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Warnings

It is not known whether bisoprolol is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not use bisoprolol if you you are allergic to it, or if you have a serious heart condition such as:

• "AV block";
• severe heart failure; or
• slow heartbeats that have caused you to faint.

Interactions

Alpha2-Agonists: May enhance the AV-blocking effect of Beta-Blockers. Sinus node dysfunction may also be enhanced. Beta-Blockers may enhance the rebound hypertensive effect of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Exceptions: Apraclonidine. Consider therapy modification

NIFEdipine: May enhance the hypotensive effect of Beta-Blockers. NIFEdipine may enhance the negative inotropic effect of Beta-Blockers. Monitor therapy

Epinephrine (Racemic): Beta-Blockers (Beta1 Selective) may diminish the therapeutic effect of Epinephrine (Racemic). Monitor therapy

Food interaction

Take without regard to meals.

Pregnancy

• If you are a woman and want to have a family, discuss this with your physician so that you can be given advice about alternative treatment before you become pregnant.
• Today, its use as an oral medication is strictly controlled and accompanied by an extensive program to prevent women who use the drug from becoming pregnant.

Overview

In pharmacies, the price of BISOPROLOL, 10 mg tablets (Moscow), is 65 rubles per pack of 30 pieces.

Bisoprolol

Structure

1 tablet 2.5 mg Active ingredient: bisoprolol fumarate 2.5 mg. 1 tablet 5.0 mg Active substances: bisoprolol fumarate 5.0 mg. 1 tablet 10.0 mg Active ingredients: bisoprolol fumarate 5.0 mg.

Pharmacotherapeutic group

ATX Code

pharmachologic effect

Bisoprolol is a selective β1-blocker, without its own sympathomimetic activity, does not have a membrane-stabilizing effect. As with other β1-blockers, the mechanism of action for arterial hypertension is unclear. At the same time, it is known that bisoprolol reduces plasma renin activity, reduces myocardial oxygen demand, and reduces heart rate (HR). It has antihypertensive, antiarrhythmic and antianginal effects. Blocking β1-adrenergic receptors of the heart in low doses, it reduces the formation of cyclic adenosine monophosphate (cAMP) stimulated by catecholamines from adenosine triphosphate (ATP), reduces the intracellular current of calcium ions, inhibits all cardiac functions, and reduces atrioventricular (AV) conductivity and excitability. When the therapeutic dose is exceeded, it has a β2-blocking effect. The total peripheral vascular resistance at the beginning of the use of the drug, in the first 24 hours, increases (as a result of a reciprocal increase in the activity of α-adrenergic receptors and elimination of stimulation of β2-adrenergic receptors), after 1-3 days it returns to its original value, and decreases with prolonged use. The antihypertensive effect is associated with a decrease in minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in great activity of the sympathoadrenal system (CAS) (of great importance for patients with initial hypersecretion of renin), restoration of sensitivity in response to a decrease in blood pressure (BP) and the effect on the central nervous system. With arterial hypertension, the effect develops after 2-5 days, a stable effect is observed after 1-2 months. The antianginal effect is due to a decrease in myocardial oxygen Bicor as a result of a decrease in contractility and other myocardial functions, lengthening of diastole, and improvement of myocardial perfusion. By increasing the final diastolic pressure in the left ventricle and increasing the stretching of the muscle fibers of the ventricles, oxygen demand may increase, especially in patients with chronic heart failure (CHF). When used in medium therapeutic doses, unlike non-selective β-blockers, it has a less pronounced effect on organs containing β2-adrenergic receptors (pancreas, skeletal muscle, smooth muscles of the peripheral arteries, bronchi and uterus) and on carbohydrate metabolism; does not cause sodium ion retention in the body; the severity of the atherogenic effect does not differ from the action of propranolol.

Indications for use

- Arterial hypertension; - Coronary heart disease: prevention of angina attacks; - chronic heart failure.

Contraindications

- Hypersensitivity to bisoprolol, other components of the drug and to other β-adrenoblockers, - acute heart failure or CHF in the decompensation stage, requiring inotropic therapy, - shock (including cardiogenic), - pulmonary edema, - atrioventricular block (AV) block II-III degree, without pacemaker, - sinoatrial blockade, - sinus node weakness syndrome, - bradycardia (heart rate less than 60 beats / min.), - severe arterial hypotension (systolic blood pressure (BP) 100 mmHg), - heavy forms of br a history of onchial Bicor and chronic obstructive pulmonary disease (COPD), - severe peripheral circulation disorders, Raynaud's syndrome, - metabolic acidosis, - pheochromocytoma (without the simultaneous use of α-blockers), - simultaneous administration of monoamine oxidase inhibitors (MAO) (with the exception of MAO inhibitors) type B), - age up to 18 years (efficacy and safety have not been established), - lactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome.

Dosage and administration