Concor

Bisoprolol fumarate

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

HTN/angina pectoris Initially 5 mg once daily, may be increased to 10 mg once daily. Max: 20 mg once daily. Stable chronic heart failure 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 following 4 wk, if well-tolerated increase to 7.5 mg once daily for the following 4 wk, if well-tolerated increase to 10 mg once daily for maintenance therapy. Max: 10 mg once daily.

May be taken with or without food: Take in the morning & can be taken w/ food. Swallow whole, do not chew/crush.

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

Allergic reactions. Avoid use in patients w/ obstructive airway diseases. Poorly controlled DM, strict fasting; 1st degree AV block; Prinzmetal's angina; peripheral arterial occlusive disease; psoriasis; phaeochromocytoma; thyrotoxicosis; IDDM; restrictive cardiomyopathy; congenital heart disease; haemodynamically relevant organic valvular disease; heart failure & MI w/in 3 mth. Avoid abrupt discontinuation. Concomitant general anaesth, desensitisation therapy. Severe renal & hepatic impairment. May affect ability to drive & use machines. Pregnancy. Not recommended during lactation. Not recommended in childn.

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

Increased depressant effect w/ class I antiarrhythmics eg, quinidine, disopyramide, lidocaine, phenytoin; flecainide, propafenone. Reduced heart muscle contractility & delayed AV impulse conduction w/ verapamil- & diltiazem-type Ca antagonists. Reduced heart rate & cardiac output w/ centrally-acting BP-lowering medicines eg, clonidine, methyldopa, moxonodine, rilmenidine. Increased hypotension w/ dihydropyridine-type Ca antagonists eg, nifedipine, felodipine, amlodipine. Increased inhibitory effect on AV impulse conduction w/ class III antiarrhythmics eg, amiodarone, parasympathomimetics. Additive systemic effects w/ topical β-blockers. Increased blood sugar-lowering effect of insulin or oral antidiabetics. Increased risk of cardiodepressive action w/ anaesth agents. Increased impulse conduction time & reduced heart rate w/ digitalis glycosides. Reduced BP-lowering effect w/ NSAIDs. Reduced effect w/ β-sympathomimetics eg, isoprenaline, dobutamine. Increased BP w/ sympathomimetics that activate both β- & α-adrenoceptors eg, noradrenaline, adrenaline. Increased BP-lowering effect w/ TCAs, barbiturates, phenothiazines. Increased bradycardia w/ mefloquine. Enhanced hypotensive effect w/ MAOIs.

Beta-Blockers

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

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