Bisoloc United medicine treats stable to moderate to severe heart failure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Bisoprolol
Ingredient United

Ingredient

Composition information	Content
Bisoprolol	2.5mg

Uses

Indications

2.5 mg Bisoloc drugs indicated the treatment of stable chronic heart failure from moderate to severe for patients with reduced ventricular systolic function (blood emulsion rate

Pharmacokological

bisoprolol is a selective inhibitor on receptor β1 - adrenergic, without membrane stability and no intrinsic stimulation activity. Bisoprolol has less affinity with β2 receptors on bronchial smooth muscles and vascular walls as well as metabolism. Therefore, Bisoprolol has little effect on gas impact and has little intermediate metabolism through receptors β2.

pharmacokinetic

bisoprolol is absorbed and biochemical about 90% after drinking. Bisoprolol binds to plasma proteins about 30%. Selling waste time in plasma from 10 - 12 hours, effective 24 hours after 1 dose 1 day. Bisoprolol is excreted through 2 lines: 50% of the drug transformed through the liver into an inactive form and eventually being 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 liver or kidney failure patients.

Before taking Bisoloc United medicine treats stable to moderate to severe heart failure (3 blisters x 10 tablets)

How to use

Should be used in the morning, can be taken with food. Should drink whole tablet with water, do not chew.

Dosage

Treatment of hypertension or coronary disease (angina):

The first usual dose is 2.5 - 5 mg, once a day. Dosage can increase to 10 mg once a day if necessary.

Treatment of hypertension or lesseeing bisoprolol is a long -term treatment. Especially in patients with local myocardial ischemia, bisoprolol should not be stopped suddenly. Dosage should be gradually reduced, ie after 1-2 weeks.

Treatment of stable chronic heart failure, added to the basic treatment:

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:

1.25 mg (half -tablet of 2.5 mg) once a day, for 1 week, if the tolerance is good, increase the dose.

2.5 mg once a day, in the next week, if the tolerance is good, the dose increases.

3.75 mg (one and a half of 2.5 mg) once a day, in the next 1 week, if the tolerance is good, the dose increases.

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

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

10 mg once a day for maintenance treatment.

After the beginning of treatment at a dose of 1.25 mg, patients should be monitored for about 4 hours (closely monitoring blood pressure, heart rate and signs of transmission disorders, symptoms of more severe heart failure).

The maximum dose is proposed as 10 mg/day. If necessary, it may gradually reduce the dose. Can stop treatment when necessary and reuse when appropriate. During the dose adjustment stage, if there is a more severe or non -tolerated 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 often long -term treatment. If it is required to stop the drug, it should be reduced to half a dose per week.

Hepatic failure or kidney failure:

Treatment of hypertension or coronary artery disease: No need to adjust the dose of bisoprolol in patients with mild or medium or renal dysfunction, in patients with end -stage renal impairment (creatinine clearance

Stable chronic heart failure: There is no information on 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.

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.

Slow heart rate: Atropine intravenous injection.

Hypotension: Using isoproterenol or an alpha -adrenerg -Adrenergic owner.

Heart Block (degree 2 or 3): careful monitoring, Isoproterenol or pacemaker.

Sound heart failure: use digitalis, diuretics, medications that increase muscle contraction, vasodilators.

Bronchospasm: Use a bronchodilator like isoproterenol and/or aminophylin.

Hypoglycemic blood glucose: glucose intravenous injection.

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

Side Effects

The common side effects of bisoprolol may include cold or numbness in limbs, nausea, vomiting, diarrhea and constipation.

Side effects such as fatigue, dizziness or headache occur, especially when starting to treat bisoprolol, these side effects are usually mild and disappear after 1 to 2 weeks of treatment.

Little side effects include muscle weakness, cramping, sleep disorders, depression, heart rate slow, heart disease disorders, more severe heart failure and lower posture. If the patient is suffering from bronchial asthma or chronic obstructive pulmonary disease, bisoprolol can cause bronchial muscle spasms but rarely.

Rare effects include hearing damage, allergic rhinitis, hepatitis, erectile dysfunction, reducing tears, nightmares, hallucinations, itching, blushing, rash, increasing liver enzymes.

Please notify your doctor the unwanted effects when taking the drug.

Warnings

Contraindicated

Bisoprolol is contraindicated for patients: acute heart failure or stages of loss of loss of intravenous injection of medications causing myocardial shrinkage; Cardioma; The atrial clog is level 2 or 3 (no pacemaker); Sinus node impairment syndrome; atrial sinus block; Slow heart rate below 50 beats/minute before starting treatment; Low blood pressure (centrifugal blood pressure is less than 100 mmHg); severe bronchial asthma or chronic obstructive pulmonary disease; Peripheral artery obstruction and raynaud syndrome are late; The adrenal glands have not been treated; metabolic acidosis; Hypersensitivity to bisoprolol or any ingredients of the drug.

Precautions when taking drugs

Heart failure:

Beta blockers can lead to a decrease in myocardial 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 with 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 carefully bisoprolol in patients with bronchospasm. The lowest -dose of Bisoprolol must be used and must be available for a beta 2 -shipping owner (bronchodilator).

Anesthesia and surgery:

Particularly cautious when using anesthesia impaired myocardial function such as ether, cyclospropan, tricloroethylen.

diabetes and hypoglycemia:

A warning to patients should be used to hypoglycemia, or patients who are taking insulin or hypoglycemic drugs for the ability to cover the symptoms of hypoglycemia.

Poisoning:

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

impaired renal and liver function:

Need to adjust the dose of Bisoprolol carefully for people with kidney failure or liver failure.

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

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 that can occur in each individual, the ability to drive and operate the machine may be affected, should pay 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 with bisoprolol 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.

Other special subjects

do not recommend using bisoprolol for children because they have no experience in using bisoprolol for children.

Drug interaction

Do not combine bisoprolol with other beta blockers.

Calcium blockers: can reduce myocardial spasm and slow down the atrial transmission and drop 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 I (such as disopyramide, quinidine): may increase the time of atrial transmission and reduce the heart muscle.

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

Sympathetic stimulants: combined with bisoproiol can reduce the effect of both drugs.

3 -round antidepressants, barbiturate, phenothiazine and other high blood pressure treatments: increase 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.

Storage

Store in a dry place, avoid light, at a temperature not exceeding 30 ° C.

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.