Bisoprolol-SZ tablets coated. 5 mg film, 50 pcs. (Bisoprolol)

Release form

film-coated tablets.

Packing

50 pcs.

Pharmacological action

Bisoprolol is a selective beta1-blocker without internal sympathomimetic activity, does not have membrane-stabilizing activity. Bisoprolol reduces plasma renin activity, reduces myocardial oxygen demand, reduces heart rate (at rest and during exercise) and cardiac output, while the shock volume does not significantly decrease. Inhibits AV conduction. It has antianginal and hypotensive effects. In high doses (200 mg or more), it can cause blockade and 2-adrenoreceptors mainly in the bronchi and in the smooth muscles of blood vessels.

Contraindications

Hypersensitivity to bisoprolol, other components of the drug and other beta-blockers, acute heart failure or chronic heart failure in the decompensation stage, requiring inotropic therapy shock (including cardiogenic) pulmonary edema pulmonary sinus block syndrome weakness syndrome and III degree without pacemaker bradycardia (heart rate less than 60 beats / min.) severe arterial hypotension (systolic arteries Flax pressure (BP) 100 mm Hg. Art. ) severe forms of bronchial asthma and chronic obstructive pulmonary disease (COPD) in the history of pheochromocytoma (without the simultaneous use of alpha-adrenergic blocking agents) difficult to control diabetes mellitus late stages of peripheral circulatory disturbance (including Raynaud's syndrome refractory hypokalemia, hyponatremia, hypercaemia, hyperkaemia monoamine oxidase inhibitors (MAOs) (except for type B MAO inhibitors) up to 18 years of age (efficacy and safety not established) intolerance l actoses, lactase deficiency or glucose-galactose malabsorption.

Special instructions

Monitoring of patients taking bisoprolol should include monitoring of heart rate and blood pressure (daily, then once every 3-4 months at the beginning of treatment), ECG, blood glucose in patients with diabetes mellitus (1 time in 4 -5 months). In elderly patients, it is recommended to monitor renal function (1 time in 4-5 months). After starting treatment of heart failure in a dose of 1. 25 mg, the patient should be examined for 4 hours (heart rate, blood pressure, ECG).

The patient should be trained in the method of calculating heart rate and instructed on the need for medical advice for heart rate less than 50 / min.

Before starting treatment, it is recommended to study the function of external respiration in patients with a history of bronchopulmonary burden.

In approximately 20% of patients with angina pectoris, beta-blockers are ineffective. The main causes are severe coronary atherosclerosis with a low threshold for ischemia (heart rate less than 100 / min) and increased BWW of the LV, which violates the subendocardial blood flow. In smokers, the effectiveness of beta-blockers is lower.

Patients using contact lenses should consider that tear fluid production may be reduced during treatment.

When used in patients with pheochromocytoma, there is a risk of developing paradoxical hypertension (unless effective alpha-adrenoblockade is previously achieved).

With thyrotoxicosis, bisoprolol may mask certain clinical signs of thyrotoxicosis (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated, since it can enhance symptoms.

With diabetes, it may mask tachycardia caused by hypoglycemia. In contrast to non-selective beta-blockers, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose to normal values.

With the simultaneous administration of clonidine, its administration can be stopped only a few days after the cancellation of bisoprolol.

Composition

1 tablet contains bisoprolol (in the form of a fumarate) 5 mg.

Dosage and administration

Inside, in the morning on an empty stomach, without chewing, with a small amount of liquid.

With arterial hypertension and coronary heart disease (prevention of attacks of stable angina pectoris), it is recommended to take 5 mg once. If necessary, increase the dose to 10 mg 1 time / day. The maximum daily dose is 20 mg.

In patients with impaired renal function (creatinine clearance less than 20 ml / min) or with severe impaired liver function, the maximum daily dose is -10 mg.

Dose adjustment in elderly patients is not required.

Side effects of

From the side of the central nervous system and peripheral nervous system: weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely hallucinations), a feeling of cold and paresthesia in the limbs.

From the cardiovascular system: orthostatic hypotension, bradycardia, impaired AV conduction, the appearance of symptoms of heart failure, worsening intermittent claudication and the main clinical symptoms in Raynaud's syndrome.

From the side of the organ of vision: decreased secretion of lacrimal fluid, conjunctivitis.

From the digestive system: diarrhea, constipation, nausea, abdominal pain.

From the musculoskeletal system: muscle weakness,

Drug Interactions

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 drugs for iv administration increase the risk of anaphylactic reactions.

Phenytoin with iv administration, drugs for inhalation general anesthesia (hydrocarbon derivatives) increase the severity of cardiodepressive action and the likelihood of a decrease in blood pressure.

Changes the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, increased blood pressure).

Antihypertensive effect weaken NSAIDs (delay Na + and blockade of Pg synthesis by the kidneys), GCS and estrogens (delay Na +).

Cardiac glycosides, methyldopa, reserpine and guanfacine, BMKK (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV block, heart failure and heart failure. Nifedipine can lead to a significant decrease in blood pressure.

Diuretics, clonidine, sympatholytics, hydralazine and other antihypertensive drugs can lead to an excessive decrease in blood pressure.

Extends the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.

Tri- and tetracyclic antidepressants, antipsychotic drugs (antipsychotics), ethanol, sedative and hypnotic drugs increase CNS depression.

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

Non-hydrogenated ergot alkaloids increase the risk of peripheral circulation disorders.

Ergotamine increases the risk of peripheral circulatory disorders Rifampicin shortens T1 / 2.

Overdose

Symptoms: arrhythmia, ventricular extrasystole, severe bradycardia, AV block, decreased blood pressure, heart failure, cyanosis of fingernails or palms of the nails, shortness of breath, bronchospasm, dizziness, fainting, convulsions.

Treatment: gastric lavage and administration of drug-adsorbing drugs symptomatic therapy:

with developed AV block - iv administration of 1-2 mg atropine, epinephrine or temporary pacemaker

for ventricular extrasystole - lidocaine (Ia class drugs are not used)

with lowering blood pressure - the patient should be in the Trendelenburg position

if there are no signs of pulmonary edema, - iv plasma-replacing solutions, if ineffective - the administration of epinephrine, dopamine, dobutamine (to maintain chronotropic and inotropic effects action and elimination of a marked decrease in blood pressure)

in heart failure - cardiac glycosides, diuretics, glucagon

for convulsions - iv diazepam

for bronchospasm - beta2-adrenostimulators inhaled.

Storage conditions

In a dry, dark place at a temperature not exceeding 25 ° C. Keep out of reach of children.

The Expiration of

is 3 years.

active substance

bisoprolol

Conditions of release from drugstores

Prescription

lekarstvennaja form

tablets

Prescribing

For Adults prescribed by a doctor

Indications

Indications

Indications

Arrhythmia, Hypertension, Heart failure

North Star, Russia



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