Binelol tabs 5mg #28

User manual for Binelol

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Composition

In 1 tablet of nebivolol hydrochloride 5 mg.
MCC, crospovidone, lactose monohydrate, poloxamer, povidone, magnesium stearate - as auxiliary substances.

Form of issue

Tablets of 5 mg № 14 and 28.

pharmachologic effect

Antianginal, hypotensive.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Highly selective beta1-blocker of the third generation. Has antianginal, hypotensive, vasodilating and antiarrhythmic action. The hypotensive effect is manifested in 3-5 days. Reduces blood pressure at rest, with stress and stress. Reduces heart rate, reduces OPSS, increases ejection fraction.
When taking the drug, the need for myocardium in oxygen decreases, so the number of attacks of angina decreases. Antiarrhythmic action is associated with a slowing of the atrioventricular conduction and suppression of the automatism of the heart.

Pharmacokinetics

When ingested quickly absorbed. Efficiency does not depend on the patient's metabolic rate. In most patients, the maximum concentration of the active substance is determined after 24 hours.
Communication with blood proteins is 98%. It is actively metabolized with the formation of active hydroxymetabolites. After a week of taking the drug, 38% is excreted by the kidneys, the rest is through the intestines. In patients with a "fast" metabolism, T 1/2 is about 10 hours, and 3-5 times more with "slow" metabolism.

Indications for use

    hypertonic disease;
    prevention of angina attacks in IHD;
    CHF.

Contraindications

    impaired liver function;
    Decompensated heart failure;
    bronchial asthma;
    myasthenia gravis;
    cardiogenic shock;
    bradycardia less than 50 bpm;
    arterial hypotension (less than 90 mm Hg systolic pressure);
    AV blockade II and III degree;
    obliterating vascular diseases;
    hypersensitivity.
It is used with caution in renal failure, hyperthyroidism, AV blockade of I degree, COPD, diabetes, psoriasis, allergic diseases.

Side effects

    weakness, dizziness, headache, paresthesia;
    depression, insomnia, drowsiness, hallucinations;
    nausea, dryness of the oral mucosa, constipation or diarrhea;
    bradycardia, dyspnea, edema, arrhythmia, cardialgia, Raynaud's syndrome;
    skin rash;
    bronchospasm, hyperhidrosis, rhinitis.

Binelol, instructions for use (Method and dosage)

Reed the instruction before buy Binelol online.
Tablets Binelol 5 mg taken internally at the same time at the same time of day. The drug is taken in monotherapy or combination therapy.
With arterial hypertension, 2.5-5 mg per day. If necessary, increase the dose to MS - 10 mg. Selection of the dose for CHF is carried out according to the scheme: 1.25 mg of the drug once a day, after a week 2.5-5 mg per day, after another week - up to 10 mg.
At the beginning of treatment, daily monitoring of heart rate and blood pressure is necessary. It is inadmissible to abruptly stop taking the drug (the possibility of withdrawal syndrome). The dose is reduced gradually over 10 days.

Overdose

Overdose is manifested by a decrease in blood pressure, vomiting, bradycardia, bronchospasm, the appearance of AV blockade, cardiogenic shock and loss of consciousness.
Treatment begins with washing the stomach and taking sorbents. With a marked decrease in blood pressure in / in the introduction of vasopressors.
With bradycardia - in / in 0.5-2 mg of atropine. In the presence of ventricular ekstrasistolii - lidocaine and diazepam with convulsions. In case of atrioventricular blockade (II-1II st.), Intravenous beta-adrenostimulants are injected.

Interaction

Contraindicated in / in the administration of verapamil and the simultaneous administration of nebivolol, as verapamil and diltiazem reduce myocardial contractility and atrioventricular conductivity.
Cardiac glycosides against nebivolol do not slow AV conduction. Class I antiarrhythmics and amiodarone increase the negative inotropic effect. Simultaneous use of funds for general anesthesia increases the risk of developing hypotension.
Barbiturates and tricyclic antidepressants increase the hypotensive effect. Cimetidine is able to increase the concentration of nebivolol in the blood. Reserpine and guanethidine reduce the effect of nebivolol.
Interaction with non-steroidal anti-inflammatory drugs is not established, so acetylsalicylic acid can be administered simultaneously with nebivolol.

Storage conditions

At temperatures up to 30 ° C.
Shelf life - 3 years.

Reviews of Binelol

Beta-blockers for more than 55 years are used in clinical practice. Negative effects of this group of drugs include negative metabolic effects: a decrease in glucose tolerance, an aggravation of insulin resistance, and a deterioration in blood lipids. When they are used, the risk of diabetes is great, which is important for patients with metabolic disorders. It is this fact that limits their purpose. Cardiologists' comments on this issue boil down to the fact that this side effect is possessed by nonselective and selective beta-blockers (for example, atenolol), while modern highly selective (binelol, nebivolol) do not have these effects and have a positive metabolic effect.
In support of this research was carried out: 30 patients with mild and moderate hypertension were prescribed Binelol 5 mg once a day for 3 months, in the absence of effect, the dose was increased to 10 mg per day. The final evaluation of the hypotensive effect was carried out after 3 months. All patients before and after therapy with this drug were assessed the level of total cholesterol, HDL, triglycerides, and microcirculation. As is known, a decrease in microcirculation leads to inadequate utilization of glucose, the development of compensatory hyperinsulinemia, and a violation of lipid metabolism.
The conclusions were drawn: the drug Binelol has not only an antihypertensive effect, but also causes positive microcirculatory changes, and, consequently, favorable metabolic effects. As a result of treatment, spastic phenomena decreased in patients, the number of functioning capillaries increased and tissue perfusion improved. This allows you to assign it to patients with hypertensive disease, combined with metabolic syndrome and type 2 diabetes. Analysis of the lipid spectrum of blood revealed a significant decrease in the level of total cholesterol and triglycerides, an increase in HDL.
Thus, the benefits of this drug: does not cause diabetes, improves insulin tolerance, dilates the blood vessels of the heart, does not affect potency and does not limit the activity of the patient. The improvement in lipid metabolism, which causes the drug, leads to a decrease in the weight and progression of atherosclerosis. The drug controls blood pressure and pulse during the day and reduces the frequency of angina attacks.