Bihasal medicine 5mg Hasan treats hypertension, angina, chronic heart failure (3 blisters x 10 tablets)

pharmacokinetics

absorption: The drug is absorbed by oral almost completely (90%). The maximum concentration in plasma is generally reached after 1-2 hours. Bioions reach 85 - 90%.

Distribution: The drug is linked to a 30%plasma protein. Drugs through placenta and breast milk.

Metabolism: Metabolic drugs through the liver.

Elimination: Eliminating drugs are almost entirely through the kidneys.

In the treatment of heart failure:

What to do when overdose? Bisoprolol must be stopped immediately and treated by intravenous intravenous (1 - 2 mg), if necessary, followed by a 25 mcg isoprenaline intravenous infusion, Glucagon can also be used at a dose of 1 - 5 mg.

There may be bronchospasm and heart failure. Treatment of bronchospasm by abandoning aminophylline and treating heart failure with cardiovascular drugs (digitalis) and diuretics.

What to do when forgetting a dose? However, if it is almost time for the next dose, skip the dose and continue the schedule of the drug as directed. Do not use double dose to compensate for missed dose.

Note:

In the case of adrenal tumors (chromium skin tumors), bisoprolol can only be used after chen.

Preventive for patients with diabetes, starvation for a long time with strong fluctuations in blood sugar index, for patients with metabolic acidosis, atrial hobby, prinzmetal angina.

Patients with a basis for themselves and their families suffered from psoriasis, are only allowed to use beta blockers after careful consideration of benefits compared to risks.

Caution when using

heart failure: Do not use beta blockers for patients with symptoms of congestive heart failure. However, in some patients with heart failure to compensate, if necessary to use the drug, it must be very cautious.

Sudden treatment: Sudden stopping treatment of beta blockers can worsen angina, myocardial infarction or ventricular arrhythmia in patients with coronary artery disease. Should be cautious when stopping treatment without a doctor's instructions.

Bronchospasm: Because of the relative beta selection, Bisoprolol can be used with the necessary caution in patients with non -response bronchospasm or non -tolerant anti -hypertension therapy. Because of the absolute beta selection, Bisoprolol can be used at the lowest doses possible with the starting dose of 2.5 mg/day. It is also possible to use simultaneously with a beta stimulant (bronchodilator).

Anatomy and anesthesia: Bisoprolol should be stopped at least 48 hours before the patient has surgery. If the drug must be used during the surgery, caution should be used for anesthesia such as Ether, Cyclopropan and Trichlorethylen. If overdose, process with Atropin 1 - 2 mg I.V.

Diabetes and hypoglycemia: Bisoprolol heals hypoglycemia (especially tachycardia). However, in diabetics prescribed insulin or oral hypoglycemic drugs, bisoprolol should be used carefully.

thyroid poisoning: Bisoprolol can hide thyroid signs (such as tachycardia). The sudden stop of beta blockers can promote thyroid poisoning.

The ability to drive and operate machinery

Because the drug has the effect of lowering blood pressure, depending on the individual can affect the ability to drive and operate machinery. Especially this condition usually occurs at the beginning of treatment and when there is a change in the medication as well as when there is an interaction with alcohol.

Pregnancy

should not use drugs for pregnant women. Due to the ability to cause slow heart rate, hypotension and hypoglycemia in newborns, 72 hours ahead of birth, must be terminated with Bisoprolol. If the treatment cannot be terminated, babies must be monitored within 48 - 72 hours after birth.

Breastfeeding period

Do not use medication for breastfeeding women.

Drug interaction

The drugs can occur:

Do not coordinate with other beta blockers.

Concomitant treatment of bisoprolol with exhausted drugs of catecholamine (reserpin, alpha - methyldopa, clonidin and guanethidine) can significantly reduce heart rate. In patients treated simultaneously with clonidine, if they want to stop the drug, it is recommended to stop using bisoprolol for a few days before stopping clonidine.

Concomitance bisoprolol use with heart muscle relaxation or atrial transmission as some calcium drugs (especially phenylalkylamine groups [verapamil] and benzothiazepine group [diltiazem]) or anti -arrhyce agents (disopyramide) may occur blood pressure, bradycardia, arrhythmia or heart failure.

When used simultaneously with reserpine, alpha - methyldopa, guanfacine, clonidine or glycosides can significantly reduce heart rate.

rifampin increases the metabolism of excretion of bisoprolol fumarate thus shortening the sale time of the drug. However, the adjustment of the dose of bisoprolol is not necessary.

Using bisoprolol at the same time as insulin and drugs that reduce oral blood sugar, can increase their ability. Symptoms of hypoglycemia (especially tachycardia) are covered or mitigated. The blood sugar content must be monitored regularly.