Mibelet 5mg Hasan tablets treat idiopathic hypertension, heart failure (3 blisters x 14 tablets)

Dosage form Box of 3 blisters x 14 tablets
Specifications Nebivolol

Ingredient

Composition information	Content
Nebivolol	5mg

Uses

Indications

Mibelet drugs are indicated in the following cases:

Treatment of high blood pressure, can be used separately or in combination with other high blood pressure medications.

The effects of the drug include: reducing heart rate and myocardial contraction, reducing the activity of renin, and reducing peripheral vascular resistance.

pharmacokinetic

absorption

cmax average from 1.5 to 4 hours.

Distribution

The ratio attached to plasma proteins is 98%, mainly albumin.

Metabolism

mainly metabolized by glucuronid, and a less part is alkyl and oxidized by CYP2D6. These metabolites all have pharmacological effects.

Elimination

Maximum metabolites are mainly eliminated 38% in urine and 44% in feces, while the metabolites are less than 67% in urine and 13% in feces.

Before taking Mibelet 5mg Hasan tablets treat idiopathic hypertension, heart failure (3 blisters x 14 tablets)

How to use

Mibelet medicine is taken orally: Should take the drug every day at the same time.

Dosage

Hypertension treatment

The normal initial dose is 5 mg/day. The dose may be increased if necessary, up to 40 mg daily after 2 weeks.

For older patients (> 65 years old) and patients with impaired renal function of the starting dose of 2.5 mg/day. Can increase the dose of 5 mg/day if necessary.

Blood pressure treatment is effective after 1-2 weeks of treatment, sometimes the maximum effect is achieved after 4 weeks of treatment.

Treatment of chronic heart failure

Start at a dose of 1.25 mg/day. Depending on the ability to tolerate, the dose can be increased every 1-2 weeks of treatment according to the following roadmap: 1.25 mg/day; 2.5 mg/day, 5 mg/day, and up to 10 mg/day.

Must take the medication to follow the instructions of the doctor, do not stop the drug suddenly because it can make the heart failure worse.

Patients need to be closely monitored at the beginning of the treatment and each dose increases by experienced doctors.

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:

When overdose is used, the main symptoms are slow heart rate and hypotension. Other symptoms that may be encountered are heart failure, dizziness, hypoglycemia, fatigue, vomiting, bronchospasm.

Handling

Use common supportive measures (for example, active carbon) and symptomatic treatment.

Slow heart rate: Atropine intravenous treatment.

Hematoplasty: Treatment with plasma and hypertension drugs, or use glucagon if necessary.

cardiac bloc (degree 2 or 3): Patients need to be closely monitored and treated with isoproterenol. In some cases, the use of heart rate air conditioner may be necessary.

SECRETING HEART. The initial measure is to use digitalis glucosids and diuretics. In some cases, it is necessary to consider the use of vasodilators and drugs that affect the heart contractions.

Bronchospasm: Use of inhaled Beta inhalers short and/or aminophyllin.

Hypoglycemia: glucose intravenous injection or use glucagon if necessary.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

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

Common

Headache, dizziness, fatigue, itching, diarrhea, constipation, nausea, shortness of breath, hands or legs.

Slow heart rate or other cardiovascular problems, low blood pressure, visual disorders, helplessness, depression, indigestion, flatulence in thick or intestines, vomiting, rash, shortness of breath, nightmares.

Rare

faint, angioedema, psoriasis worse.

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

Mibelet drugs contraindicated in the following cases:

allergies to the ingredients of the drug.

If the patient has one of the following diseases: slow heart rate, arrhythmia, heart disease 2 or 3, loss of heart failure, impaired liver function, bronchospasm, asthma, Raynaud syndrome, metabolic acidosis.

Caution when using

Nebivolol can hide signs of tachycardia of hyperthyroidism and severe myasthenia gravis.

Matching low blood sugar warning signs (hitting chest drums, tachycardia).

This drug can worsen psoriasis.

The drug may increase allergic reactions or anaphylaxis.

The drug can increase the number of times and prolong the attack time, prinzmetal angina.

Patients who are treating for a long time with beta blockers should stop the drug slowly after 1 to 2 weeks because the sudden stopping of the drug can lead to the risk of angina, myocardial infarction, ventricular and die.

For patients with surgery and use of anesthesia, anesthesia, the use of beta blockers may reduce the risk of arrhythmia but increase the risk of lowering blood pressure or maintain heart rate. Continuing or not depends on the risk of each patient object. If you continue to use Nebivolol, it is necessary to closely monitor patients, especially when using anesthetic drugs that affect the heart muscle (cyclopropan, tricloroethylen, ether).

The ability to drive and operate machinery

There has been no study of the influence on the ability to drive and operate Nebivolol's machines. This drug can cause dizziness, dizziness due to lowering blood pressure, so do not drive or operate machines when having this side effect. This is more common than the beginning of the drug or the new dose.

Pregnancy

should not use Nebivolol for pregnant women if not really necessary because the effects may be harmful to pregnant women, fetus or infants.

Breastfeeding period

Animal studies show that Nebivolol is secreted in milk. It is unknown whether this drug is secreted through breast milk or not. So do not use nebivolol when breastfeeding.

Medicinal interaction

Calcium channel blockers (diltiazem, nifedipin, verapamil)

Nebivolol's pharmacological effects may increase by some calcium blockers. Some phenomena can occur such as low blood pressure, slow pace, heart failure. Caution should be careful when combining these two drugs and monitoring patients closely.

cimetidine

Nebivolol concentration in plasma may increase. Nebivolol dose should be adjusted if there is a suspected interaction.

Clonidin

In patients with Nebivolol, high blood pressure bowl can become more serious if the clonidine stops suddenly. Nebivolol should be stopped for a few days before stopping Clonidin. If high blood pressure occurs, continue to use clonidin or use alpha - adrenergic blockers.

CYP2D6 Inhitors (fluoxetin, paroxetin, propafenon, quinidine)

Plasma Nebivolol levels may increase, increasing the pharmacological effects and the risk of side effects of the drug. Need to monitor blood pressure and adjust the dose of Nebivolol reasonable.

digitalis glycosids

Both Digitalis Glycosids and Nebivolol slow down the atrial transmission and reduce heart rate. Simultaneous use of these two drugs can slow the heart rate, need to monitor the function and heart rate for appropriate adjustment.

disopyramid

Disopyramid's clearance may be reduced if they share beta blockers, the side effects may occur (low blood pressure, slow heart rate). Need to combine caution, monitor cardiovascular function, especially at the beginning of treatment.

guanethidin, reserpin, other beta blockers

Need to closely monitor patients because of excessive sympathetic activity that may appear. Do not share other beta blockers.

Hypergagns (insulin, sulfonylurs)

Beta blockers can hide signs of hypoglycemia, especially fast pace.

Mibefradil

The common use may increase the risk of cardiovascular toxicity, including slow heart rate, and reducing the atrioventricular activity.

nsaids (indomethacin)

This drug may reduce the hypotension effect of Nebivolol. If shared, Nebivolol's dose may be increased.

Sildenafil

Sildenafil and Nebivolol plasma concentrations may be slightly reduced if shared.

terbinafin

Plasma concentrations and pharmacological effects of Nebivolol may increase. Control heart rate and blood pressure. Adjust the dose of Nebivolol if necessary.

Storage

Where dry, less than 30 ° C. Avoid light.

Other drugs

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