cold skin).

Cardiatricity disorders (atrial atrial block 2 and 3 without a pacemaker, atrial sinus block).

Slow heart rate below 60 beats/minute before starting treatment, sinus impairment syndrome.

Low blood pressure (systolic blood pressure below 100 mmHg, hypotension).

Heavy bronchial asthma, severe chronic obstructive pulmonary disease (COPD).

Simultaneously used with Mao inhibitors.

Severe disorders of peripheral blood supply (late stage of peripheral artery disease and Raynaud's syndrome).

Metabolic acidosis.

Being sick in the adrenal gland (chrome cell tumor) has not been treated.

Be cautious when using

If any disease or condition below, report to the treating doctor before taking Bihasal 2.5:

Chest pain during rest (Prinzmetal angina). condition.

Starting Bihasal 2.5 treatment should be monitored regularly in the last 3 months.

The ability to drive and operate machinery

Due to the different 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

risks affecting pregnancy. Always consult a doctor before taking Bihasal 2.5 during pregnancy.

The period of breastfeeding

is not recommended to use Bihasal 2.5 during breastfeeding. Always consult your doctor before taking the medication.

Interactive drug

Notice to the doctor if you are taking or new use any other drug including non -prescription drugs:

Treatment of cardiovascular disease (calcium channel blockers such as Verapamil, Diltiazem, Nifedipin): due to the increased hypotension effect of Bisoprolol Tumarat 2.5 mg. Heart rate, heart transmission, and myocardial tone may be adversely affected.

Treatment of depression, Parkinson's disease (monoaminoxidase inhibitors, except IMAO-B): Bisoprolol's hypotension effects may be stronger but there is also a sudden increased risk of blood pressure (hypertension attack).

Clonidin -containing drugs: Hypertension can occur (corresponding hypertension) as well as overheat 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 sympathetic agent (including tacrin): cardiac transmission system may be affected.

Beta blockers, 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.

Epilepsy (Barbiturat, ...), Psychotropic Drugs (3 -round antidepressant, phenothiazin) increase the lowering effect of bisoprolol.

Rifampicin affects the effect of bisoprolol but often does not need to adjust the dose.

metloquin: Increases the effect of the heartbeat of bisoprolol.

Storage

Store in a dry place, less than 30 ° C.

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