Bisostad 5 Stella medicine for hypertension and angina (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Bisoprolol
Ingredient High blood pressure, angina

Ingredient

Composition information	Content
Bisoprolol	5mg

Uses

indications

Bisostad 5 drugs are indicated in the case:

Bisoprolol is used in the form of fumarat in controlling hypertension and angina. The drug is also used to combine standard therapy in patients with chronic heart failure.

Pharmacokology

Pharmacological group: selective beta blockers.

Bisoprolol is a selective blockbuster Beta 1 - Adrenergic but has no membrane stability and has no effect similar to intrinsic sympathetic nerve when used within the dose of treatment.

In low doses, Bisoprolol inhibits selectively responding to adrenergic stimulation by competing for the Beta 1 - adrenergic receptor of the heart, while less acting on the beta 2 adrenergic receptor of bronchial muscles and vascular walls. With high doses, the selective properties of bisoprolol on the beta 1 receptor - Adrenergic usually drops and the drug will compete inhibiting both beta 1 and beta 2 -adrenergic receptors.

Pharmacokinetics

absorption

Bisoprolol is absorbed almost completely through the gastrointestinal tract and oral bioavailability is about 90% because the drug is less metabolized through the liver for the first time. Peak concentration in plasma is achieved from 2-4 hours after drinking.

Distribution

about 30% bisoprolol binds to plasma proteins. Bisoprolol is a moderate solute in lipid.

Metabolism and elimination

The drug is metabolized in the liver and is eliminated in the urine, about 50% of the drug in the form of intact and 50% in the form of metabolites. The drug has a semi -discharged time in plasma about 10 - 12 hours.

Before taking Bisostad 5 Stella medicine for hypertension and angina (3 blisters x 10 tablets)

How to use

Bisostad 5 is taken orally.

Dosage

Hypertension or angina

The usual oral dose of Bisoprolol Fumarat is 5 - 10 mg x 1 time/day, the maximum dose is recommended for 20 mg/day.

Sound heart failure

The starting dose of Bisoprolol Fumarat is 1.25 mg x 1 time/day. If tolerated, the dose can be doubled after 1 week and then increasing the dose slowly for about 14 weeks to the maximum dose is tolerated, should not exceed 10 mg x 1 time/day.

Dosage for patients with liver failure and kidney failure

Bisoprolol Fumarat's starting dose for patients with hypertension 2.5 mg/day and increased the dose slowly above patients with severe hepatic impairment or renal failure (creatinine clearine 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?

Symptoms

Slow heart rate, hypotension, congestive heart failure, trachea and hypoglycemia are the most common signs of beta blockers overdose.

Handling

Normally, if overdose occurs, Bisoprolol stops and conducts supportive treatment and symptomatic treatment. There are a few data that suggest bisoprolol fumarat is not separated. Based on pharmacokinetics and recommendations for other beta blockers, consider general methods after seeing clinical signs:

Slow heart rate: Atropine intravenous injection. If not responded, use isoproterenol or another drug with a strong mechanical properties carefully. In some cases, pacemaker can be placed if necessary. Glucagon intravenous injection may also be helpful. isoproterenol and/or aminophyllin. 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

When using Bisostad 5, you may experience unwanted effects (ADR).

Central nervous system: dizziness, headache, abnormalities, tactile, drowsiness, anxiety, restlessness, relief/memory.

Automatic nervous system: dry mouth. Insomnia, depression. Skin. Optical, kidney pain.

Hematology: rash.

Instructions on how to handle ADR

When ADR occurs with the above manifestations, it can be treated as cases of overdose symptoms (see overdose and treatment).

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Bisostad 5 contraindications in the following cases:

Acute heart failure or during loss of loss of heart failure requires muscle -oriented therapy.

Cardioma.

Atrial atrial clog II or III (no pacemaker).

Sinus syndrome.

Atrial sinus block.

Slow heart rate below 60 times/minute before starting treatment.

Hypotension (systolic pressure below 100 mmHg).

Severe bronchial asthma or chronic obstructive pulmonary disease.

The final stage of peripheral congestion and Raynaud syndrome.

Chromium -loving cells are not treated.

Metabolic acidosis.

Hypersensitivity to bisoprolol or any ingredients of the drug.

Be cautious when using

need to adjust the dose of bisoprolol carefully for patients with liver or kidney failure.

heart failure

Psychic stimulation is an essential component that supports circulatory function in the beginning of congestive heart failure and beta blockers can lead to further decline in cardiac contraction and promote worse heart failure.

Patients without a history of heart failure

The continuous inhibition of the heart muscle of beta blockers on some patients can cause heart failure. When there are signs and the first symptoms of heart failure, it is necessary to consider stopping the drug. In some cases, Beta blockers can continue to continue treating heart failure with other drugs.

Sudden stop treatment

Server angina and in some cases of myocardial infarction or ventricular arrhythmia in people with coronary artery disease after sudden stopping of beta blockers.

Peripheral vascular disease

Beta blockers can cause or worsen artery anemia in patients with peripheral vascular disease.

Bronchospasm

In general, patients with bronchospasm must not use beta blockers. However, due to the relatively selective properties Beta 1, caution can be used with bisoprolol in patients with bronchospasmic spasms that do not respond or unable to tolerate other anti -hypertension treatment. Because the beta 1 selection is not absolutely absolutely, the lowest bisoprolol dose is possible, and starts at a dose of 2.5 mg. There must be a Beta 2 -maneuverbate (bronchodilator).

diabetes and hypoglycemia

Beta blockers can cover the manifestations of hypoglycemia, especially tachycardia. Unstolant beta blockers may increase the level of hypoglycemia caused by insulin and slow down the recovery of serum glucose concentrations. Due to the selective properties of beta 1, this is less likely to occur with bisoprolol. However, it is necessary to warn patients or hypoglycemia, or people with diabetes using insulin or oral hypoglycemic medications for their ability and must use bisoprolol.

Thyroid hyperplation disease

Beta blockers cover the clinical signs of hyperthyroidism such as fast heartbeat.

The ability to drive and operate machinery

bisoprolol can cause unwanted effects such as drowsiness, dizziness and fatigue, which can affect the ability to drive or operate the patient's machines.

Pregnancy

There is no full and tight test in pregnant women. Bisoprolol is only used during pregnancy when proving the benefit of treatment than the potential risk to the fetus.

Breastfeeding period

Small amount of Bisoprolol was discovered in mother mouse milk. It is unknown whether or not to excrete in human milk or not. Because many drugs are excreted on breast milk, they should be cautious when using bisoprolol for women who are breastfeeding.

Medicinal interaction

Patients who are taking drugs that exhausted catecholamine such as reserpin or guanethidin, should be closely monitored because of the impact of the inhibition of beta - adrenergic can reduce the excessive sympathetic activity. In patients being treated simultaneously with clonidin, if stopped treatment, bisoprolol should be discontinued a few days before stopping clonidin.

Be cautious when using Bisoprolol simultaneously with cardiac inhibitors or atrial inhibitors, such as calcium blockers [specifically like phenylalkylamin (verapamil) and benzothiazepine (diltiazem)] or arrhythmias such as disopyramid.

Concentrated with rifampicin increases the metabolism of bisoprolol, resulting in shortening the waste time of bisoprolol. However, it is not necessary to adjust the first dose.

Risk of anaphylaxis: During the use of beta blockers, patients with a history of anaphylactic reaction with different allergens may react stronger with the use of repeated drugs, by accident, diagnosis or treatment. Such patients may not respond to conventional doses of epinephrin used to treat allergic reactions.

Storage

In closed packaging, in a dry place, avoiding light, temperatures below 30 ° C.

Expiry date: 24 months from the date of manufacture. Do not use overdue drugs stated on the packaging.

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