Bisoprolol

Bisoprolol – the drug used at treatment of diseases of cardiovascular system.

Form of release and structure

Bisoprolol is issued in the form of tablets, film coated (on 10 pieces in blister strip packagings, on 1 packaging in a cardboard pack; on 30 pieces in polymeric or glass jars, after 1 bank in a cardboard pack).

Active agent – a bisoprolola fumarates, in 1 tablet – 2,5 mg, 5 mg or 10 mg.

Indications to use

Bisoprolol has anti-anginal (antiischemic) properties which are expressed in ability of drug to reduce the heart rate and contractility of a myocardium that allows to reduce the need of a myocardium for oxygen and improves its supply with blood.

Hypotensive action (reduction of arterial pressure) of Bisoprolol is caused by his ability to reduce the general peripheric resistance and to reduce cordial emission.

Bisoprolol's use allows to stop tachycardia, to oppress activity of a sympathetic nervous system, to reduce arterial pressure, to slow down atrioventricular conductivity that demonstrates antiarrhytmic effect of drug.

Active ingredient of drug is the bisoprolola fumarates. The maximum effect of this medicine is observed in 1-3 hours after oral administration and remains within a day.

Bisoprolol appoint:

• Arterial hypertension;
• Angina of exertion;
• Coronary heart disease;
• Myocardial infarction (for secondary prevention);
• Chronic heart failure.

Also drug is effective at disturbance of a rhythm (sinus tachycardia, supraventricular and ventricular premature ventricular contraction), arrhythmias against the background of a prolapse of the mitral valve, a thyrotoxicosis.

Contraindications

Contraindications to Bisoprolol's use are:

• Atrioventricular block of II and III degrees;
• Cardiogenic shock;
• Sick sinus syndrome;
• Bradycardia;
• The expressed sinuatrial blockade;
• Arterial hypotension;
• Decompensation phase at heart failure;
• Raynaud's disease, heavy disturbances of peripheric circulation;
• Obstructive respiratory diseases, including bronchial asthma;
• Simultaneous use of monoamine oxidase inhibitors;
• Pheochromocytoma;
• Psoriasis;
• Children's age up to 18 years;
• Period of pregnancy and lactation;
• Hypersensitivity to a bisopralol to a fumarat.

Care at appointment Bisoprolola is necessary at the following diseases: diabetes mellitus, metabolic acidosis, thyrotoxicosis, vasospastic stenocardia, atrioventricular block of the first degree.

Additional consultation of the doctor is required concerning Bisoprolol's use at a rigid diet and the desensibilizing (antiallergic) therapy.

Route of administration and dosage

It is recommended to accept Bisoprolol in the morning, irrespective of meal. It is necessary to swallow of tablets entirely, without chewing, washing down with water.

The mode of dosing is defined by the attending physician individually for each patient. Bisoprolol's use at stable stenocardia and arterial hypertension should be begun with 2,5-5 mg a day with the subsequent increase up to 5-10 mg, without exceeding a daily dose in 20 mg.

At chronic heart failure Bisoprolol's use is possible only the patients staying in a condition of stabilization for the last 6 weeks. Within the first week such patients accept 1,25 mg of drug of 1 times a day. The second week drug is appointed on 2,5 mg a day, the third week – on 3,75 mg, from the fourth to the eighth week – on 5 mg, from the eighth to the twelfth week – on 7,5 mg, after the twelfth week the daily dose of Bisoprolol is increased to 10 mg.

To patients with chronic heart failure after the beginning of administration of drug within the first several hours the arterial pressure, conductivity, heart rate upon compliance to norm have to be checked. If all indicators as it should be perhaps further increase in a dose if there are deviations – drug withdrawal is necessary.

The maximum daily dose of Bisoprolol makes 20 mg, however patients with heavy abnormal liver functions and the expressed renal failure should not accept more than 10 mg a day. It is necessary to cancel drug slowly, reducing a dose gradually.

Side effects

• Depression, sleep disorders, headache, dizziness, hallucinations, feeling of numbness, pricking;
• Conjunctivitis, decrease in lacrimation, vision disorder;
• Aggravation of symptoms of patients with Reynaud's syndrome or the alternating lameness (usually in an initiation of treatment);
• Bradycardia, orthostatic hypotension, disturbance of atrioventricular conductivity;
• Nose congestion, bronchospasm, asthma;
• Abdominal pain, vomiting, nausea, locks, diarrhea, increase in activity of liver enzymes in blood;
• Spasms, muscular weakness, mono - or polyarthritis;
• Enanthesis, reddenings, an itch, the increased perspiration;
• Sonitus, hair loss, short-term loss of memory, increase in body weight.

Special instructions

Bisoprolol apply with care at psoriasis (including instructions on psoriasis in the family anamnesis), a diabetes mellitus in a phase of a decompensation, predisposition to development allergic reactions.

At a pheochromocytoma administration of drug is possible only after use of alpha adrenoblockers.

Before carrying out operations it is necessary to inform the anesthesiologist of Bisoprolol's reception.

Drug should be taken with caution the patient whose work is connected with need of high concentration of attention and speed of psychomotor reactions.

Analogs

Bisoprolol's analogs are:

• On active agent – Concor, Biol, Aritel, Korbis, Bisomor, Kordinorm, Bisokard, Bisogamma, Tirez, Bidop, Biprol;
• On the action mechanism – Betak, Lidalok, Atenolol, Kordanum, Betalok, Betakard, Vazokardin, Serdol, Vero-Atenolol, Nebivator, Nebilet, Nebivolol, Egilok, Lokren, Metokard, Breviblok, Nevotenz, Metozok, Metoprolol-Acre.

Terms and storage conditions

Drug is released according to the recipe of the doctor.

Period of validity – 3 years at a temperature of storage up to 25 °C.