Domecor 2.5mg Domesco medicine for hypertension, angina, chronic heart failure (2 blisters x 14 tablets)
Dosage form Box of 2 blisters x 14 tablets
Specifications Bisoprolol
Ingredient Heart failure, high blood pressure, angina
Ingredient
| Composition information | Content |
| Bisoprolol | 2.5mg |
Uses
Indications
Domecor drugs are indicated in the following cases:
Bisoprolol is used to treat hypertension. Bisoprolol's effectiveness is equivalent to other beta blockers. Bisoprolol's mechanism of hypotension may include the following factors:
Reduces cardiac flow, inhibits renin release and reduces the impact of sympathetic nerve from vasomotor centers in the brain. But the most prominent effect of Bisoprolol is to reduce the heart frequency, both resting and at exertion.
Bisoprolol reduces the flow of the heart at a break and when exertion, accompanied by few changes in the volume of blood emul for each heart squeeze and only increases less right atrial pressure or pulmonary capillary pressure at rest and exertion.Unless there is a contraindication or an intolerant patient, beta blockers have been used in combination with enzyme inhibitors, diuretic and heart glycosides to treat heart failure due to left ventricular dysplasia, to reduce progressive heart failure.
The good effect of beta blockers in the treatment of congested heart failure is mainly due to inhibiting the effects of sympathetic nervous system. Using long -term beta blockers, as well as passive inhibitors, can reduce symptoms of heart failure and improve clinical status of people with chronic heart failure.
These good effects have been shown in people who are taking a transferred inhibitor, showing the inhibitor of the reheating of the Renin - Angiotensin system and the sympathetic nervous system are plus effects.
pharmacokinetics
bisoprolol is almost completely absorbed through the digestive tract. Because only in initial metabolism is very small, oral bioavails are about 90%.
After drinking, the peak concentration in plasma is reached from 2 to 4 hours. About 30% of the drug attaches to plasma proteins. Food does not affect the absorption of the drug. Sell waste time in plasma from 10 to 12 hours.
Bisoprolol is moderately dissolved in lipids. Metabolic drugs in the liver and excretion in urine, about 50% in constant form and 50% in the form of metabolites.
In the elderly, the sale time in plasma is slightly longer than young people, although the average plasma concentration in a stable state increases, there is no significant difference in the accumulation of bisoprolol among young people and the elderly.
In people with creatinine clearance coefficient below 40 ml/minute, plasma disposal time increases about 3 times higher than normal people.
In people with cirrhosis, the rate of excretion of Bisoprolol changes more and lower is significant than normal people (8.3 - 21.7 hours).
Before taking Domecor 2.5mg Domesco medicine for hypertension, angina, chronic heart failure (2 blisters x 14 tablets)
How to use
Take domecor with water. Should drink in the morning, can drink at meals. Do not chew the tablet.
Dosage
The dose of Bisoprolol Fumarat must be determined for each patient and calibrated depending on the response of the disease and tolerance of the patient, usually at least 2 weeks apart.
Treatment of hypertension and angina
Should adjust the dose for each patient. Adults start the starting dose usually use 2.5 - 5 mg, 1 time/day. The usual dose is 10 mg x 1 time/day, up to 20 mg/day.
Patients with impaired renal function
For patients with severe renal failure (creatinine clearance
Patients with liver function impaired
Do not use more than 10 mg/day for patients with severe liver failure.
Treatment of stable chronic heart failure
The conditions before treatment with bisoprolol are:
Treatment must be monitored by a cardiologist. Treatment of chronic heart failure with bisoprolol must start with a dose adjustment period, the dose is gradually increasing according to the following diagram:
1 week 1: 1.25 mg x 1 time/day, if the tolerance is good to increase the dose.
week 2: 2.5 mg x 1 time/day, if tolerated well, increased.
Week 3: 3.75 mg, 1 time/day, if the intake is well increased.
week 4 - 7: 5 mg x 1 time/day, if tolerated well, increased.
week 8 - 11: 7.5 mg x 1 time/day, if tolerated well, increased.
week 12: 10 mg x 1 time/day for maintenance treatment.
After starting the first dose of 1.25 mg, the patient must be monitored within 4 hours (especially monitoring blood pressure, heart frequency, conduction disorders, severe signs of heart failure). The maximum dose recommends 10 mg x 1 time/day.
Chronic stable heart failure usually has to be treated for a long time. Do not stop treating suddenly or changing the dose without consulting the doctor because this can make the heart failure temporarily. Especially for patients with ischemic heart anemia, it is not advisable to stop treatment suddenly. If it is necessary to stop treatment, the dose should be reduced slowly.
impaired renal or liver function
There is no information about Bisoprolol's pharmacokinetics in patients with chronic heart failure with liver or kidney function. Increasing dose in these patients should be careful.
Stop medicine
Do not stop the drug suddenly. Should stop the drug gradually by reducing half a weekly dose.
Old people
No need to adjust the dose. Should start with the lowest dose possible.
Children under 12 years old and teenagers
Not used due to insufficient clinical data.
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? Observed the slow heart rate and/or hypotension. In some cases, medications have been like sympathetic nerve and all patients recovered.
Signs of overdose due to beta blockers include slow heartbeat, hypotension and sleep, if severe delirium, coma, convulsions and respiratory extra stops. Sound blood failure, bronchospasm and hypoglycemia may occur, especially in people who have diseases in these organs.
Handling
If an overdose occurs, bisoprolol must be stopped, supported treatment and symptoms. Bisoprolol cannot be separated.
Slow heart rate: Atropine intravenous injection. If the response is incomplete, caution can be used with isoproterenol or another drug that increases the heart rate. In some cases, temporary pacemaker places to stimulate the rhythm.
Hypotension: intravenous fluid and use of hypertension (isoproterenol or an alpha-adrenergiconor. An intravenous glucagon can be used.
Heart Block (two or three): Careful monitor the patient and Isoproterenol infusion or pacemaker placing, if appropriate.
SECRETING HEART: Take common measures (use digitalis, diuretics, medications that increase muscle contraction, vasodilators).
Bronchospasm: Use a bronchodilator like isoproterenol and/or aminophylin.
Hypoglycemic blood glucose: glucose intravenous injection.
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.
Side Effects
When using 2.5 mg domecor drug, you may experience unwanted effects (ADR).
CommonLess
Rare
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.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Domecor 2.5 mg contraindicated drug in the following cases:
Precautions when using
heart failure
Parasma 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 heart muscle contraction and promote more severe heart failure. However, in some patients with congested heart failure, compensation may need this medication. In this case, the medication must be used carefully. The drug is only added when it has been treated for heart failure with basic drugs (diuretics, digitalis, inhibiting enzymes) under the strict control of a specialist.
For patients without heart failure
The continuous inhibition of the heart muscle of beta blockers can cause heart failure. When there are signs or first symptoms of heart failure, it is necessary to consider stopping bisoprolol. In some cases, Beta blockers may continue to be treated while treating heart failure with other drugs.
Sudden stop treatment
Heavy angina and in some cases, myocardial infarction or ventricular arrhythmia in people with coronary artery disease after a sudden stopping of beta blockers. The patient must not stop the drug without the advice of a physician. Even for patients with unknown coronary artery disease, it is advisable to gradually reduce Bisoprolol for about a week under the careful monitoring of a physician.
Peripheral vascular disease
Beta blockers can worsen the symptoms of artery failure in people with peripheral artery inflammation. Be cautious for this patient.
Bronchospasm
Patients with bronchospasm must not use beta blockers. However, due to the relatively selective nature of Beta1, bisoprolol can be used in patients with bronchospasms that do not respond to or unable to tolerate other anti -hypertension treatment. Because of the absolute beta1 selection, the lowest possible Bisoprolol dose of Bisoprolol must be used, starting at a dose of 2.5 mg and in combination with a Beta1 fortunist (bronchodilator).
Anesthesia and surgery
If it is necessary to continue treating with bisoprolol near surgery, it is necessary to be especially cautious when using anesthesia to impair myocardial function such as Ether, Cyclopropan and Triclorethylen.
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 nature of Beta1, this is less likely to occur with Bisoprolol. However, it is necessary to warn patients or hypoglycemia or diabetes who are taking insulin or oral hypoglycemic drugs for these possibilities and must be used carefully.
thyroid poisoning
Beta - adrenergic blockers can cover the clinical signs of hyperthyroidism such as tachycardia. The sudden stopping of beta blockers can worsen the symptoms of the thyroid function or may promote the storm.
impaired renal and liver function
Need to adjust the dose of bisoprolol carefully for patients with kidney or liver failure.
Be cautious about taking drugs in cases of allergic treatment, prinzmetal angina, patients or families with a history of psoriasis.
The ability to drive and operate machinery
studies in coronary coronary patients show that Bisoprolol does not affect the patient's driving ability. However, due to the difference in each individual, the ability to drive and operate machinery may be affected. It should be noted this possibility when starting treatment, when changing the dose as well as when drinking alcohol.
Pregnancy
only use bisoprolol for women during pregnancy if the benefits are higher than the risk that may occur for the fetus.
Breastfeeding period
Whether Bisoprolol is excreted in breast milk or not. Because many drugs are excreted on breast milk, it is necessary to be cautious when using bisoprolol for women who are breastfeeding.
Drug interaction
flocfenin
Beta blockers can hinder the cardiovascular compensation reaction accompanied by hypotension or shock caused by flocfenin.
Sultoprid
Do not use bisoprolol in combination with sultoprid due to increased risk of ventricular arrhythmia.
Do not combine bisoprolol with other beta blockers. Need to closely monitor patients taking drugs that consume catecholamine such as reserpin or guanethidin, because the increased beta - adrenergic blocker effect can cause excessive decrease in sympathetic activity. In patients treated simultaneously with clonidin, if needed to stop treatment, bisoprolol should be stopped for many days before stopping clonidin.
It is necessary to be careful to use bisoprolol when used simultaneously with myocardial inhibitors or inhibitors of atrial conductivity - ventricular as some antagonistic drugs, especially belonging to phenylalkylamin groups (verapamil) and benzothiazepine (diltiazem) or anti -arrhythmic drugs such as disopyramid, quinidine, lidocaine, phenytoin, fleecainid, fleecainide, fleecainid, fleecainid, fleecainid, fleecainid, fleecainid, fleecainid, fleecainid, fleecainide Propafenon, Amiodaron.
The simultaneous use of rifampicin increases the clearance of bisoprolol metabolism, resulting in shortening the sale time of bisoprolol. However, usually not the first dose adjustment.Risk of anaphylactic reaction
While using 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 adrenaline doses often used to treat allergic reactions.
Simultaneous use of Bisoprolol with sympathetic nerve stimulants can increase the time of atrial transmission and increase the risk of slow heart rate.
insulin and oral diabetes drugs increase hypoglycemic effects. Beta blockers can obscure the signs of hypoglycemia.
Anesthesia
Reduces the tachycardia and increases the risk of hypotension.
digitalis
Reduce heart rate, increase the atrial transmission time.
Non -steroid anti -inflammatory drugs (NSAIDs)
can reduce the hypotension effect of bisoprolol.
Sympathomas Beta (Isoprenaline, Dobutamine)
Simultaneous use with bisoprolol may reduce the effects of both drugs.
Parolic drugs act on both adrenal receptors Alpha and Beta (Noradrenaline, Adrenaline)
Use with Bisoprolol may not lose the effect of vasodilation through the adrenal receptor alpha of these drugs that leads to hypertension and worsen hypertension. These interactions should be considered more with unsatisfactory beta blockers.
Using antihypertensive drugs with other drugs that lower blood pressure (3 -round antidepressants, barbiturates, phenothiazin) may increase the risk of hypotension.
mefloquin
Increased risk of heart rate.
monoamine oxidase inhitors (except for Mao-B inhibitors)
Increase the hypotension effect of beta blockers but may also be at risk of hypertension.
Use bisoprolol with food and drinks
Bisoprolol's hypotension effect increases when used with alcohol.
Storage
Store in a dry place, temperatures below 30 ° C, avoid moisture and light.
Expiry date: 36 months from the date of manufacture. Do not use overdue drugs stated on the packaging.
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