Bisosten

Bisoprolol fumarate

Management of HTN & angina pectoris. Adjunct to standard therapy of stable chronic heart failure.

HTN or angina pectoris 5-10 mg as single dose daily. Max: 20 mg daily. Single chronic heart failure Initially 1.25 mg once daily. Titration phase: 1.25 mg once daily for 1 wk, if well tolerated increase to 2.5 mg once daily for a further wk, if well tolerated increase to 3.75 mg once daily for a further wk, if well tolerated increase to 5 mg once daily for the 4 following wk, if well tolerated increase to 7.5 mg once daily for the 4 following wk, if well tolerated increase to 10 mg once daily for the maintenance therapy. Max: 10 mg once daily.

May be taken with or without food.

Hypersensitivity. Acute heart failure or during episodes of heart failure decompensation requiring IV inotropic therapy. Cardiogenic shock; AV block of 2nd or 3rd degree; sick sinus syndrome; SA block; symptomatic bradycardia or hypotension; severe bronchial asthma or COPD; severe forms of peripheral arterial occlusive disease or Raynaud's syndrome; untreated pheochromocytoma; metabolic acidosis.

Patients w/ pheochromocytoma w/o α-adrenoceptor blocking therapy. May mask symptoms of hyperthyroidism & hypoglycemia; unmask myasthenia gravis; aggravate psoriasis; increase the number of chest pain attacks in patients w/ Prinzmetal's angina; increase sensitivity to allergens & severity of anaphylactoid reactions. Pregnancy & lactation.

Bronchospasm, shortness of breath & dyspnea. Pneumonitis, pulmonary fibrosis & pleurisy. Headache, depression, dizziness, hallucination, confusion, amnesia & sleep disturbances including nightmares; coma & convulsions. Fatigue; paresthesia, arthralgia, myopathies including muscle cramps; reduced peripheral circulation may produce coldness of the extremities & exacerbate peripheral vascular disease eg, Raynaud's syndrome. Nausea & vomiting, diarrhea, constipation & abdominal cramping.

May potentiate AV conduction time effect & increased negative inotropic effect w/ class I antiarrhythmics (eg, quinidine, disopyramide; lidocaine, phenytoin; flecainide, propafenone). May potentiate AV conduction time effect w/ class III antiarrhythmics (eg, amiodarone). May lead to profound hypotension & AV block w/ IV verapamil. May increase risk of rebound HTN in abrupt w/drawal of centrally-acting antihypertensives eg, clonidine & others (eg, methyldopa, moxonidine, rilmenidine). May increase risk of hypotension w/ Ca antagonists of the dihydropyridine type eg, felodipine & amlodipine; TCAs, barbiturates, phenothiazines. May add to the systemic effects w/ topical β-blocking agents (eg, eye drops for glaucoma treatment). May increase AV conduction time & risk of bradycardia w/ parasympathomimetics. Increased blood sugar lowering effect & may mask symptoms of hypoglycemia w/ insulin & oral antidiabetics. Attenuate reflex tachycardia & increase risk of hypotension w/ anaesth. Reduced heart rate & increase AV conduction time w/ digitalis glycosides. May reduce hypotensive effect w/ NSAIDs. Combination w/ β-sympathomimetics (eg, isoprenaline, dobutamine) may reduce effect of both agents. May unmask the α-adrenoceptor-mediated vasoconstrictor effects of sympathomimetics that activate both β- & α-adrenoceptors (eg, noradrenaline, adrenaline). Increased risk of bradycardia w/ mefloquine. Enhanced hypotensive effect & risk for hypertensive crisis w/ MAOIs (except MAO-B inhibitors). Slight t_½ reduction w/ rifampicin. Exacerbation of peripheral circulatory disturbances w/ ergotamine derivatives.

Beta-Blockers

C07AB07 - bisoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

Rx