Bisoprolol-Vertex, 10 mg 30 pcs.

Bisoprolol is a selective beta1-adrenoblocker without intrinsic sympathomimetic activity and has no membrane-stabilizing activity.

Bisoprolol decreases plasma renin activity, decreases myocardial oxygen demand, decreases HR (at rest and during exercise) and cardiac output without significantly decreasing stroke volume. It suppresses AV conduction.

It has antianginal and hypotensive effect. In high doses (200 mg and more) it can also cause blockade of β2-adrenoreceptors mainly in bronchi and in vascular smooth muscle.

Indications

Arterial hypertension, prevention of angina attacks.

Active ingredient

Composition

1 tablet contains bisoprolol (in fumarate form) 10 mg.

How to take, the dosage

The dosing regimen is individualized.

For oral administration the daily dose of Bisoprolol is 2.5-10 mg, the frequency of administration is once daily.

The maximum daily dose is 10 mg.

Interaction

Allergens used for immunotherapy or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol.

Iodine-containing intravenous radiopaque drugs increase the risk of anaphylactic reactions.

Phenytoin when administered by IV, drugs for inhaled general anesthesia (hydrocarbon derivatives) increase the severity of cardiodepressive effects and the likelihood of BP reduction.

Alter the effectiveness of insulin and oral hypoglycemic drugs, mask the symptoms of developing hypoglycemia (tachycardia, increased BP).

Decreases clearance of lidocaine and xanthines (except diphylline) and increases their plasma concentrations, especially in patients with initially increased clearance of theophylline under the influence of smoking.

The hypotensive effect is weakened by NSAIDs (Na+ retention and blockade of prostaglandin synthesis by the kidneys), GCS and estrogens (Na+ ion retention).

The cardiac glycosides, methyldopa, reserpine and guanfacine, slow calcium channel blockers (verapamil, diltiazem), amiodorone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV blockade, heart failure and heart failure.

Nifedipine may cause a significant decrease in BP.

Diuretics, clonidine, sympatholytics, hydralazine, and other hypotensive drugs may cause excessive BP lowering.

Longens the effects of nondepolarizing myorelaxants and the anticoagulant effect of coumarins.

Tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and sleeping pills increase CNS depression.

The concomitant use with MAO inhibitors is not recommended due to the significant increase in hypotensive effect; a break in treatment between MAO inhibitors and bisoprolol should be at least 14 days.

Unhydrogenated ergot alkaloids increase the risk of peripheral circulatory disorders.

Ergotamine increases the risk of peripheral circulatory disorders; sulfasalazine increases the plasma concentration of bisoprolol; and rifampicin shortens the elimination half-life.

Special Instructions

With caution, use in psoriasis and with indications of psoriasis in family history, decompensated diabetes mellitus, predisposition to allergic reactions.

In pheochromocytoma, bisoprololol may be used only after taking alpha-adrenoblockers. Bisoprolol should not be abruptly withdrawn; the course of treatment should be ended slowly with gradual dose reduction.

Contraindications

Chronic heart failure stages II B – III, cardiogenic shock, AV-blockade of II and III degree, CCSU, sinoatrial block, bradycardia, arterial hypotension (systolic pressure less than 90 mm Hg.

B: susceptibility to bronchospasm (bronchial asthma and other diseases with bronchoobstructive syndrome), significant disorders of peripheral circulation, concurrent use of MAO inhibitors (except for MAO type B inhibitors), hypersensitivity to bisoprolol and other beta-adrenoblockers, pregnancy and lactation.

Side effects

CNS and peripheral nervous system disorders: weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely – hallucinations), cold sensation and paresthesias in the extremities.

Cardiovascular system disorders: orthostatic hypotension, bradycardia, AV conduction disorders, occurrence of symptoms of heart failure, worsening of intermittent claudication and basic clinical symptoms in Raynaud’s syndrome.

Eye: decreased tear fluid secretion, conjunctivitis.

Digestive system: diarrhea, constipation, nausea, abdominal pain.

Musculoskeletal system: muscle weakness, muscle cramps.

Overdose

Symptoms:

Arrhythmia, ventricular extrasystole, marked bradycardia, AV blockade, marked BP decrease, chronic heart failure, cyanosis of finger or palm nails, difficulty breathing, bronchospasm, dizziness, fainting, seizures.

Treatment:

Gastric lavage and administration of adsorbents; symptomatic therapy: if AV blockade developed – IV injection of 1-2 mg of atropine, epinephrine, or placement of a temporary pacemaker; if ventricular extrasystole – lidocaine (Class IA drugs are not used ); if BP decreases – the patient should be in the Trendelenburg position; If there are no signs of pulmonary edema – IV plasma exchange solutions, if ineffective – injection of epinephrine, dopamine, dobutamine (to maintain chronotropic and inotropic action and to eliminate marked BP decrease); in heart failure – cardiac glycosides, diuretics, glucagon; in convulsions – IV diazepam; in bronchospasm beta-adreno stimulants inhaled.

Similarities