Aritel tabs 10mg #30

Aritel instruction

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Composition

In 1 tablet of bisoprolol fumarate 5 mg or 10 mg.
Potato starch, povidone, hypromellose, lactose, silicon dioxide, cellulose, magnesium stearate, talc, - as auxiliary substances.

Form of issue

Tablets in a film coat of 5 mg and 10 mg.

pharmachologic effect

Hypotensive, antiarrhythmic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Highly selective β1-blocker. Has hypotensive and antiarrhythmic effect. Reduces the frequency of cardiac contractions (with exercise and at rest), its need for oxygen, cardiac output, inhibits excitability and conductivity. OPSS in the first day of use of the drug increases, then returns to the original, and decreases with long-term admission.
Hypotensive effect is associated with depression of the renin-angiotensin system and a decrease in the minute volume of blood.
The antianginal effect is explained by the decrease in the need for cardiac muscle in oxygen due to a decrease in heart rate and diastole lengthening.
Antiarrhythmic effect is realized due to elimination of factors provoking arrhythmia: tachycardia, arterial hypertension and slowing of AV-conduction.
In average doses, β2-adrenergic receptors of the smooth muscles of the bronchi, pancreas, and peripheral arteries are practically not affected. Does not affect carbohydrate metabolism, does not delay sodium ions in the body.

Pharmacokinetics

When ingested, approximately 90% of the drug is absorbed. Cmax in the blood is noted after 1-3 hours. It binds to blood proteins by 30%. T1 / 2 about 10-12 hours. Unchanged is excreted mainly with urine.

Indications for use

Aritel is used for:
    rhythm disturbances (ventricular extrasystole, sinus tachycardia);
    chronic heart failure;
    angina pectoris tension;
    arterial hypertension;
    prevention of angina attacks and myocardial infarction.

Contraindications

    decompensated chronic heart failure;
    acute heart failure;
    cardiogenic shock;
    bradycardia;
    AV blockade II and III degree;
    severe course of bronchial asthma;
    hypotension;
    Raynaud's syndrome;
    lactation period;
    reception with MAO inhibitors;
    intolerance to lactose and galactose;
    hypersensitivity to the drug;
    age to 18 years.
It is used with caution in patients with prinzmetal angina, hyperthyroidism, type 1 diabetes, AV block I degree, marked renal and hepatic insufficiency, congenital heart defects with hemodynamic disorders.

Side effects

Before you buy Aritel you should know reactions that can cause Aritel:
    dizziness;
    bradycardia, worsening of CHF;
    coldness and numbness in the limbs;
    a decrease in blood pressure;
    increased fatigue;
    nausea, vomiting, upset of the chair.
Rarely encountered:
    loss of consciousness, depression, insomnia;
    skin itching, exacerbation of psoriasis, rash;
    violation of potency and libido, renal colic;
    muscle weakness, convulsions;
    thrombocytopenia, agranulocytosis;
    hepatitis;
    bronchospasm in patients with bronchial asthma and COPD;
    reduction of lacrimation, conjunctivitis;
    hearing impairment.

Instructions for the use of Aritel (Method and dosage)

Tablets are taken orally, without chewing, before or during a meal, once a day.
In chronic heart failure, the initial dose of 1.25 mg / day. In this case, it is convenient to use the drug Aritel Kor-1/2 table. 2.5 mg each. With good tolerability, the dose is gradually increased to 2.5-10 mg 1 time per day in 2 weeks. 10 mg / day. is the maximum dose for CHF.
During the selection of the dose, blood pressure, heart rate and symptoms of CHF are monitored. In the first days of admission, temporary worsening of symptoms of CHF is possible. In such cases, the dose is reduced, and after the stabilization of the condition, treatment is continued.
With arterial hypertension and ischemic heart disease 5 mg / day. with an increase to 10 mg / day. With these diseases, the maximum dose can be 20 mg / day. For elderly patients, dose adjustment is not required.
Instruction for the use of Aritel contains warnings that patients at the time of taking the drug should independently monitor heart rate and blood pressure.

Overdose

It is manifested by symptoms: acute heart failure, decreased blood pressure, AV blockade, bradycardia, hypoglycemia, bronchospasm.
Symptomatic therapy is performed. With bradycardia - the introduction of Atropine.
With severe hypotension, the appointment of vasopressors.
With exacerbation of CHF - the introduction of diuretics, vasodilators.
With a decrease in blood sugar - the introduction of glucose.
At bronhospazme - bronchodilators (β2-sympathomimetics).
With AV blockade - β-adrenomimetics (Epinephrine), an artificial pacemaker.

Interaction

Contraindicated combinations
With sultopride, there is an increased risk of ventricular arrhythmia.
Combinations of drugs that are not recommended
Antiarrhythmics (Lidocaine, Phenytoin, Quinidine, Dysopyramide, Propafenone, Flecainide) and BCC (Verapamil, Diltiazem), when used with bisoprolol, reduce AV conduction and contractile function of the heart.
Clonidine, moxonidine, methyldopa, Rilmenidine lead to a decrease in heart rate, vasodilation and a decrease in cardiac output.
Combinations that require caution
Amiodarone enhances the disturbance of AV conduction.
Eye drops of β-adrenoblockers increase the systemic effects of bisoprolol.
Means for general anesthesia increase the risk of cardiodepressant action of bisoprolol.
Cardiac glycosides exacerbate bradycardia, and diuretics, sympatholytics, hydralazine, hypotensive action of bisoprolol.
NSAIDs, GCS and estrogens reduce the hypotensive effect of bisoprolol.
Tricyclic antidepressants, neuroleptics, ethyl alcohol, hypnotics increase the CNS depression.
The hypoglycemic effect of hypoglycemic oral drugs and insulin is enhanced.
Ergot alkaloids increase peripheral circulatory disturbances.
Meflokhin (a synthetic antibacterial drug) increases the risk of bradycardia.

Storage conditions

At a temperature not exceeding 20 ° C.
Shelf life - 2 years.

Reviews

According to the patients' feedback, beta-blockers were prescribed to them immediately in the diagnosis of IHD with heart failure, as these drugs reduce the progression of heart failure and reduce the risk of sudden death. Long-term use of these leads to an improvement in hemodynamics, a decrease in the severity of CHF. Bisoprolol is one of the drugs of this group, which has a high degree of selectivity and safety.
The original preparation of bisoprolol, which is registered in Russia, is Concor. Aritel is the first Russian generic, for use in patients with CHF, Aritel Cor is produced in tablets of 2.5 mg. In many studies, Aritel® has confirmed its therapeutic equivalence to the original drug.
Treatment with Aritel was carried out individually, with a gradual increase in the dose until the effect was obtained. Many patients were prescribed bisoprolol with ACE inhibitors, and this combination was more effective in improving the well-being of patients, reducing the frequency of hospitalizations for cardiac decompensation.
According to reviews, Aritel is an effective drug for the treatment of hypertension, especially in combination with coronary pathology and CHF. It reduces ischemic manifestations in the myocardium and prevents the occurrence of arrhythmias. All patients note good tolerability of the drug. Side effects are rare, often on the first days of taking the drug.