Bisocar 2.5mg Rusan Pharma medicine for hypertension (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Bisoprolol
Ingredient Coronary artery disease, arrhythmia, esophageal ulcer, heart failure, angina, high blood pressure, hyperthyroidism

Ingredient

Composition information	Content
Bisoprolol	2.5mg

Uses

Indications

Bisocar 2.5 drugs are indicated in the following cases:

Treatment of hypertension is used alone or in combination with other drugs. Membrane stabilizer. Bisoprolol shows a low affinity with the beta-2 receptor of bronchial muscles and blood vessels as well as the effect on the beta-2 receptor related to metabolic regulation.

Therefore, Bisoprolol generally does not affect the airway impedance and the conversion effects through the beta-2 receptor receptor. Selective characteristics on Beta-1 of the drug still exist with the dose exceeding the treatment dose. Bisoprolol is used to treat hypertension, angina and heart failure. The effectiveness of bisoprolol is equivalent to other beta blockers, the mechanism of impact on hypertension has not been understood.

However, bisoprolol reduces the plasma Rennin effects significantly. Mechanism of treating angina: By inhibiting the beta receptor on the heart, bisoprolol inhibits the sympathetic nerve effects. The result is to reduce the heart rate and reduce myocardial contraction leading to reduced oxygen needs of myocardial muscle.

In acute treatment in coronary heart disease without chronic heart failure, bisoprolol reduces heart rate and reduces blood volume emitted in each heart squeeze, thus reducing cardiac flow and reducing oxygen consumption. In chronic treatment, bisoprolol reduces the resistance of peripheral artery in the beginning.

pharmacokinetic

absorption

Bisoprolol is almost completely absorbed through the gastrointestinal tract and metabolized through the liver for the first time so it is quite high, so it is quite high, about 90%. The drug has a linear pharmacokinetic drug in a wide dose of 2.5 - 100 mg, regardless of age. Food does not affect drug absorption.

Distribution

about 30% bisoprolol attaches to plasma proteins. The distribution volume is 3.5 l/kg.

Metabolism and elimination

Half of the plasma of the drug in healthy people is about 9 - 12 hours, increasing in cases of impaired renal function or liver fibrosis. The drug excreted in urine is about 50% of the metabolic and 50% in the form of intact.

Before taking Bisocar 2.5mg Rusan Pharma medicine for hypertension (10 blisters x 10 tablets)

How to use

Used by oral. Should take the drug in the morning and can be taken with food. Swallowing the whole tablet with water, not chewed.

Dosage

Adults

Treatment of hypertension

The recommended starting dose is 2.5 - 5 mg x 1 time/day.

For patients who do not control the blood pressure with the beginning dose, it may increase depending on the tolerance of up to 10 mg, severe cases may increase to a maximum of 20 mg/day.

Treatment of increased angina

Common dose: 10 mg x 1 time/day, up to 20 mg/day. Some patients can achieve a dose of 5 mg/day.

Elderly

Has a normal liver and kidney function: No dose changes.

kidney failure or liver failure

For patients with severe renal impairment (creatinine clearance in about 5-20 ml/minute) and patients with severe or progressive liver damage, recommend not to use more than 10 mg/day.

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 shows that Bisoprolol is difficult to be separated.

Based on the known effects and recommendations for other beta blockers, it is necessary to consider the following measures when there are the following clinical signs:

• Slow heart rate: Atropine intravenous injection. If the response is incomplete, one cautious isoprenalin can be used or some other drugs have the effect of increasing heart rate. In some cases, place the pacemaker if necessary.

• Hypotension: Intravenous fluid and use of hypertension drugs. An intravenous glucagon can be used.

• Atrial block (degree 2 or 3): carefully monitor the patient and isoprenali infusion or pacemaker.

• Severe acute heart failure: Intravenous diuretics, heart muscle contractions, vasodilators.

• Bronchospasm: Use bronchodilators such as isoprenalin, sympathetic stimulants beta-2 and/or aminophyllin.

• Hypoglycemia of blood glucose: intravenous glucose.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not use double the prescribed dose.

Side Effects

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

Common (1/100 to

Mental: Sleep disorders, depression.

nerve: dizziness, headache. Heart: Increased heart failure (in patients with chronic heart failure). blood vessels: Feeling cold or numbness in the limbs, hypotension especially in patients with heart failure. digestive: Nausea, vomiting, diarrhea, constipation.

Uncommon (> 1/1,000 to

Mental: nightmares, hallucinations.

Respiratory, chest and mediastinum: bronchospasm in bronchial patients or a history of trachea obstruction.

Muscle and connective tissue: muscle weakness and withdrawal.

Rare (1/10,000 to

Neurological: fainting.

Eyes: Reduce tear secretion (Note if the patient uses contact lenses).

ears: hearing disorders. Heart: Atrial transmission disorders, increased heart failure (in patients with hypertension or angina), slow heart rate (in hypertension patients or angina).

Respiratory, chest and mediastinum: allergic rhinitis.

Hepatitis: Hepatitis.

Breeding system: erectile dysfunction.

Skin and subcutaneous tissue: Hypersensitive reaction (such as itching, redness, rash).

Testing: Increasing triglycerides, increasing liver enzymes (ALAT, ASAT).

Very rare (

Eye: conjunctivitis.

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

Contraindicated

Bisocar 2.5 contraindications in the following cases:

Acute heart failure or in the stages of loss of heart failure need intravenous medications that cause myocardial CO. Low causes physical symptoms.

Precautions when using

Treatment of chronic heart failure:

Treatment of stable chronic heart failure with bisoprolol must be started with a special dose adjustment phase.

Starting and stopping the treatment of stable chronic heart failure with bisoprolol requires regular monitoring.

There is no experience in bisoprolol treatment for patients with heart failure and accompanied by the following diseases:

Insulin -dependent diabetes (type 1).

Other indications:

There is a risk of myocardial infarction and sudden death if the patient has a sudden treatment of coronary artery disease.

Especially for patients with heart disease due to ischemia, bisoprolol is not stopped suddenly unless indicated, because this can make the heart condition worse when transferred. Caution to treat hypertension or angina: Bisoprolol must be used carefully for patients with hypertension or angina with heart failure. Bronchial asthma, chronic obstructive pulmonary disease

Bisoprolol must be used carefully in the following cases :.

Bronchospasm (bronchial asthma, airway obstruction). In bronchial asthma or other chronic obstructive pulmonary diseases, which can cause symptoms, should combine the use of bronchodilators. Occasionally an increase in airway resistance in asthma patients, so Beta-2 stimulant dose may have to increase.

Diabetes with a large vibration of blood sugar. Symptoms of hypoglycemic hypoglycemia (such as tachycardia, chest drum or sweating) may be concealed.

fast fasting.

is conducting sensitive solution. Like other beta blockers, Bisoprolol may increase the sensitivity of allergens and the severity of the hypersensitivity reactions. Treatment with Adrenalin does not always bring the desired treatment effect.

atrial atrial block 1.

Prinzmetal angina.

Peripheral artery blockage. Symptoms may be worse, especially at the beginning of treatment.

Body anesthesia.

Lactose.

This drug contains lactose. Patients with rare Galactose-intolered genetic problems, lactase lactase deficiency or Glusoe-Galactose are not absorbed by this drug.

The ability to drive and operate machinery

There has been no research on the effect of the drug on the ability to drive and operate machinery. In a study in patients with coronary heart disease showed that Bisoprolol did not affect the ability to drive. However, depending on the reaction of each individual, the ability to drive and operate machinery is impaired. It is necessary to pay special attention to this ability when starting treatment, when changing the dose or when taking the drug with alcohol.

Pregnancy

Bisoprolol's pharmaceutical effects can be harmful to pregnant women and/or fetus/infant. In general, the beta receptor blockers reduce the amount of blood to the placenta, leading to development of pregnancy, fetus, miscarriage or premature birth. Side effects (such as hypoglycemia, slow heart rate) can occur with the fetus and babies. If the treatment with beta blockers is necessary, it is advisable to use the selective of the beta-1 receptor blockers. It is not recommended to use bisoprolol for pregnant women unless really necessary. If the treatment with bisoprolol is necessary, it is necessary to closely monitor the amount of blood to the uterus, the placenta and the development of the fetus. In case of harmful effects on pregnant women or fetus, it is necessary to consider changing the treatment. Babies should be closely monitored.

Breastfeeding period

There is no data on Bisoprolol's distribution ability to breast milk or the safety of bisoprolol for babies. Therefore, it is not recommended to use bisoprolol for nursing women.

Drug interaction

not recommended in combination

Treatment of chronic heart failure:

Group I anti -arrhyths (such as quinidin, disopyramid; lidocaine, phenytoin, flecainid, propafenon): capable of affecting the atrial transmission time and increased the inhibition of myocardial contraction.

All indications:

Veparamil and diltiazem antagonists (at a lower level): reducing the contraction and atrial transmission. When the veeparamil intravenous injection for patients being treated with beta blockers can cause strong hypotension and atrial clog.

Hematopsius drugs act on the central nervous system such as clonidin and other drugs (such as methyldopa, moxonodin, rilmenidin): simultaneously used with antihypertensive drugs acting on the central nervous system can worsen heart failure due to reducing central sympathetic force (reducing heart rate and heart attack, vasodilation). Stop using the drug suddenly, especially before stopping the use of beta blockers may increase the risk of "hypertension bound backwards".

Combining carefully

Treatment of hypertension/angina:

Group I anti -arrhyths (such as quinidin, disopyramid; lidocaine, phenytoin, flecainid, propafenon): capable of affecting the atrial transmission time and increased the effect of inhibiting myocardial contraction.

All indications:

Dihydropyridin Calcium channel blockers such as felodipine and amlodipine: When used simultaneously, the risk of hypotension, and does not rule out the risk of deteriorating the blood pumping function of ventricular in patients with heart failure.

Anti -arrhythmic drugs Group III (such as amiodaron): capable of affecting the atrial transmission time. • Beta blockers acting on the spot (such as eye drops in glaucoma treatment): can have a combination of energy with the body effect of bisoprolol.

Sympathomical stimulants: simultaneous use may increase the atrial transmission time and increase the risk of slow heart rate.

insulin and oral diabetes anti -diabetic drugs: increase hypoglycemic effects.

Anesthesia: Reduce heart reflexes quickly and increase the risk of hypotension (see the "warning and caution" section).

Cardia Glycosides (Digitalis): Reduce heart rate, increasing the atrial transmission time.

Non -steroid anti -inflammatory drugs (NSAIDs): NSAIDs can reduce the hypotension effect of bisoprolol.

Sympathetic stimulants (such as isoprenalin, dobutamin): simultaneously used with bisoprolol can reduce the effect of both drugs.

Sympathetic stimulants act on both β and α receptors (such as noradrenalin, adrenalin): combined with bisoprolol may increase the indirect vascular effect through the α receptor of these drugs that lead to hypertension and worsen the lame of the regression. These interactions often occur with unsatisfactory beta blockers.

Combining anti -hypertension with other drugs that can lower blood pressure (such as three -round antidepressants, barbiturat, phenothiazin) may increase the risk of hypotension.

Combining to consider

Mefloquin: Increased risk of heart rate.

Monoamine inhibitors of oxidase (except Mao-B inhibitors): Increases the hypotension effect of beta blockers, but may also be at risk for hypertension.

rifampicin: may reduce the sale time of bisoprolol due to stimulating metabolic enzymes in the liver. Usually no dose adjustment is needed.

Ergotamine derivatives: Increased peripheral circulatory disorders.

Storage

Store at a temperature not exceeding 300C.

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