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Tablete Concor 5 mai contraindicații în psoriazis de ce Updated on eMC Jun View changes Accord Healthcare Limited Contact details.
Sign up to bookmark this SPC already have an account? Find medicines with the same active ingredients. Find medicines from the same company. Qualitative and quantitative composition For 2. Each film-coated tablet contains 2. Each film-coated tablet contains 5 mg Bisoprolol fumarate For 10mg: Each film-coated tablet contains 10 mg Bisoprolol fumarate For a full list of excipients, see section 6. Pharmaceutical form Tablete Concor 5 mai contraindicații în psoriazis de ce tablet For 2.
White to off white, round, biconvex, film coated tablets, debossed 'b1' on one side and break line on other side For 5mg: White to off white, round, biconvex, film coated tablets, debossed 'b2' on here side and break line on other side For 10mg: White to off white, round, biconvex, film coated tablets, debossed 'b3' on one side and break line on other side The tablet can be divided into equal halves.
Bisoprolol fumarate tablet should be taken in visit web page and can be taken with food in morning. They should be swallowed in liquid and should not be chewed. Treatment of hypertension and chronic stable angina pectoris. The dosage should be individually adjusted.
It is recommended to start with tablete Concor 5 mai contraindicații în psoriazis de ce mg per day. The usual dose is 10 mg once daily with a maximum recommended dose of 20 mg Monti, degetele de la picioare artrita psoriazică für day.
Patients with renal impairment. This dosage may eventually be menopauzei timpul psoriazis in into halves. Patients with severe liver impairment. No dosage adjustment is required, however careful monitoring is advised. No dosage adjustment is normally required. It is recommended to start with the lowest possible dose. There is no experience with bisoprolol in children, therefore its use cannot be recommended tablete Concor 5 mai contraindicații în psoriazis de ce children.
Treatment should not be stopped abruptly see section 4. The dosage should be diminished slowly by a weekly halving of the dose. Treatment of stable chronic heart failure. Standard treatment of CHF consists of an ACE inhibitor or an angiotensin receptor blocker in case this web page intolerance to ACE inhibitorsa beta-blocker, diuretics, and when appropriate cardiac glycosides.
Patients should be stable without acute failure when bisoprolol treatment is initiated. It is recommended that the treating physician should be experienced in the management of chronic heart failure. Transient worsening of heart failure, hypotension, or bradycardia may occur during the titration period and thereafter. The treatment of stable chronic heart failure with bisoprolol requires a titration phase The treatment with bisoprolol is to be started with a gradual uptitration according to the following steps: The maximum recommended dose is 10 mg once please click for source. Close monitoring of vital signs heart rate, blood pressure and symptoms of worsening heart failure is recommended Tipuri de psoriazis de the titration phase.
Symptoms may already occur within the first day after initiating the therapy. If the maximum recommended dose is not well tolerated, gradual dose reduction may be considered. In case of transient worsening of heart failure, hypotension, or bradycardia reconsideration of the dosage of the concomitant medication is recommended. It may also be necessary to temporarily lower the dose of bisoprolol or to consider discontinuation. If discontinuation is considered, gradual dose decrease is recommended, since abrupt withdrawal may lead to acute deterioration of the patient's condition.
Treatment of stable chronic heart failure with bisoprolol is generally a long-term treatment. There is no information regarding pharmacokinetics of bisoprolol in patients with chronic heart failure and with impaired hepatic or renal function. Up titration of the dose in these populations should therefore be made with additional caution. There is no paediatric experience with bisoprolol, therefore its use cannot be recommended for children.
The treatment of stable chronic heart failure with bisoprolol has to be initiated with special titration phase see section 4. Applies to all indications: Especially in patients with ischemic heart disease the cessation of therapy with bisoprolol must not be done abruptly unless clearly indicated, because this may lad to transition worsening of heart condition See section 4. Bisoprolol must be used with caution in patients with hypertension or angina pectoris and accompanying heart failure.
Applies only to chronic heart failure: The initiation of treatment with bisoprolol necessitates regular monitoring. For posology and method of administration please See section 4. There is no therapeutic experience of bisoprolol treatment of heart failure in patients with the following diseases and conditions: Bisoprolol must be used with caution in: In bronchial asthma or other chronic obstructive lung diseases, which may cause symptoms, bronchodilating therapy is recommended to be given concomitantly.
Occasionally an increase of the airway resistance may occur read article patients with asthma, therefore the dose of beta2-stimulants may have to be increased.
Adrenaline treatment does not always give the expected therapeutic effect. It is currently recommended that maintenance beta-blockade be continued peri-operatively. The anaesthesist must be aware of beta-blockade because of the potential for interactions with other drugs, resulting in bradyarrhythmias, attenuation of the reflex tachycardia and the decreased reflex ability to compensate for blood loss.
If it is thought necessary to withdraw beta-blocker therapy before surgery, this should be done gradually and completed about 48 hours before anaesthesia. Patients with psoriasis or with a history of psoriasis should only be given beta-blockers e. In patients with phaeochromocytoma bisoprolol must not be administered until after alpha-receptor blockade.
Under treatment with bisoprolol the symptoms of a thyrotoxicosis may be masked. Effect on atrio-ventricular conduction time may be potentiated and negative inotropic effect increased. Negative influence on contractility and atrio-ventricular conduction. Intravenous administration of verapamil in patients on β-blocker treatment may lead to profound hypotension and atrioventricular block. Concomitant use of centrally acting antihypertensive drugs may worsen heart failure by a decrease in the central sympathetic tonus reduction of heart rate and cardiac output, vasodilation.
Abrupt withdrawal, particularly if prior to beta-blocker discontinuation, may increase risk of rebound hypertension. Combinations to be used with caution. Class-I antiarrhythmic drugs e.
Applies to all indications. Concomitant use may increase the risk of hypotension, and an increase in the risk of a further deterioration of the ventricular pump function in patients with heart failure cannot be excluded.
Effect on atrio-ventricular conduction time may be potentiated. Concomitant use may increase atrio-ventricular conduction time and the risk of bradycardia. Increase of blood sugar lowering effect. Blockade of beta-adrenoreceptors may mask symptoms of hypoglycaemia. Attenuation of the reflex tachycardia and increase of the risk of hypotension for further information on general anaesthesia see also section 4. Reduction of heart rate, increase of atrio-ventricular conduction time.
NSAIDs may reduce the hypotensive effect of bisoprolol. Combination with bisoprolol may reduce the effect of both agents. Combination with bisoprolol may unmask the α-adrenoceptor-mediated vasoconstrictor effects of these agents leading to blood pressure increase and exacerbated intermittent claudication.
Such interactions are considered to be more likely with nonselective β-blockers. Combinations to be considered. Enhanced hypotensive effect of the beta-blockers but also risk for hypertensive crisis.
Slight reduction of the half-life of bisoprolol due to the induction of hepatic drugmetabolising enzymes. Normally no dosage adjustment is necessary. Exacerbation of peripheral circulatory disturbances. In general, beta-adrenoceptor blockers reduce placental perfusion, which has been associated with growth retardation, intrauterine death, abortion or early labour.
If tablete Concor 5 mai contraindicații în psoriazis de ce with beta-adrenoceptor blockers is necessary, beta1-selective adrenoceptor blockers are preferable. Bisoprolol is not recommended during pregnancy unless clearly necessary. If treatment with bisoprolol is considered necessary, the uteroplacental blood flow and the fetal growth should be monitored.
In case of harmful effects on pregnancy or the fetus alternative treatment should be reccomended. The tablete Concor 5 mai contraindicații în psoriazis de ce infant must be closely tablete Concor 5 mai contraindicații în psoriazis de ce. Symptoms of hypoglycaemia and bradycardia are generally to be expected within the first 3 days. There are no data on the excretion of bisoprolol excreted in human milk.
Therefore, breastfeeding is not recommended during administration of bisoprolol. However, due to individual variations in reactions to the drug, the ability to drive a vehicle or to operate machinery may be impaired. This should be considered particularly at start of treatment and upon change of medication as well as in conjunction with alcohol.
Ear and labyrinth disorders: AV-conduction disturbances, worsening of pre-existing heart failure in patients with hypertension or angina pectoris ; bradycardia in patients with hypertension or angina pectoris.
Respiratory, thoracic and mediastinal disorders: Musculoskeletal and connective tissue disorders: Reproductive system and breast disorders: Applies only to hypertension or angina pectoris: They are generally mild and usually disappear within 1 - 2 weeks.
There is limited experience with overdose of bisoprolol, only a few cases of overdose with bisoprolol have been reported. There is a wide inter-individual variation in sensitivity to one single high dose of bisoprolol and patients with heart failure are probably very sensitive.
In general, if overdose occurs, discontinuation of bisoprolol treatment and supportive and symptomatic treatment is recommended. Based on the expected pharmacologic actions and recommendations for other beta-blockers, the following general measures may be considered when clinically warranted.
If the response is inadequate, isoprenaline or another agent with positive chronotropic properties may be given tablete Concor 5 mai contraindicații în psoriazis de ce. Under some circumstances, transvenous pacemaker insertion may be necessary. Intravenous fluids and vasopressors should be administered. Intravenous glucagon may be useful.
AV block second or third degree: Patients should be carefully monitored and treated with isoprenaline infusion or temporary pacing. Acute worsening of heart failure: Limited data suggest that bisoprolol is hardly dialysable. Beta blocking agents, selective ATC Code: C07AB07 Bisoprolol is a potent highly see more 1 -selective-adrenoceptor blocking agent, lacking intrinsic stimulating and without relevant membrane stabilising activity.
It only shows low affinity to the beta 2 -receptor of the smooth muscles of bronchi and vessels as well as to the beta 2 -receptors concerned with metabolic regulation.
Therefore, bisoprolol is generally not to be expected to influence the airway resistance and beta 2 -mediated metabolic effects. Its beta 1 -selectivity extends beyond the therapeutic dose range. In total patients were included in the CIBIS II trial.
Total mortality was reduced from A decrease in sudden death 3. Finally, a significant improvement of the functional status according to NYHA classification has been shown. During the initiation and titration of bisoprolol hospital admission due tablete Concor 5 mai contraindicații în psoriazis de ce bradycardia 0. The numbers of fatal and disabling strokes during the total study period were 20 in the bisoprolol group and 15 in the placebo group.
Patients were treated with a combination of bisoprolol and enalapril for 6 to 24 months after an initial 6 months treatment with either bisoprolol or enalapril. There was a trend toward higher frequency of chronic heart failure worsening when bisoprolol was used as the initial 6 months treatment.
Non inferiority of bisoprolol-first versus enalapril-first treatment was not proven in the per-protocol analysis, although the two strategies for initiation of CHF treatment showed a similar rate of the primary combined endpoint death and hospitalization at study end The study shows that bisoprolol can also be used in elderly chronic heart failure patients with mild to moderate disease.
Hypertension or angina pectoris: Bisoprolol is used for the treatment of hypertension and angina pectoris. As with other Beta- 1-blocking agents, the method of acting in hypertension is unclear. However, it is known that Bisoprolol reduces plasma renin activity markedly. Bisoprolol by inhibiting the cardiac beta receptors inhibits the response given to sympathetic activation. That results in the decrease of heart rate and contractility this way decreasing the oxygen demand of the cardiac muscle.
In acute administration in patients with coronary heart disease without chronic heart failure bisoprolol reduces the heart rate and stroke volume and thus the cardiac output and oxygen consumption. In chronic administration the initially elevated peripheral resistance decreases. The distribution volume is 3. The plasma elimination half-life hours provides 24 hours efficacy following a once daily dosage.
Since elimination takes place in the kidneys and the liver to tablete Concor 5 mai contraindicații în psoriazis de ce same extent a dosage adjustment is not required for patients with impaired liver function or renal insufficiency.
In patients with chronic heart failure NYHA stage III the plasma levels of bisoprolol are higher and the half life is prolonged compared to healthy volunteers. Cellulose microcrystalline Sodium starch glycolate Type-A Povidone K Silica colloidal anhydrous Magnesium stearate E Coating: Hypromellose E E Macrogol E Titanium dioxide E Talc 6. Not all pack sizes may be marketed. Any unused product or waste material should be disposed of in accordance with local requirements. Marketing authorisation holder Accord Healthcare Ltd Sage HousePinner Road North Harrow, Middlesex HA1 tablete Concor 5 mai contraindicații în psoriazis de ce United Kingdom 8.
Patient Information print SPC this link will open a new window Bookmark This Tablete Concor 5 mai contraindicații în psoriazis de ce please click for source related medicine report side effect.
Find medicines with the same active ingredients Find medicines from the same company. Name of the medicinal product 2. Qualitative and quantitative composition 3. Marketing authorisation holder 8. Marketing authorisation number s 9. Date of revision of the text. Name of the medicinal product. Film-coated tablet For 2. Treatment of Hypertension Treatment of stable chronic angina Treatment of stable chronic heart failure with reduced systolic left ventricular function in addition to ACE inhibitors, and diuretics, and optionally cardiac glycosides for additional information see section 5.
Treatment of hypertension and chronic stable angina pectoris Adults The dosage should be individually adjusted.
Patients tablete Concor 5 mai contraindicații în psoriazis de ce severe liver impairment No dosage adjustment is required, however careful monitoring is advised. Elderly No dosage adjustment is normally required.
Children There is no experience with bisoprolol in children, therefore its use cannot be recommended for children. Discontinuation of treatment Treatment should not be stopped abruptly see section 4.
Treatment of stable chronic heart failure Adults Standard treatment of CHF consists of an ACE inhibitor or an angiotensin receptor blocker in case of intolerance to ACE inhibitorsa beta-blocker, diuretics, and when tablete Concor 5 mai contraindicații în psoriazis de ce cardiac glycosides. Titration phase The treatment of stable chronic heart failure with bisoprolol requires Schnelle psoriazisul scalpului frotiu empfohlen titration phase The treatment with bisoprolol is to be started with a gradual uptitration according to the following steps: Treatment modification If the maximum recommended dose is not well tolerated, gradual dose reduction may be considered.
Special population Renal or hepatic impairment There is no information regarding pharmacokinetics of bisoprolol in patients with chronic heart failure and tablete Concor 5 mai contraindicații în psoriazis de ce impaired hepatic or renal function. Bisoprolol is contraindicated in chronic heart failure patients with: Combinations not recommended Applies only to chronic heart failure: Combinations to be used with caution Applies only to hypertension or angina pectoris: In a study with coronary heart disease patients bisoprolol did not impair driving performance.
The following definitions apply to the frequency terminology used hereafter: Skin and subcutaneous tissue disorders: The most common signs expected with overdose of a beta-blocker are bradycardia, hypotension, bronchospasm, acute cardiac insufficiency and hypoglycaemia. Bisoprolol is absorbed almost completely from the gastrointestinal tract. Preclinical data reveal no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity or carcinogenicity.
Hypromellose E E Macrogol E Titanium dioxide E Talc. Accord Healthcare Ltd Sage HousePinner Road North Harrow, Middlesex HA1 4HF United Kingdom. POM - Prescription Only Medicine. Find out more here.