|The name of the preparation||Character; dose; package||Manufacturer||Price 100%||Price after refund||In which pharmacy?|
|Bisopromerck 10||coated tablets; 10 mg; 30 tabl.||Merck||14.99||Check|
Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.
A drug from the beta-blocker group that reduces the heart rate and its contraction force, and lowers blood pressure.
The active substance is Bisoprolol . It is a substance belonging to a group of medicines called beta-blockers (another name is beta-blockers). These drugs work by blocking certain types of receptors, called beta adrenergic receptors. These are receptors stimulated in physiological conditions by adrenaline or noradrenaline released after the activation of the sympathetic nervous system. The pharmacological blockade of beta receptors prevents them from being stimulated, thereby reducing the effects of adrenaline or noradrenaline on target tissues with beta receptors. Adrenaline increases the heart rate and spasm of the blood vessels. The effect of bisoprolol, like other drugs in this group, leads to a reduction in the rate of heart rhythm and the strength of its contraction, decreased ejection volume and to lower blood pressure. Bisoprolol is selective for beta 1 receptors, which means, inter alia, that it does not usually cause narrowing of the airways dependent on the beta 2 receptors located in the bronchial smooth muscle.
The preparation is indicated for the treatment of:
• ischemic heart disease.
Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients. You can not use the preparation if you are present:
• acute heart failure as well as in periods of worsening heart failure requiring intravenous inotropic treatment
• cardiogenic shock
• second or third degree atrioventricular block in patients without a pacemaker (pacemaker)
• syndrome of a sick sinus node
• sinoatrial block
• symptomatic bradycardia
• symptomatic hypotension
• severe bronchial asthma or severe COPD (chronic obstructive pulmonary disease)
• advanced stage of peripheral arterial occlusive disease or Raynaud's syndrome
• metabolic acidosis
• untreated phaeochromocytoma.
The preparation should not be used during pregnancy unless in the opinion of the doctor it is absolutely necessary (bisoprolol may have a detrimental effect on the course of pregnancy, fetal and neonatal development). The preparation is contraindicated during breast-feeding.
Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Do not suddenly stop using the preparation, especially in people with ischemic heart disease. If treatment is required, the dose should be gradually reduced as prescribed by your doctor. Abrupt cessation of bisoprolol therapy may lead to worsening of disease symptoms.
Caution should be used if the product is used in patients with arterial hypertension or angina pectoris and with concomitant heart failure; patients should remain under careful medical supervision.
It should be under the strict supervision of a doctor and be careful when using the preparation:
• in people with an increased risk of bronchoconstriction (patients with bronchial asthma or other obstructive airways disease, in this group of patients an increase in resistance in the airways may occur and the use of bronchodilators in parallel, and sometimes a transient increase in their doses, according to doctor's instructions)
• in patients with diabetes (the preparation may mask the symptoms of hypoglycaemia, such as palpitations, increased heart rate (tachycardia) or sweating, blood Glucose should be closely monitored)
• during a strict diet
• during desensitization treatment (the preparation may increase sensitivity to allergens and exacerbate Anaphylactic reactions and reduce the effectiveness of adrenaline used in such cases)
• in patients with first degree atrioventricular block
• in patients with vasospastic angina (Prinzmetal)
• in the case of peripheral arterial occlusive disease (symptoms may increase, especially in the initial period of application)
• in case of general anesthesia (if you plan any surgery requiring anesthesia, please inform your doctor that you are taking beta blockers due to the risk of serious interactions with other medicines, if necessary, your doctor will recommend a gradual reduction of the dose leading to a complete discontinuation of the drug 48 hours before the planned general anesthesia).
If you suspect or diagnose psoriasis, please inform your doctor. Before starting treatment with psoriasis, the physician will consider the benefit / risk ratio and will in each case individually decide whether treatment with bisoprolol can be started.
In patients with pheochromocytoma of the adrenal gland, treatment to block alpha-adrenergic receptors is necessary before and during treatment.
The preparation may mask symptoms of hyperthyroidism, including increased heart rate (tachycardia).
Does this preparation affect the ability to drive vehicles?
The preparation, depending on individual response to treatment, may impair the ability to drive vehicles and operate equipment / machines. This effect may occur especially at the beginning of treatment, during dose escalation, when the preparation is changed into another medicine and if alcohol is consumed during the treatment period.
The preparation is in the form of coated tablets. It is intended for oral use. The tablets should be taken in the morning, with or without a meal, with liquid. Do not chew tablets. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Hypertension and ischemic heart disease: the doctor will set the dose individually. Usually 5-10 mg per day are used. The maximum dose is 20 mg per day.
Treatment is long-lasting. Do not stop the treatment suddenly. If cessation of treatment is required, the dose should be gradually reduced by following the doctor's instructions. Abrupt cessation of bisoprolol therapy may lead to worsening of disease symptoms.
No dose adjustment is required in patients with mild or moderate renal or hepatic impairment. In patients with severe renal impairment (creatinine clearance less than 20 ml / min) or liver, the 10 mg daily dose should not be exceeded.
There is insufficient clinical experience regarding the use of the preparation in patients undergoing hemodialysis; there is no evidence for the need to modify the dosage.
Elderly patients do not need to adjust their dosage.
There are insufficient data on the safety and efficacy of the preparation in children and its use is not recommended in this age group.
During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
Bisoprolol may have a detrimental effect on pregnancy, fetus and newborn development. The preparation must not be used during pregnancy unless in the opinion of the doctor it is absolutely necessary. If the physician considers the use of the preparation to be strictly necessary, he will recommend appropriate precautions and necessary check-ups.
The use of the preparation is contraindicated during breast-feeding.
Tell your doctor about all medicines you have recently taken, including those that are over the counter.
It is not recommended to use the preparation in parallel with:
• Calcium antagonists, from the group of Verapamil and diltiazem, due to the effect on weakening myocardial contraction force and inhibition of AV conduction and risk of significant hypotension (intravenous verapamil by a beta-blocker can cause severe hypotension and atrial block) chamber)
• central antihypertensive drugs (eg clonidine, methyldopa, Moxonidine , rylmenidine) due to the risk of decreased heart rate and minute capacity as well as vasodilation and worsening of heart failure; in addition, the risk of a significant increase in blood pressure (possibly life-threatening) after a sudden discontinuation of the use of this drug during the beta-blocker period
• Class I antiarrhythmics (quinidine, disopiramid, Lidocaine , phenytoin, flecainide, propafenone) - the risk of worsening the disruption of the atrioventricular conduction and the weakening of the contraction force of the myocardium.
Caution should be exercised if the preparation is used in parallel with:
• Class III antiarrhythmics, such as: Amiodarone - risk of worsening of the atrio-ventricular conduction
• calcium antagonists from the dihydropyridine group (eg Nifedipine , Amlodipine , felodipine ) - risk of hypotension and further worsening of symptoms in patients with heart failure
• topical beta-blockers, such as, for example, eye drops used to treat glaucoma - the risk of increasing the systemic effect of the preparation
• parasympathomimetic drugs (acetylcholinesterase inhibitors, including tacrine) - the risk of worsening of the atrio-ventricular conduction and reduction of heart rate (bradycardia)
• insulin and oral antidiabetic agents - hypoglycemic effects may be exacerbated (beta-blockers, including bisoprolol, may mask the symptoms of hypoglycaemia)
• preparations used for general anesthesia - cardiodepressive action of both drugs may occur and significant hypotension may occur (the anaesthesiologist should be advised to the use of beta-blockers)
• digitalis glycosides - the risk of worsening of atrio-ventricular conduction and reduction of heart rate (bradycardia)
• non-steroidal anti-inflammatory drugs - the anti-hypertensive effect of beta-blockers, including bisoprolol, may be reduced
• sympathomimetic drugs that act on beta receptors (eg isoprenaline, dobutamine) - risk of mutual impairment of drug action
• sympathomimetic drugs that act on the alpha and beta receptors (adrenaline, noradrenaline) - the risk of increased blood pressure and worsening of intermittent claudication symptoms
• antihypertensive drugs and other drugs that may lower blood pressure (tricyclic antidepressants, barbiturates, phenothiazine derivatives, baclofen, amifostine) - the risk of increased antihypertensive effect and hypotension
• mefloquine - the risk of reducing the heart rate (bradycardia)
• monoamine oxidase inhibitors (MAO inhibitors) - intensification of antihypertensive effect as well as risk of hypertensive crisis that is life-threatening
• rifampicin - the risk of weakening the effects of bisoprolol
• ergotamine derivatives - possible worsening of peripheral circulation disorders.
Like all medicines, Bisopromerck 5, -10, it can cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Common: headache and dizziness, nausea, vomiting, diarrhea, constipation, abdominal pain, feeling cold or numbness in the extremities, intensification of concomitant intermittent claudication, severity of Raynaud's symptoms, fatigue, clinical fatigue and exhaustion (asthenia). Uncommonly possible: increased heart failure, decreased heart rate (bradycardia), atrioventricular conduction disturbances, bronchospasm in patients with bronchial asthma or obstructive pulmonary disease, muscle weakness, muscle spasms, orthostatic hypotension (associated with a change in body position), depression, sleep disorders. Rarely: fainting, decreased tear secretion (this is particularly important for people using contact lenses), impaired hearing, allergic rhinitis, allergic reactions (rash, pruritus, redness), the occurrence of antinuclear antibodies, hepatitis, increased triglycerides, increased activity liver enzymes (AST, ALT), reduced blood glucose (hypoglycaemia), sexual dysfunction, nightmares, hallucinations. Very rare: conjunctivitis, alopecia, worsening of psoriasis symptoms, rash similar to psoriasis.
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