* Bisocard:
Superior beta-1 selectivity.
– Guarantees 24-hour coverage.
– No change in AWR in COPD patients or smokers.
– No effect on lipid profile or glucose tolerance.
* Indications:
– Management of hypertension, used alone or in combination with other anti-hypertensive agents.
Management of angina pectoris.
* Contraindications:
As with other beta-blockers, Bisocard should not be used in cases of untreated cardiac failure,
cardiogenic shock, sinoatrial block, second or third degree atrioventricular block, marked bradycardia
or extreme hypotension or severe asthma, severe peripheral arterial disease.
* Precautions:
Pregnancy, breast-feeding, myasthenia gravis; patients with a history of hypersensitivity reactions.
– Bisoprolol, as a cardioselective beta-blocker, is less likely to induce bronchospasm in patients with asthma,
Caution to be taken with patients suffering from asthma or history of obstructive airways disease.
As well, it does not appear to have a hypoglycaemic effect but caution with diabetic patients since
symptoms of hypoglycaemia may be masked.
– Avoid abrupt withdrawal especially in angina, as it may cause an exacerbation of angina & therefore gradual
reduction of dose is preferable when beta blocker is to be stopped.
* Dosage & administration:
# Adults: for hypertension & angina:
– Individualise dosage. May be given without regard to meals.
Initial dose: 5 mg once daily. In some patients, 2.5 mg may be appropriate. If the antihypertensive effect of
5 mg is inadequate, the dose may be increased to 10 mg & then, if necessary, to 20 mg once daily.
# Renal/hepatic function impairment:
In patients with renal dysfunction (creatinine clearance < 40 ml/min) or hepatic impairment (hepatitis or cirrhosis),
Use an initial daily dose of 2.5 mg & use caution in dose titration. The dosage should not exceed 10 mg daily.
# Elderly:
Dose adjustment is not necessary, 5 mg daily may be adequate in some elderly patients; as for other adults,
the dosage may have to be reduced in cases of severe renal or hepatic dysfunction.
# Children:
Its administration to children is not recommended, as safety is not yet established.
* Store at room temperature not exceeding 30 degrees C, in a dry place, Away from light and humidity.
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