Bisoprolol-Vertex, 5 mg 30 pcs.

Bisoprolol is a selective beta1-adrenoblocker without intrinsic sympathomimetic activity; it 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.

Depresses AV conduction. It has antianginal and hypotensive effects. 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) 5 mg.

How to take, the dosage

Individual.

For oral administration, the daily dose of Bisoprolol is 2.5-10 mg, and the frequency of administration is 1 time per day.

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 radiopaque IV drugs increase the risk of anaphylactic reactions.
Phenytoin in IV administration, drugs for inhaled general anesthesia (hydrocarbon derivatives) increase the severity of cardiodepressive effects and the possibility of BP reduction.

Changes the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, BP increase).

Hypotensive effect is weakened by NSAIDs (Na+ retention and blockade of Pg synthesis by kidneys), GCS and estrogens (Na+ retention).
Cardiac glycosides, methyldopa, reserpine and guanfacine, DMARDs (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of development or worsening of bradycardia, AV block, cardiac arrest and CH. Nifedipine may lead to a significant decrease in BP.
Diuretics, clonidine, sympatholytics, hydralazine and other hypotensive drugs may lead to an excessive decrease in BP.

It prolongs the effect of nondepolarizing myorelaxants and the anticoagulant effect of coumarins.

Tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and hypnotics increase CNS depression.
Concomitant use with MAO inhibitors is not recommended due to significant increase in hypotensive effect; a treatment break 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; rifampicin shortens T1/2.

Special Instructions

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

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 Bisoprolol should not be abruptly withdrawn; the course of treatment should be ended slowly with gradual reduction of the dose.

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: weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely – hallucinations), cold sensation and paresthesias in the extremities.
Cardiovascular system: orthostatic hypotension, bradycardia, impaired AV conduction, the appearance 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 extrasystoles, marked bradycardia, AV blockade, decreased BP, CHF, cyanosis of finger nails or palms, difficulty breathing, bronchospasm, dizziness, fainting, seizures.

Treatment:

Gastric lavage and administration of adsorptive drugs; symptomatic therapy:
with developed AV blockade – intravenous injection of 1-2 mg of atropine, epinephrine or placement of a temporary pacemaker;
with ventricular extrasystole – lidocaine (Class Ia drugs are not used);
with decreased BP – the patient should be in Trendelenburg position;
If there are no signs of pulmonary edema – intravenous plasma exchange solutions, if ineffective – injection of epinephrine, dopamine, dobutamine (to maintain chronotropic and inotropic action and eliminate marked BP decrease);
in CH – cardiac glycosides, diuretics, glucagon;
in convulsions – intravenous diazepam;
in bronchospasm – inhaled beta2-adrenergic stimulants.

Similarities