Bisoprolol Fumarate 2.5mg Actavis treatment for hypertension, chronic stable angina (2 blisters x 14 tablets)

In patients with angina, choosing receptors, reducing the activity of the heart thus reduces oxygen needs. Bisoprolol also has local analgesic properties like propranolol.

pharmacokinetic

bisoprolol fumarate 2.5 mg is absorbed almost completely from the digestive tract. Due to a very small amount beyond the impact in the liver, highly available, approximately 90%.

The cohesion with plasma protein is about 30%. The distribution volume is 3.1 liters/kg. The total clearance amount is approximately 15 liters/hour. Semi -cancellation time in plasma (for 10 - 12 hours) gives valid for 24 hours after the dose once a day.

Bisoprolol Fumarate 2.5 mg is eliminated in two ways, 50% is converted in the liver into non -activity metabolites and then excreted through the kidney.

50% of the maintenance dose is excreted by the renal in a constant form. Due to the same elimination in the liver and kidneys, there is no need to adjust the dose in patients with liver failure, or renal failure.

Dynamics of Bisoprolol independent of age. Patients with saline heart failure (NYHA level III) Bisoprolol concentration in plasma are higher and the semi -waste time lasts longer than healthy volunteers. The peak of plasma peaks in a stable state is 6421 ng/ml at a dose of 10 mg daily and the waste time is 17 + 5 hours.

In patients with severe kidney function (creatinine purification

Patients with severe liver failure:

Should be monitored carefully, the dose of bisoprolol should not exceed 10 mg daily.

Older patients:

No need to adjust the dosage, recommend starting with the minimum dose.

What to do when overdose?

In general, when overdose, should stop the drug, treat symptoms and support treatment. Bisoprolol re -absorption should be avoided from the digestive tract. It is recommended that gastric wash or drink absorbent (activated carbon) and laxative (sodium sulphate). Should monitor respiratory status and if needed should support ventilation. Bronchospases should treat bronchiectasis such as intravenous isoprenaline or triple stimulants.

The acute manifestations of the heart function need to be treated with symptoms: Block A - V (degree || or III) must be carefully monitored and should be treated with intravenous isoprenaline or venous pacemaker.

Slow pace should be treated with intravenous atropine (or methyldopa). Hypotension or shock should be treated with infusion and vasoconstrictor drugs.

Hypoglycemia can be treated with intravenous glucose.

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.

Be cautious when taking drugs

drugs containing bisoprolol ingredients are used to treat heart failure. Need kidney when using beta - blockers in this indication and should start with reserved dose.

The combination of bisoprolol with amiodarone is not recommended due to the risk of automatic disorders in muscle contraction and transmission, Bisoprolol must be used carefully in bronchial spasms (bronchial asthma, respiratory obstructive diseases): In asthma or chronic obstructive pulmonary diseases that can cause symptoms, should treat bronchial dilatation simultaneously.

Sometimes an increase in airway resistance can occur in asthma patients, so an increase in sympathetic medicine should be increased. Before starting treatment, it is recommended to conduct respiratory function.

Simultaneous treatment with anesthetic, respiratory anesthetic.

diabetes with a large fluctuating blood sugar level; Symptoms of hypoglycemia may be obscured. During the treatment of Bisoprolol Fumarate 2.5 mg should monitor blood sugar.

Thyroid poisoning - When treating bisoprolol, symptoms may be obscured.

Strict fasting.

As other Beta - Blockers, bisoprolol can increase the sensitive personality to the original allergies and the severity of the hypersensitivity reactions. Adrenalin usually does not work Block A - V.

Prinzmetal angina: B - blockers may increase in number and time of angina in patients with Prinzmetal angina. B - Selective Blockers can be used in medium forms and only used in combination with vasodilators.

peripheral artery disease such as Raynaud's syndrome and other evidence when the recovery; These diseases may be worse, especially during the beginning of treatment.

Patients with chromium skin tumors in the adrenal marrow, only use Bisoprolol Fumarate 2.5 mg after selecting Alpha receptors.

Patients with psoriasis or have a history of psoriasis, should only use Bisoprolol only after careful consideration of benefits and risks.

Starting for treatment with Bisoprolol Fumarate 2.5 mg needs to be monitored regularly, especially in older patients. Do not stop the drug suddenly unless indicated clearly. There is a risk of myocardial infarction and sudden death if the drug suddenly stops in patients with myocardial ischemia. This drug contains 1 active ingredient that can be tested against doping.

This drug contains 65 mg of monohydrate lactose.

The ability to drive and operate machinery

in a study with patients with coronary coronary artery disease does not affect the ability to operate the train. However, depending on the difference in the reaction to the drug in each individual, the ability to control the train or operate machinery may be affected. This should be considered especially when starting treatment and when changing the drug as well as when taking alcohol.

Pregnancy

Bisoprolol Fumarate 2.5 mg has pharmacological effects that can cause harm to pregnant women and/or fetus/infant. In general, the Beta - Blockers drugs reduce nutrition through the placenta, slow development, dying, miscarriage and premature birth.

Side effects (such as hypoglycemia and slow heart rate) can occur in fetus and infants. If you need to treat with beta blockers, you should choose the selective group of Beta1 bisoprolol fumarate 2.5 mg should not be used during pregnancy unless necessary.

If you need to treat with bisoprolol, the uterine blood flow should be monitored and the development of the fetus. It is recommended to consider the effects of damaging pregnant women or fetal fetuses. Babies must be carefully monitored. Symptoms of hypoglycemia and fast tachycardia in the first 3 days.

Breastfeeding period

It is not known whether the drug is secreted in breast milk or not, so it is not advisable to breastfeed during treatment with bisoprolol.

Special subjects

Children under 12 years old and teenagers.

There is no experience in using this drug for children, so this use is not recommended.

Drug interaction

Combining combination of contraindications:

Floctafenine: Beta - Blockers may inhibit cardiovascular compensation reactions with hypotension or shock caused by Floctafenine.

Softoprid: Should not use Bisoprolol simultaneously with sultoprid due to increased risk of ventricular arrhythmia.

Not recommended coordinates:

Calcium antagonists (Verapamil, Diltiazem, Bepridil): negative effects on muscle contraction, atrial transmission and blood pressure.

Clonidine: Increasing the risk of "hypertension" as well as reducing heart rate and heart transmission.

Monoamine oxidase inhibitors (except for Mao - b inhibitors): Increasing the lowering effect of B - Blockers but also at risk of hypertension.

Anti -arrhythmia type I (such as Quinidine, Disopyramide): can affect the atrial transmission time and increase negative muscle efficiency (clinical monitoring and ECG).

Anti -arrhythmia type III (such as amiodarone): may affect the atrial transmission time.

Calcium antagonists (such as dihydropyridine derivatives): increased the risk of hypotension. Patient patients with heart failure, treatment in combination with beta blockers can lead to heart failure.

Sympathetic drugs (including tacrine): may increase the atrial transmission time. Other B - Blockers drugs, including eye drops, increase the effect.

insulin and oral hypoglycemic drugs: increase hypoglycemia. Sympathetic beta receptors can fade the symptoms of hypoglycemia.

Anesthesia, anesthesia: Reduce reflex tachycardia and increase the risk of hypotension.

Select the beta receptor continuously reduces the risk of arrhythmia during intubation. Should notify the anesthetist when the patient is being treated with Bisoprolol Fumarate 2.5 mg.

Ergotamine derivatives: Make worse peripheral disorders.

Sympathetic nerve stimulants: combined with bisoprolol can reduce the gift of both drugs. Hypertension and excessive slow rhythm can be recorded. Higher EPINE may be necessary for the treatment of allergic reactions.

Three -round antidepressants, barbiturates, phenothiazin as well as other lowering antihypertensive drugs: increase the effectiveness of hypotension.

Rifampicin: A slightly reducing the sale time of bisoprolol may be due to the induction of the liver metabolic enzymes. Often do not need to adjust the dose.

baclofen: Increase low voltage activity.

Lodine antagonists: Beta - Blockers can inhibit clearing reactions with hypotension or shock caused by iodine antagonists.

The coordinates need to consider:

mefloquine: Increased risk of slow rhythm.

moxisylyte: may cause serious posture lowering.

Dihydropyridine antagonists such as Felodipine and Amlodipine: Use simultaneously can increase the risk of lowering blood pressure, increasing the risk of getting worse of the blood pumping function of ventricular pumping in patients with heart failure.

Central blood pressure drugs such as Clonidine and other drugs (methyldopa, moxonodine, filmenidine): Concentrated use of central impact blood pressure medications may worsen heart failure due to decreased central sympathetic tone (reduced heart rate and cardiacemia, vasoconstriction). Stop drugs, especially if stopped beta - blockers first, can increase the risk of hypertension. "

Using Verapamil intravenously on patients treated with bisoprolol can lead to Block A - V and lower blood pressure.

digitalis glycosides: Reduce heart rate, increase atrial transmission time.

Non -steroid anti -inflammatory drugs (NSAIDs): NSAIDs can reduce the lowering effectiveness of bisoprolol of sympathetic nerve stimulants B (isoprenaline, dobutamine) a combination with bisoprolol can reduce the effectiveness of both drugs.

Sympathetic nerve stimulants both B and C (Noradrenaline, Adrenaline): A combination with bisoprolol can reveal the vasoconstrictor effects related to the G -medications of these drugs, leading to hypertension and worsen the regression lame. These interactions can also be found in unsatisfactory beta blockers. Concentrated use of antihypertensive drugs as well as other drugs that are likely to lower blood pressure (tricyclic antidepressants, barbiturates, phenothiazines) may increase the risk of hypotension.