Bisoprolol instructions for use
Tablets Bisoprolol belong to the therapeutic group of medicines antihypertensive drugs. Their main therapeutic effect is the reduction of systemic blood pressure, therefore this drug is used for the complex treatment of various diseases of the cardiovascular system.
Form of issue and composition
Bisoprolol is available in the form of tablets that have a round shape, biconvex surface and dividing risk in the middle for a convenient fracture in half, if necessary to reduce dosage. The main active substance of the drug is bisoprolol fumarate, which is contained in a tablet in 2 concentrations - 5 mg (tablets of light blue color) and 10 mg (have a light pink color). Also in the composition of the tablets are auxiliary substances, which include:
- Microcrystalline cellulose.
- Calcium dihydrogen phosphate.
- Corn starch.
- Silica colloidal anhydrous.
- Magnesium stearate.
- Opadrai II (contains polyvinyl alcohol, partially hydrolyzed, talc, macrogol 3350, a coloring pigment of pink color (contains titanium dioxide E 171, carmine E 120, aluminum lacquer based on indigo carmine E 132, iron oxide black E 172), or blue pigment Contains titanium dioxide E 171, aluminum lacquer based on indigo carmene E 132, aluminum varnish based on yellow quinoline E 104).
- Sodium starch glycolate (type A).
Tablets are packaged in a contour squamous package of 10 pieces. One carton can contain 3 (30 tablets), 5 (50 tablets) and 6 (60 tablets) of cell contour packs and instructions for use.
The main active substance of the drug bisoprolol fumarate is a cardioselective blocker of β 1 -adrenoceptors. It acts directly on the receptors of the heart cells, which react to adrenaline, and blocks them. Due to this bisoprolol fumarate has several pharmacological effects:
- Reducing the frequency of heart contractions - leads to a decrease in myocardial (cardiac muscle) in oxygen and a decrease in the minute volume of the heart (a decrease in the amount of blood pushed by the heart into the aorta for a minute).
- Reduction of the reaction of arterial vessels to adrenaline, due to which the tonus of their walls decreases and the diameter of the lumen increases.
These pharmacological effects of bisoprolol fumarate provide its hypotensive (lowering blood pressure) and antianginal (reducing the need for myocardium in oxygen and nutrients, thereby reducing the intensity of pain with insufficient blood flow to the heart muscle).
Bioavailability of the drug when ingested reaches 90%, the active substance is almost completely absorbed from the lumen of the small intestine into the blood. The therapeutic concentration in the blood is reached after 30-40 minutes after taking the pill inside. Bisoprolol fumarate penetrates the blood-brain barrier into the tissues of the central nervous system, through the placenta into the developing fetus during pregnancy and into breast milk during lactation. More than 95% of the active substance of the drug is excreted by the kidneys, and half of this quantity is unchanged. Partially bisoprolol fumarate is processed in the liver to intermediate decay products. Half-life (the time through which half of the entire dose of the drug is excreted from the body) is 12 hours, which makes it possible to provide therapeutic effect with bisoprolol tablets during the day.
Indications for use
Bisoprolol tablets are indicated for use in such diseases of the cardiovascular system:
- Hypertensive heart disease is a prolonged increase in systemic arterial pressure (arterial hypertension), in most cases caused by the formation of atherosclerotic plaques in the vessels with their atherosclerosis.
- Ischemic heart disease is a cardiac pathology characterized by a mismatch between the need for myocardium in oxygen and nutrients with the possibility of arterial blood vessels (coronary vessels) in ensuring this. Often manifested by angina (pain in the region of the heart compressive nature) after physical or emotional stress and arterial hypertension.
Since the drug is used for long-term therapy of cardiovascular disease, it is not used to rapidly reduce blood pressure in hypertensive crisis (a sharp and significant increase in systemic blood pressure to high figures).
Contraindications for use
The use of tablets Bisoprolol is contraindicated in a number of pathological (including diseases of the cardiovascular system) and the physiological states of the body:
- Individual intolerance or hypersensitivity to bisoprolol fumarate or excipients of the drug.
- Acute or chronic heart failure, in which there is a marked decrease in the impact and minute volume of the heart.
- Atrioventricular blockade of 2 and 3 degrees - a violation of the passage of the cardiac nerve impulse through the atrioventricular node (in this case, the use of the drug in the presence of an electrocardiostimulator).
- Syndrome of weakness of the sinus node, responsible for the generation of cardiac impulses.
- Decrease in systemic arterial pressure (arterial hypotension).
- Obstructive diseases of the respiratory system, including bronchial asthma - bisoprolol fumarate can provoke spasm (constriction) of the bronchi.
- Pathology of peripheral arteries, accompanied by their spasm - Raynaud's disease, obliterating endarteritis.
- Pheochromocytoma is a benign hormone-producing tumor of adrenal medulla that leads to an increase in the level of epinephrine in the blood.
- Metabolic acidosis is an exchange pathology in which the pH of the blood is reduced to the acidic side.
- Children under 18 years of age, pregnancy, the period of breastfeeding.
In the absence or presence of contraindications it is necessary to be convinced even before the beginning of application of tablets Bisoprolol.
Dosing and Administration
Tablets are taken orally regardless of the meal, washed down with a sufficient amount of water. Reception is carried out once a day, usually in the morning. The dosage of the drug is determined individually, depending on the underlying pathology of the cardiovascular system and the severity of the increase in systemic blood pressure. To start taking is necessary with a minimum dosage, gradually increasing it to achieve a therapeutic effect. Usually start with 2.5 mg (1/2 tablet with a dose of 5 mg), then under the control of systemic blood pressure, the dose is increased to 5 mg. If necessary, dosage can be increased to 10 mg per day in a single dose. In the absence of efficacy for individual indications, the maximum daily dose may be increased to 20 mg in one or two doses.
Tablets Bisoprolol have a pronounced effect on the entire body and can lead to the development of side effects and negative reactions from various organs and systems:
- The central nervous system - dizziness, weakness, fatigue even under the influence of small loads, headache. Sometimes you can develop insomnia, a tendency to depression (depression and decreased mood), confusion. Rarely - short-term memory loss (amnesia), hallucinations, muscle weakness, tremor of hands and paresthesia (a violation of skin sensitivity).
- Cardiovascular system - the development of arrhythmia (violation of the rhythm of contractions of the heart), arterial hypotension, aggravation of heart failure, pain in the heart.
- Organs of the senses - visual impairment, dry eyes (consequence of reduced tear fluid production), conjunctivitis (inflammation of the conjunctiva).
- The digestive system - nausea, vomiting, unstable stool (constipation or diarrhea), dry mouth, change in taste or its decrease, change in functional activity of the liver.
- Organs of the respiratory system - nasal congestion, laryngospasm or bronchospasm (especially when taking a high dose of the drug).
- Skin reaction - increased sweating, redness (hyperemia), the appearance of rashes without itching, exacerbation of psoriasis.
- Red bone marrow and blood - thrombocytopenia (decrease in the number of platelets in the blood), leukopenia (decrease in the number of leukocytes in the blood).
- Endocrine system - a decrease in the functional activity of the thyroid gland (hypothyroid condition), fluctuations in blood sugar (hyperglycemia or hypoglycemia).
- Allergic reactions - occur rarely, there may be a rash on the skin, itching, hives (a characteristic rash and swelling, reminiscent of a nettle burn). Even more rarely there are severe allergic reactions in the form of angioedema angioedema (pronounced swelling of the skin and subcutaneous tissue in the face or external genital organs) or anaphylactic shock (a progressive pronounced decrease in systemic arterial pressure and multiple organ failure).
Also bisoprolol tablets can cause pain in the lumbar region, joints (arthralgia), decreased libido (sexual attraction to the opposite sex) and potency in men. In case of occurrence of manifestations of side effects, it should be discontinued and consult a doctor.
Taking the drug is possible only after the appointment of a doctor. There are a number of special indications regarding its use, which need to be addressed:
- After the start of taking bisoprolol tablets, it is necessary to monitor the systemic blood pressure and heart rate every day for the first week, then this control is carried out once a week.
- In the case of presence of any diseases of the respiratory system, the function of external respiration is evaluated before starting the use of the drug.
- People who use contact lenses, it is desirable to use eye drops "artificial tears."
- Taking bisoprolol tablets can lead to masking a number of symptoms of the thyroid gland pathology and diabetes mellitus.
- A sharp discontinuation of the drug may lead to the development of withdrawal syndrome, which sharply increases blood pressure and tachycardia (increased heartbeats).
- Bisoprolol fumarate can interact with drugs from other pharmacological groups, so before starting taking bisoprolol tablets, you must warn your doctor about the possible use of other drugs.
- Alcohol intake is excluded, since the drug intensifies its inhibitory effect on the central nervous system.
- For pregnant women, the use of bisoprolol tablets is only possible if the expected benefit to the mother exceeds the potential risk to the fetus. During breastfeeding, the baby is taken for feeding by an artificial adapted milk formula.
- When taking the drug, special care must be taken when driving a vehicle or performing work that requires an increased concentration of attention and speed of psychomotor reactions.
In pharmacies, bisoprolol tablets are dispensed on prescription. Do not allow their own reception or on the recommendation of third parties. In case of any doubts or questions, it is advisable to consult a doctor.
Exceeding the recommended therapeutic dose may lead to the development of arrhythmia, atrioventricular blockade, a marked decrease in the rate of cardiac contractions (bradycardia), difficulty breathing and bronchospasm, an increase in manifestations of cardiac and respiratory insufficiency. In this case, detoxification measures are carried out - gastric and intestinal flushing, intravenous drip introduction of sorbing, saline solutions, symptomatic therapy.
According to the active substance, similar drugs are - Bisoprol, Biprol, Concor, Coronale, Niperten.
Terms and conditions of storage
Shelf life from the date of manufacture of the drug is 2 years. Keep in a place protected from light and moisture at an ambient temperature of no higher than + 25 ° C. Keep out of the reach of children.
Bisoprolol tablets 5 mg, 30 pcs. - 43-57 rubles.