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Mechanism of action

Selective beta1-adrenergic blocker without ISA, does not possess membrane stabilizing activity. It reduces plasma renin activity, reduces myocardial oxygen demand, reduces heart rate (at rest and under load) and cardiac output, while the stroke volume does not significantly decrease. Inhibits AV conductivity. It has antianginal and hypotensive effects. In large doses (200 mg or more) can cause blockade and beta2-adrenoreceptors mainly in the bronchi and vascular smooth muscle.

Indications and usage

Arterial hypertension, prevention of strokes.

Individual. For oral administration the daily dose is 2.5-10 mg, the frequency of administration is 1 time / day. The maximum daily dose is 10 mg.

Adverse reactions

Weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely - hallucinations), feeling cold and paresthesia in the extremities, orthostatic hypotension, bradycardia, AV conduction symptoms, symptoms of heart failure, decreased secretion of lacrimal fluid, conjunctivitis, aggravation of intermittent claudication and the main clinical symptoms of Raynaud's syndrome, diarrhea, constipation, nausea, abdominal pain, muscle weakness, muscle cramps, pruritus, sweating,hot flashes, impaired potency, reduced glucose tolerance in patients with diabetes, allergic reactions; in some cases - increased manifestations of psoriasis, the appearance of psoriasis-like lesions.
Symptoms of bronchial obstruction may occur in predisposed patients.


Chronic heart failure II B - stage III, cardiogenic shock, AV block II and III degree, SSS, sinoatrial block, bradycardia, arterial hypotension (GAD less than 90 mm Hg); a tendency to bronchospasm (bronchial asthma and other diseases with broncho-obstructive syndrome), pronounced disorders of the peripheral circulation; simultaneous administration of MAO inhibitors (with the exception of MAO-B inhibitors), hypersensitivity to Bisoprolol and other beta-blockers.

It is used with caution in concomitant psoriasis, in the presence of indications of psoriasis in the family history, diabetes mellitus in the phase of decompensation, patients prone to allergic reactions. With pheochromocytoma, use of bisoprolol is possible only after taking alpha-blockers. To prevent the sudden withdrawal of bisoprolol, the treatment should be completed slowly with a gradual decrease in dose. Before surgery, an anesthesiologist should be advised of treatment with bisoprolol.
Bisoprolol in a dose of more than 10 mg / day should be used only in exceptional cases.
Do not exceed this dose in renal failure (CC less than 20 ml / min) and severe liver dysfunction.
Not recommended for use during pregnancy, lactation, as well as in children. In exceptional cases of use during pregnancy, bisoprolol should be canceled 72 hours before the expected term of labor due to the possibility of bradycardia, hypotension, hypoglycemia and respiratory depression in the newborn. If cancellation is not possible, then the condition of the newborn must be carefully monitored within 72 hours after delivery.
During the period of treatment to prevent the use of alcohol.
It is used with caution in patients whose activity is related to the need for concentration and high speed of psychomotor reactions.
Bisoprolol may enhance the effects of other antihypertensive drugs, as well as drugs that may have a hypotensive effect. When used simultaneously with reserpine, alpha-methyldopa, clonidine, digitalis or guanfacine, pronounced bradycardia is possible. Against the background of bisoprolol intake, it is not necessary to prescribe IV Calcium channel blockers and antiarrhythmic drugs. The simultaneous intake of ergotamine derivatives may exacerbate peripheral circulation disorders. With the simultaneous use of insulin or other hypoglycemic drugs may increase their actions.

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