Bisolota 5mg medicine for high blood pressure (10 blisters x 10 tablets)

Bisoprolol has low affinity on the receptor β2 of bronchial smooth muscles and blood vessels, as well as β2 receptors that are associated with metabolic regulation. Therefore, in general, bisoprolol does not affect the transformation through the receptor intermediaries β2 and trachea. Selection on receptors β1 is wider than the dose of treatment.

pharmacokinetic

absorption

Bisoprolol is absorbed almost completely (> 90%) by oral.

The first metabolic effect only accounts for a small part (about 10%), so bioavailability is about 90%. Birth is not affected by food.

Bisoprolol has linear pharmacokinetic pharmacokinetics in the dose range of 5 - 20 mg, plasma concentration in dosage. The highest concentration in plasma is achieved after taking the drug about 2-3 hours.

Distribution

Bisoprolol is widely distributed, the distribution volume is 3.5 l/kg, combined with plasma proteins of 30%.

Metabolism

bisoprolol is metabolized by oxidation, no combined reaction later.

High polarized metabolites and are excreted through the kidneys. The metabolites in plasma and urine are not active.

According to the body test data on human microsome, Bisoprolol is mainly transformed through CYP3A4 (about 95%), a small amount transformed through CYP2D6.

Elimination

Bisoprolol is excreted through the kidneys in the form of unprovered (about 50%), the rest is metabolized through the liver and then excreted through the kidney (about 50%).

These two elimination lines are maintained at equilibrium. The total clearance of bisoprolol is about 15 l/hour. Selling time is about 10 - 12 hours.

When starting to treat chronic heart failure stability, low doses should start.

The maximum recommended dose is 10 mg/time/day. Except for the case of bad excretion reaction, the dosage for patients should be adjusted gradually to this dose and maintained at this dose.

After starting a dose of 1.25 mg of bisoprolol, patients should be monitored within 4 hours (should note blood pressure, heart rate, conduction disorders, bad signs of heart failure).

After adjusting the dose, it may also appear bad signs of heart failure, edema, low blood pressure or slow heart rate. If there is the above phenomenon, suggest to reduce the dose.

In case of really necessary, will stop using Bisoprolol, after the patient's condition has stabilized, it may consider reusing or adjusting the doses slowly.

Time to use drugs for all indications

Bisoprolol treatment is long -term treatment.

When necessary, can stop treatment, at the right time that can be used again.

When there is no discussion with a physician, it is recommended that not to stop taking the drug or change the dose, as this can lead to a temporary bad condition for the heart. Especially for patients with heart anemia, can not suddenly stop taking the drug. When it is necessary to stop taking the drug, the dose must be reduced slowly.

Patients with liver or renal failure

Treatment of hypertension or angina

Patients with hepatic or kidney failure mildly and average, no need to adjust the dose. Severe renal failure (Creatinine clearance

Treatment of chronic heart failure

There is currently no pharmacokineticocalt fluid in patients with stable chronic heart failure to use bisoprolol, and suffer from kidney failure or liver failure. Need to be especially cautious when adjusting the dose.

Elderly patients

No dose adjustment.

Special patient groups

Until now, there is no enough experience in bisoprolol treatment for patients with heart failure simultaneously: diabetes dependent insulin (type 1), kidney failure (serum creatinine ≥ 3.4 mg/100 ml), liver failure, limited myocardial disease, congenital heart disease. For mild heart failure (degree 2) and myocardial infarction in the last 3 months does not have enough experience.

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?

When suspected of overdose of Bisoprolol, please report immediately to the physician. The physician will depend on the overdose to handle. In general, when overdose, stop using bisoprolol, symptomatic treatment and supportive treatment.

According to a small amount of data, Bisoprolol is difficult to be released by hemorrhage.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting 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 drink twice as prescribed.

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.

Respiratory system

Patients with bronchial asthma or chronic obstructive pulmonary disease can combine the use of bronchodilators.

The respiratory obstacles can increase for bronchial asthma patients, which are necessary to increase the dose of stimulants β2.

Hypersensitivity reaction

As well as other beta receptors, bisoprolol can increase the level of hypersensitivity reactions. Using Adrenalin may not achieve the expected treatment effect.

Body anesthesia

If the patient wants anesthesia to the whole body, the anesthetist must notify the anesthetist about using beta blockers.

If considered necessary, stop using bisoprolol before surgery. Should reduce the dose slowly and stop taking the drug about 48 hours before anesthesia.

Chrome -preferred cells

Chromic cell patients can only use bisoprolol if alpha receptor blockers are used.

thyroid poisoning

When treated with bisoprolol, symptoms of thyroid poisoning can be hidden.

The ability to drive and operate machinery

According to the research results in patients with coronary artery disease, Bisoprolol does not affect the ability to drive and operate machinery. However, due to the physical body of each person, some people may be affected. Should be especially cautious when starting treatment, after adjusting the dose and after drinking alcohol.

Pregnancy

During pregnancy, the use of bisoprolol must be carefully assessed by the physician for benefits and risks to be used.

In general, beta blockers reduce blood flow to the placenta, so it can affect the development of the fetus. In this case, blood flow controls to the uterus and the development of the fetus. If there is a negative effect on pregnant women or fetus, physicians should consider replacing with other drugs.

Newborns need to be carefully monitored. Usually symptoms of hypoglycemia and slow heart rate may occur within 3 days.

Breastfeeding period

There is currently no document about the excretion of bisoprolol into breast milk as well as safety for children. So do not use bisoprolol for nursing women.

Medicinal interaction

The reaction and tolerance of the drug may be affected by other drugs used in time. If before taking this medication, there are other drugs in the nearest time, there may be drug interactions. If you use other drugs, please notify the physician, including those without prescribing drugs.

should not be coordinated

Treatment of stable chronic heart failure

Group I anti -arrhyths (for example, quinidin, disopyramid, lidocaine, phenytoin, flecainid, propafenon) may increase the effect of bisoprolol on atrial transmission and inhibit myocardial force.

For all indications

Verapamil -type anti -calcium -type anti -calcium (similar to diltiazem drugs, but lighter effects) reduce heart muscle contraction and atrial transmission. Especially for patients who are taking beta blockers, if using Verapamil intravenously can worsen the atrial block and hypotension.

Hematoplasty drugs acting on the central nervous system (for example, clonidin, methyldopa, moxonodin, rilmenidin) can reduce heart rate, reduce cardiac efficiency, vasodilate. If suddenly stopped using beta blockers may increase the risk of hypertension again.

Precautions when coordinating

Treatment of hypertension and angina

Group I anti -arrhyths (for example, quinidin, disopyramid, lidocaine, phenytoin, flecainid, propafenon) may increase the effect of bisoprolol on atrial transmission and inhibit myocardial force.

For all indications

Use bisoprolol simultaneously with anti -calcium anti -calcium -type dihydropyridine type (e.g. nifedipine) will increase the risk of lowering blood pressure. In addition, the risk of reduced ventricular function.

Anti -arrhythmia group III (for example, amiodaron) may increase the atrial transmission time.

Beta blockers on the spot (for example, eye drops for glaucoma) may increase the body effect of bisoprolol.

Concomitance Bisoprolol and drugs that have a strong sympathetic effect can increase the time of the atrial transmission and the risk of heart rate.

can increase the hypoglycemia of insulin and oral hypoglycemic drugs. Signs of hypoglycemia - especially tachycardia - can be hidden. Beta inhibitors are not selective easily with this interaction.

Anesthesia may increase the risk of bisoprolol's hypotension (see more information "special and cautious notes when used").

Using combination of bisoprolol and glycosid digitalis (royal monk) can increase the time of the atrial transmission, thus reducing the heart rate.

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

Beta sympathetic drugs (for example, isoprenalin, Dobutamin), used in combination with Bisoprolol, will reduce the effect of both drugs.

Concomitance bisoprolol and active drugs both Adrenergic Alpha and Beta (for example: Noradrenalin, Adrenalin) can increase blood pressure and severe regression. This interaction is common in unsatisfactory beta blockers.

Hydropherellation and drugs that are likely to lower blood pressure (for example, three -round, Barbiturat, Phenothiazin -phenothiazin inhibitors) may increase bisoprolol's hypotension.

Consider when coordinating