Bisoloc United medicine for hypertension and coronary artery disease (3 blisters x 10 tablets)

Bisoprolol is a selective inhibitor on the beta-1-adrenergic receptor, without membrane stability and has no internal sympathetic stimulation. Bisoprolol has less affinity for the beta-2 receptor on bronchial muscles and vessels as well as metabolism. Therefore, Bisoprolol has little influence on gas impact and has little intermediate metabolism through Beta-2 receptors.

pharmacokinetic

absorption

Bisoprolol is absorbed and bioavailable about 90% after drinking.

Distribution

bisoprolol binds to plasma proteins about 30%.

Metabolism

The drug is metabolized through the liver.

Elimination

Semi -selling time in plasma from 10 to 12 hours, for effective 24 hours after taking 1 dose/day. Bisoprolol is excreted through 2 lines, 50% of the drug converts through the liver into an inactive form and eventually is discharged through the kidneys, the remaining 50% is discharged through the kidneys in a constant form. Because the elimination occurs in the kidneys and liver at the same level, there is no need to adjust the dose for patients with liver or kidney failure.

Conditions before treatment with bisoprolol: Patients with stable chronic heart failure without acute heart failure in the previous 6 weeks, without changing the basic treatment method in the past 2 weeks, being treated with optimal dose with enzyme inhibitors (or another vasodilat drug in case of intolerance with enzyme inhibitors), diuretics and glycoside heart support if needed.

Warning: Treatment of stable chronic heart failure with bisoprolol must be started by the increasing dose adjustment period according to the following steps:

The maximum dose is proposed as 10 mg/day. If necessary, it is possible to gradually reduce the dosage in use. Can stop treatment when necessary and reuse when appropriate. During the dose adjustment stage, if there is a more severe or non -tolerant heart failure, the first thing to do is to reduce the dose of bisoprolol or stop use immediately if needed.

In general, the treatment of stable chronic heart failure with bisoprolol is usually long -term treatment. If it is required to stop the drug, it should be reduced to half a dose per week.

liver failure or kidney failure

Treatment of hypertension or coronary disease:

No need to adjust the dose of bisoprolol in patients with mild or medium or medium degenerative kidney dysfunction. In patients with end -stage renal impairment (creatinine clearance

Treatment of stable chronic heart failure:

There is no information about Bisoprolol's pharmacokinetics in patients with chronic heart failure with liver or kidney failure. Determining the dose for these cases should be very cautious.

Old people

Often do not need to adjust the 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?

In general, when an overdose occurs, Bisoprolol should be discontinued and patients should be treated and treated with symptoms. Resticular data shows that Bisoprolol is difficult to separate.

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.

Caution when using

heart failure: Beta blockers can lead to further decline in heart muscle contraction and promote more severe heart failure. Can be used in patients with congested heart failure and only added when there is treatment for heart failure with basic drugs under the strict control of a specialist.

Patients have no history of heart failure: The continuous inhibition of myocardial muscle of beta blockers can cause heart failure. In some cases, it is possible to continue beta blocking treatment during heart failure treatment with other drugs.

Sudden stop treatment: Add severe angina or myocardial infarction, ventricular arrhythmia in patients with coronary artery disease after stopping a sudden beta blocker.

Peripheral vascular disease: Beta blockers can reduce peripheral circulation and worsen these conditions.

Bronchospasm: Use bisoprolol cautiously in patients with bronchospasm. The lowest-dose of Bisoprolol must be used and must be available for a beta-2 lubricant (bronchodilator).

Anesthesia and surgery: Especially cautious when using anesthesia to impair myocardial function such as ether, cyclospropan, tricloroethylen.

Diabetes and hypoglycemia: A warning to patients or hypoglycemia or patients who are taking insulin or hypoglycemic medications for the ability to cover the symptoms of hypoglycemia.

Armor poisoning: The beta-adrenergic blocker can cover the clinical signs of hyperthyroidism. The sudden stop of beta blockers can worsen the symptoms of hyperthyroidism or may cause thyroid storm.

Improving kidney and liver function: The dose of bisoprolol should be carefully adjusted for people with kidney failure or liver failure.

Bisoprolol may increase the sensitivity to allergens and the degree of anaphylactic reactions.

It is not recommended to use bisoprolol for children because they have no experience in using bisoprolol for children.

The ability to drive and operate machinery

In a study in patients with coronary artery disease, Bisoprolol does not affect the patient's driving ability. However, due to the different reactions in each individual, the ability to drive and operate the machine may be affected. It should be paid attention to this possibility, especially when starting treatment, when changing the dose as well as when drinking alcohol.

Pregnancy

should not use bisoprolol during pregnancy unless indicated clearly. If the treatment is necessary, it is necessary to monitor uterine perfusion, placenta and fetal development. In case of harm to the mother or fetus, it is necessary to consider changing the treatment. Babies should be carefully monitored. Symptoms of hypoglycemia and bradycardia usually occur within the first 3 days.

Breastfeeding period

The excretion of the drug in breast milk is not known. Therefore, it is not recommended to use bisoprolol during breastfeeding.

Drug interaction

Do not combine bisoprolol with other beta blockers.

Calcium blockers: may reduce myocardial spasm and slow down the atrial transmission and lower blood pressure.

Clonidine: Increases the risk of "corresponding hypertension" as well as reducing heart rate and reducing the atrial transmission if the drug is stopped suddenly.

Anti -arrhythmia group 1 (such as disopyramide, quinidine): may increase the time of the atrial transmission and reduce the heart muscle.

Anti -arrhythmia group 3 (such as amiodarone): may increase the time of atrial transmission.

Popolytic stimulants (Tacrine): Simultaneous use may increase the time of the atrial transmission and slow heart rate.

insulin and medications for oral diabetes: increase hypoglycemia.

Anesthesia: Reduce fast heart rate and increase the risk of hypotension.

Digitalis Glycoside: Reducing heart rate, increasing atrial transmission time.

Parasma stimulants: In combination with Bisoprolol can reduce the effect of both drugs.

3 -round antidepressants, barbiturate, phenothiazine and other hypertension drugs: increasing the hypotension effect of bisoprolol.

mefloquine: Increased risk of heart rate.

Rifampicin: Increases the clearance and metabolism, resulting in shortening the sale time of Bisoprolol. However, usually do not have to increase the dose.