Saviprolol 5 medicine for hypertension, angina (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Bisoprolol

Ingredient

Composition information	Content
Bisoprolol	5mg

Uses

indication

Prolol Savi 5 is indicated in the following cases:

Treatment hypertension .

Treatment of angina.

Treatment Chronic heart failure stable, from moderate to severe, accompanied by reducing the function of the left ventricular ventricular use with enzyme inhibitors, diuretic and maybe with cardiac glycosides. This indication is made by a specialist. With low doses, Bisoprolol inhibits selectively responding to adrenalin stimulation by competing receptor β1 adrenalin of the heart, but has little effect on receptor β 2 adrenalin of bronchial muscles and vascular walls. With high doses (for example, 20 mg or more), the selective properties of bisoprolol on receptors β1 usually decrease and the drug will compete inhibiting both receptors β1 and β2.

bisoprolol is used to treat hypertension. Bisoprolol's effectiveness is equivalent to other beta blockers.

The mechanism of lowering the hypotension of Bisoprolol may include the following factors: Reducing cardiac flow, renal inhibitors releasing renin and reducing the impact of sympathetic nerves from vascular 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, and only increases less right atrial pressure or pulmonary capillary pressure at rest and at exertion. Unless there is a contraindication or an intolerant, beta blockers have been used in combination with transferred 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 congestive heart failure is mainly due to inhibition of the effects of sympathetic nervous system. Using long -term beta blockers, as well as transferred inhibitors, can reduce heart failure symptoms and improve the clinical condition of people with chronic heart failure. These good effects have been shown in people who are taking a transferred inhibitor, showing the inhibition of the coordination of the renin-angiotensin system and the sympathetic nervous system are plus effects.

pharmacokinetic

absorption

Bisoprolol is almost completely absorbed through the gastrointestinal tract. And only through the initial metabolism is very little, so orally via oral about 90%. After drinking, the peak concentration in plasma is reached from 2 to 4 hours. Food does not affect the absorption of the drug.

Distribution

About 30% of the drug attaches to plasma proteins.

Metabolism and elimination

Half lifetime elimination in plasma from 10 to 12 hours. Bisoprolol dissolves moderate in lipid. Metabolic drugs in the liver and excretion in urine, about 50% in constant form and 50% in the form of metabolites.

In the elderly, half a lifetime elimination 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 between young and elderly people.

In people with creatinine clearance ratio below 40 ml/minute, half -life plasma increases about 3 times compared to 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 Saviprolol 5 medicine for hypertension, angina (3 blisters x 10 tablets)

How to use

Prolol Savi 5 is used orally.

Dosage

The dose of Bisoprolol Fumarat must be determined for each patient and calibrated depending on the patient's response and the patient's tolerance, usually at least 2 weeks apart.

Adults

To treat hypertension and angina

The first usual dose is 2.5 - 5 mg, once a day. Because the selection of Beta1 blockers (β1) adrenergic of bisoprolol fumarat is not absolute (selective selection decreases when increasing the dose), caution must be used for patients with bronchial spasms, and start treatment at 2.5 mg doses a day. The starting dose can also be suitable for other patients. If the dose of 5 mg is not effective, it may increase the dose to 10 mg, and then, if necessary, it may gradually increase the dose to be tolerated to a maximum of 20 mg, once a day.

Treatment of chronic heart failure

Patients with chronic heart failure must be stable, there is no exacerbation within 6 weeks and must be treated with an enzyme inhibitor in the appropriate dose (or with another vasodilator in the event of an inhibitor of transferred inhibitors) and a diuretics and/or sometimes with a digitan, before bisoprolol treatment. Treatment has not changed much in the last 2 weeks before using bisoprolol.

The 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:

1.25 mg/1 time/day (taken in the morning) for 1 week. If tolerated, dose increased:

2.5 mg/day per day for 1 week; If tolerated well, increase:

5 mg/day/day for 4 weeks later; If tolerated well, increase:

7.5 mg/day/day for 4 weeks later; If tolerated well, increase:

10 mg/day/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, signs of severe heart failure).

Maximum doses recommend: 10 mg/day/day.

The adjustment dose is not clinically, but according to the level of tolerance to the target dose. In some patients, the side effects may appear, so it is impossible to achieve the maximum recommended dose. If necessary, the dose must gradually reduce. In case of necessity, it is necessary to stop treatment, then continue treatment again. During the dose adjustment period, when the heart failure worsens or is not tolerated, the dose must be reduced, even stopped immediately if needed (severe blood pressure, severe heart failure accompanied by acute pulmonary edema, heart shock, bradycardia or atrial - ventricular heartbeat).

Treatment of chronic heart failure with Bisoprolol is a long -term treatment, not sudden stop, which can worsen the heart failure.

If it is necessary to stop, reduce the dose gradually, divide the dose half a week.

kidney failure or liver failure in people with chronic heart failure

There is no dynamic data on pharmacokinetics. Must be very careful to increase the dose in this patient.

Elderly

No need to adjust the dose.

Children

There is no data. Unsired for children.

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 using overdose? Observed the slow heart rate and/or hypotension. In some cases, drugs have been used as sympathetic nerve effects and all patients have recovered. Signs of overdose due to beta blockers include slow heartbeat, hypotension and sleep, and if severe, delirium, coma, convulsions and respiratory arrest. Sound blood failure, bronchospasm and hypoglycemia may occur, especially in people who have diseases in these organs.

If an overdose occurs, bisoprolol stops and support treatment and symptoms. There are a few data that suggest Bisoprolol Fumarat 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 drugs. An intravenous glucagon can be used.

Heart block (degrees two or three): careful monitoring of patients 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 aminophyllin.

Hypoglycemic blood glucose: glucose intravenous injection.

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 Prolol Savi 5 , you may experience unwanted effects (ADR).

Bisoprolol is well tolerated in most patients. Most unwanted effects are mild and temporary. The proportion of patients who need to stop treatment due to unwanted effects is 3.3% for patients using bisoprolol and 6.8% for patients using Placebo.

Common, ADR> 1/100

digestive: diarrhea , vomiting.

common: weakness, fatigue.

Uncommon, 1/1000

skeletal muscle: joint pain.

TKTW: Reduce sensation, difficulty sleeping.

Cardiovascular: Slow heart rate .

Digestive: Nausea.

Respiratory: Difficulty breathing.

general: chest pain, peripheral edema.

Instructions on how to handle ADR

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

Prolol Savi 5 contraindicated in the following cases:

Patients with heart shock.

severe Reynaud syndrome.

sensitive to bisoprolol.

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.

With patients without a history of heart failure

The continuous inhibition of the heart muscle of beta blockers 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, it is possible to continue beta blocking treatment during heart failure treatment with other drugs.

Stop sudden treatment. Heavy angina and in some cases, myocardial infarction or ventricular arrhythmia in people with coronary artery disease after a sudden stop of beta blockers. Therefore, it is necessary to remind these patients to not stop taking the drug without the advice of a physician. Even for patients with unknown coronary artery disease, it is recommended to gradually reduce Bisoprolol for about a week under the careful monitoring of a physician. If the symptoms of cessation occur, the drug should be used at least for a period of time.

Peripheral vascular disease

Beta blockers can worsen the symptoms of artery failure in people with peripheral artery inflammation. Be cautious for these patients.

Bronchospasm

In general, patients with bronchospasm must not use beta blockers. However, due to the relatively selective properties Beta1 (β1), caution can be used with bisoprolol carefully in patients with bronchospasms that do not respond to or can not be used with other anti -hypertension treatment. Because of the selection of β1, not absolute, the lowest Bisoprolol dose must be used and started at 2.5 mg. There must be a Beta2 transport owner (bronchiectasis).

Anesthesia and surgery

If you need to continue treating with bisoprolol near surgery, you must be particularly cautious when using anesthesia to impair myocardial function, such as ether, cyclopropan and tricroethylen.

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 beta, this is less likely to occur with bisoprolol. However, a patient should be warned or hypoglycemia or diabetes patients taking insulin or oral hypoglycemic medications for these possibilities and must be used carefully.

thyroid poisoning

The beta-adrenergic blocker 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 renal failure or liver failure.

The ability to drive and operate machinery

No impact.

Pregnancy

only use bisoprolol for women during pregnancy if the likelihood of justified benefits is possible for the risk of pregnancy.

Breastfeeding period

whether Bisoprolol is excreted in human milk or not. Because many drugs are excreted in human milk, it is necessary to be cautious when using bisoprolol for women who are breastfeeding.

Drug interaction

Do not combine bisoprolol with other beta blockers. Need to closely monitor patients using drugs that consume catecholamine, such as reserpin or quanethidin, because the increase in the effect of beta - adrenergic blocker 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. Caution should be used to use bisoprolol when used simultaneously with cardiomyopathy inhibitors or atrioventricular inhibitors, such as some calcium antagonists, especially belonging to phenylalkylamine groups (Verapamil) and benzothiazepine ( diltiazem ), or anti -arrhythmic drugs, such as Disaseramid. The simultaneous use of rifampicin increases the clearance of bisoprolol metabolism, resulting in shortening the half -life of Bisoprolol. However, usually not the first dose adjustment.

Risk of anaphylactic reaction: While using beta blockers, patients have a history of anaphylactic reaction with different allergens that may react more strongly to the use of repeated drugs, due to accidental, diagnosis or due to treatment. Such patients may not respond to epinephrin doses often used to treat allergic reactions.

Storage

In the dry place, the temperature does not exceed 30 ° C. Avoid light.

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