Concore

Bisoprolol fumarate

2.5, 5 & 10 mg tab: Treatment of stable chronic heart failure w/ reduced systolic left ventricular function in addition to ACE inhibitors & diuretics & optionally cardiac glycosides. 5 & 10 mg tab: High BP (HTN) & CHD (angina pectoris).

HTN or angina pectoris Initially 5 mg once daily, may be increased to 10 mg once daily. Max recommended dose: 20 mg once daily. Stable chronic heart failure Standard treatment of CHF consists of an ACE inhibitor, a β-blocker, diuretics & when appropriate cardiac glycosides. Patients should be stable (w/o acute failure) when bisoprolol is initiated. Recommended starting dose: 1.25 mg once daily. Depending on individual tolerance, the dose is increased to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg & 10 mg once daily, in intervals of 2 wk or longer. Max of 10 mg once daily.

May be taken with or without food: Take in the morning. Swallow w/ some liqd, do not chew.

Hypersensitivity to bisoprolol; acute heart failure or during episodes of heart failure decompensation requiring IV inotropic therapy; cardiogenic shock; 2nd or 3rd degree AV block w/o pacemaker; sick sinus syndrome; SA block; symptomatic bradycardia & hypotension; severe bronchial asthma, peripheral arterial occlusive disease or Raynaud's syndrome; pheochromocytoma; metabolic acidosis.

DM w/ extremely fluctuating blood glucose levels (hypoglycemia), strict fasting, ongoing desensitization therapy, 1st-degree AV block, Prinzmetal's angina, peripheral arterial occlusive disease; increase sensitivity to allergens & severity of anaphylactic reactions; psoriasis; may mask symptoms of thyrotoxicosis; patients w/ pheochromocytoma. W/draw bisoprolol 48 hr prior anesth. Patient w/ obstructive airways disease. IDDM, severely impaired renal or hepatic function, restrictive cardiomyopathy, congenital heart disease, hemodynamically significant organic valvular disease, MI w/in the last 3 mth. Ability to drive a vehicle or to use machines may be impaired. Pregnancy & lactation. Not recommended for childn.

Bradycardia (in patients w/ chronic heart failure). Worsening of pre-existing heart failure (in patients w/ chronic heart failure); dizziness, headache; GI complaints eg, nausea, vomiting, diarrhea, constipation; feeling of coldness or numbness in the extremities, hypotension especially in patients w/ heart failure; asthenia (in patients w/ chronic heart failure), fatigue.

Potentiated effect on AV conduction time & increased -ve inotropic effect w/ class IA antiarrhythmic drugs (eg, quinidine, disopyramide, lidocaine, phenytoin, flecainide, propafenone). Profound hypotension & AV block w/ IV administration of verapamil. Decrease the central sympathetic tonus & thus lead to the reduction of heart rate & cardiac output & vasodilatation w/ concomitant use of centrally-acting antihypertensive drugs (eg, clonidine, methyldopa, moxonidine, rilmenidine). Increased risk of hypotension w/ concomitant use of Ca antagonists of dihydropyridine type (eg, felodipine & amlodipine) & other drugs w/ BP-lowering potential (eg, TCAs, barbiturates, phenothiazines). Potentiated effect on AV conduction time w/ class III antiarrhythmic drugs (eg, amiodarone). Added systemic effects w/ topical β-blockers (eg, eye drops for glaucoma treatment). Increased effect on AV conduction time & risk of bradycardia w/ parasympathomimetic drugs, cardiac glycosides (digitalis). Increased blood-sugar lowering effect of insulin or oral antidiabetic drugs. Attenuation of the reflex tachycardia & increased risk of hypotension w/ anesth agents. Reduced hypotensive effect w/ NSAIDs. Reduced effect of β-sympathomimetics (eg, isoprenaline, dobutamine). Increased BP & exacerbated intermittent claudication w/ non-selective β-blockers (eg, norepinephrine, epinephrine). Increased risk of bradycardia w/ mefloquine. Risk for hypertensive crisis w/ MAOIs (except MAO-B inhibitors). Slight reduction of t_½ w/ rifampicin. Exacerbation of peripheral circulatory disturbances w/ ergotamine derivatives. May enhance toxic effect of salicylates in high dose administration.

Beta-Blockers

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

Rx