Description

Compound:

Bisoprolol fumarate 

Auxiliary components: microcrystalline cellulose, corn starch, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide.

Properties: Selective beta1-blocker without internal sympathomimetic activity, does not have membrane stabilizing activity. It reduces plasma renin activity, reduces myocardial oxygen demand, reduces heart rate (at rest and during exercise) and cardiac output, while stroke volume does not significantly decrease. Inhibits AV conduction. It has antianginal and hypotensive effect. In high doses (200 mg or more), it can also cause blockade of β2-adrenergic receptors, mainly in the bronchi and vascular smooth muscles. The hypotensive effect is associated with a decrease in the minute volume of blood, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (it is more important for patients with initial renin hypersecretion), restoration of sensitivity in response to a decrease in blood pressure and an effect on the central nervous system. The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in heart rate and a decrease in contractility, a prolongation of diastole, and an improvement in myocardial perfusion. The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased cAMP content, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers and a slowdown in AV conduction (mainly in the antegrade and, to a lesser extent, in the retrograde directions). through the AV node) and via additional pathways.

Indications: Arterial hypertension, prevention of angina attacks, chronic heart failure.

Dosage and administration: The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed. For oral administration, the daily dose is 2.5-10 mg, the frequency of administration is 1 time / day. The maximum daily dose is 10 mg.

Contraindications: Acute heart failure, chronic heart failure in the stage of decompensation, cardiogenic shock, collapse, II and III degree AV blockade (without a pacemaker), SSS; sinoatrial blockade, severe bradycardia (heart rate <50 beats/min), Prinzmetal's angina, marked decrease in blood pressure (systolic blood pressure <90 mm Hg), history of severe forms of bronchial asthma and COPD, late stages of peripheral circulatory disorders, Raynaud's disease , pheochromocytoma (without the simultaneous use of alpha-blockers), metabolic acidosis, simultaneous use of MAO inhibitors (with the exception of type B MAO inhibitors), children and adolescents under 18 years of age, hypersensitivity to bisoprolol and other beta-blockers.

Precautionary measures: It is used with caution in psoriasis and with indications of psoriasis in a family history, diabetes mellitus in the decompensation phase, with a predisposition to allergic reactions. With pheochromocytoma, the use of bisoprolol is possible only after taking alpha-blockers. To prevent sudden withdrawal of bisoprolol, the course of treatment should be completed slowly with a gradual decrease in dose. Before surgery, the anesthesiologist should be informed about the treatment with bisoprolol.

Side effects: From the nervous system: weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely – hallucinations), a feeling of cold and paresthesia in the extremities. From the side of the cardiovascular system: orthostatic hypotension, bradycardia, impaired AV conduction, the appearance of symptoms of heart failure, aggravation of intermittent claudication and the main clinical symptoms in Raynaud’s syndrome. On the part of the organ of vision: a decrease in the secretion of lacrimal fluid, conjunctivitis. From the digestive system: diarrhea, constipation, nausea, abdominal pain. From the musculoskeletal system: muscle weakness, muscle cramps. From the skin and subcutaneous tissues: skin itching; in some cases – increased manifestations of psoriasis, the appearance of psoriasis-like rashes. From the respiratory system: in predisposed patients, symptoms of bronchial obstruction may appear. Others: sweating, hot flashes, impaired potency, reduced glucose tolerance in patients with diabetes mellitus, allergic reactions.

Storage method: At a temperature not higher than 30 degrees. In a dry place.