Maxxprolol 2.5 ampharco medicine for hypertension, heart failure, angina (10 blisters x 10 tablets)

Therefore, generally Bisoprolol has no effect on respiratory resistance and metabolic processes through beta intermediaries). However, the selective properties on the heart are not absolutely absolutely, and at higher doses (≥ 20 mg) Bisoprolol Fumarat also inhibits the betapadrenergic receptor receptor, mainly on bronchial muscles and blood vessels. Thus, the lowest dose is required to maintain the selection on the heart.

Bisoprolol has no activity to reduce myocardial contraction (negative inserrope).

During the acute treatment of patients with coronary artery disease without chronic heart failure, Bisoprolol reduces the pace of finding and the volume of squeezing leads to reducing blood pressure complex and oxygen consumption. In prolonged treatment of peripheral resistance increases at first, it will decrease.

Bisoprolol inhibits response to adrenergic sympathetic activity by blocking the beta1 receptors in the heart. This leads to slow heart rate and reducing contractions, thus reducing oxygen consumption in the heart muscle. This is the expected effect in patients with angina and coronary artery disease. Its mechanism of hypotension has not been completely determined. Relevant groups may include:

More than 90 % of Bisoprolol dose by oral is absorbed in the digestive tract. The absorption does not depend on food. The first metabolic impact ≤ 10% so the absolute bioavailability of the drug is about 90%.

Distribution:

about 30% bisoprolol binds to plasma proteins. The distribution volume is 3.5 l/kg. Total clearance is about 15 l/hour. The drug has a semi-discharged time in plasma for 10-12 hours for 24 hours after one-time dosage of the day.

Metabolism and elimination:

Bisoprolol is excreted from the body through two sectors of equal excretion with 50% metabolized in the liver into non -active metabolites and 50% of non -metabolic drugs are eliminated through the kidneys. Because the elimination in the kidneys and liver takes place at the same level, it is generally not necessary to adjust the dose for patients with liver or kidney failure. The pharmacokinetics of Bisoprolol are linear and regardless of age.

In patients with chronic heart failure (classification of phase III), the concentration of bisoprolol in plasma is higher and the semi -cancellation time is prolonged compared to healthy volunteers. The maximum concentration in plasma is stable 64+21 ng/ml at a dose of 10 mg per day and the half -life is 17+5 hours.

Recommended monitoring of survival signs (heart rate, blood pressure) and symptoms of heart failure deteriorating during the dose period. Symptoms may occur on the first day of treatment.

For some patients, the 2.5 mg Bisoprolol Fumarat dose may be sufficient for maintenance treatment.

Dosage adjustment during treatment: If the patient does not tolerate the dosage to maximize, it is necessary to consider reducing the dose gradually. In case of heart failure, fleeting, lowering blood pressure, or a slow heart rate, it is necessary to reconsider the dose of combined drugs. Lower doses may be taken temporarily or consider stopping bisoprolol. Only reuse and/or increase the dose of bisoprolol when the patient stabilizes. If the drug is needed, patients should be recommended to reduce the dose gradually, because the sudden stopping of the drug can lead to the health condition of the patient deteriorating.

Treatment of chronic heart failure with bisoprolol is generally long -term treatment.

Special cases

Hepatic failure or renal failure: There is no information related to Bisoprolol's pharmacokinetics in patients with chronic heart failure and accompanied by liver or renal failure. Therefore, it should be noted when detecting increasing dose in these patients.

Older patients: Normally do not need dose.

Children: Inexperienced using bisoprolol in children, so it is not recommended to use this drug for children.

In general, if overdose occurs, bisoprolol must be discontinued and started treatment and symptomatic treatment. There are a few data that suggest bisoprolol is difficult to separate. Based on the pharmacological effects that may occur and recommendations for other beta blockers, the following measures should be taken if clinically required:

Notify the doctor with adverse effects encountered when taking the drug.

Be cautious when using

heart failure: Stimulating sympathetic nerves is an essential component that supports circulatory function in the beginning of congestive heart failure, and beta blockers can lead to additional cardiac contraction and promote more severe heart failure. In general, avoid using beta blockers for patients who show congestion. However, these drugs may be used in some patients with heart failure. In this case, the medication must be used carefully.

Patients with a history of heart failure: Celestic inhibition of myocardial with beta blockers can promote more heart failure in some patients. When the first symptoms of function or entity of the heart failure, it is advisable to consider stopping the use of bisoprolol fumarat. In some cases, Bisoprolol may continue to be used while heart failure is treated with other drugs.

Sudden stop treatment: The outbreak of angina and in some cases, myocardial infarction or ventricular arrhythmia has been recorded in patients with coronary artery disease after stopping treatment with beta blockers. Therefore, it is necessary to remind these patients to not be interrupted or stop taking this drug without a doctor's advice. Even for patients who have not manifested coronary artery disease, it is advisable to advise patients to gradually reduce treatment with Bisoprolol Fumarat for about a week with a careful monitoring of a doctor. If the symptoms of cessation occur, the drug should be used again, at least temporarily for a period of time.

peripheral vascular disease: Beta blockers can cause or worsen artery anemia symptoms in patients with peripheral vascular disease. Be cautious for these patients.

Bronchospasm: In general, patients with bronchospasm should not use beta blockers. However, due to the relative selection of beta1, caution can be used with bisoprolol fumarat for patients with bronchospasm without responding or intolerant to other hypertension medications. Because the selection of beta1 is not absolutely absolutely, the lowest possible Bisoprolol Fumarat dose of Bisoprolol Fumarat and the beginning of treatment is at 2.5 mg. There must be a Beta2 motorbike owner (bronchodilator).

Surgery: Do not stop treating with long -lasting beta blockers before the regular surgery; However, the ability to respond to the heart with impaired sympathetic reflex stimulation can increase the risks of systemic anesthesia and surgical procedures.

diabetes and hypoglycemia: Beta blockers can cover some manifestations of hypoglycemia, especially tachycardia. Unstolant beta blockers can increase the level of hypoglycemia caused by insulin and slow down the recovery of serum glucose levels. Due to the selection of beta1, this is less likely to occur with Bisoprolol Fumarat. However, patients are prone to hypoglycemia or patients with diabetes using insulin or oral hypoglycemic drugs should be noted about these possibilities and should be carefully used Bisoprolol Fumarat.

thyroid poisoning: Beta blockers can cover clinical symptoms of hyperthyroidism such as tachycardia. Suddenly stopping beta blockers may cause outbreaks of hyperthyroidism or may promote the storm.

The effect of the drug on driving and operating machinery

In a study of coronary artery disease, patients using Bisoprolol without driving impairment. However, due to different changes in the drug reactions in each individual, the ability to drive or operate machines may be impaired. This should be paid special attention when starting to treat Bisoprolol and when changing the drug as well as drinking with alcohol.

Using drugs for women during pregnancy and lactation

Pregnancy:

Bisoprolol (beta blockers) reduce the perfusion of the placenta related to the fetal retardation in the uterus, the fetus is stored in the uterus, miscarriage or early labor. Side effects (such as hypoglycemia and slow heart rate) can occur to the fetus and babies. If it is necessary to treat with beta blockers, selective beta blockers are preferred. Bisoprolol is not recommended during pregnancy unless necessary.

If it is necessarily treatment with bisoprolol, uterine blood flow monitoring, placenta and fetal growth. In case of side effects that are harmful to the mother or fetus, it is necessary to consider alternative treatments. Babies must be closely monitored. Symptoms of hypoglycemia and slow heart rate can usually occur within the first 3 days of birth.

Breastfeeding period:

It is unknown whether bisoprolol is excreted in human milk or not. Therefore, it is not recommended for breastfeeding during treatment with bisoprolol.

Drug interaction