Description
Release form
Film-coated tablets.
Packing
30 pcs.
Pharmacological action
Aritel – selective beta1 – adrenergic blocker, without its own sympathomimetic activity, does not have clinically significant membrane-stabilizing properties. It reduces the activity of plasma renin, reduces the need for myocardium in oxygen, reduces the heart rate (HR) (at rest and during exercise). It has hypotensive, antiarrhythmic and antianginal effects. By blocking beta1-adrenoreceptors of the heart in low doses, it reduces the formation of cAMP stimulated by catecholamines from ATP, reduces the intracellular current of calcium ions, and has a negative chrono-, dromo-, batmo- and inotropic action, inhibits conduction and excitability, reduces myocardial contractility.
The antihypertensive effect of Aritel is associated with a decrease in minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (of great importance for patients with initial hypersecretion of renin), restoration of sensitivity in response to a decrease in blood pressure (BP) and the effect on the central nervous system (CNS). With arterial hypertension, the effect occurs after 2 5 days, a stable effect – after 1 2 months.
The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in heart rate and contractility, lengthening of diastole, and improvement of myocardial perfusion. By increasing the final diastolic pressure in the left ventricle and increasing the stretching of the muscle fibers of the ventricles, it can increase the need for oxygen, especially in patients with chronic heart failure.
Antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased content of cAMP, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers, and a slowdown in atrioventricular (AV) conduction (mainly in antegrade and, to a lesser extent, in retrograde directions through the AV node) and along additional paths.
Indications
Arterial hypertension
Coronary heart disease: prevention of angina attacks.
Contraindications
Hypersensitivity to the drug and other beta-blockers,
Shock (including cardiogenic)
Collapse
Pulmonary edema
Acute heart failure, chronic heart failure in the stage of decompensation, AV block II-III stage, cynoatrial blockade, sinus node weakness syndrome, severe bradycardia, angina pectoris, cardiac angina pectoris signs of heart failure), arterial hypotension (systolic blood pressure less than 100 mm Hg, especially with myocardial infarction)
Bronchial asthma and chronic obstructive pulmonary disease with a history of
ibitorov monoamine oxidase (MAO) (except MAO-B)
Later stages of peripheral circulation, Raynaud’s disease)
Pheochromocytoma (without the simultaneous use of alpha-blockers)
Metabolic acidosis
Under 18 years of age (efficacy and safety have not been established).
Precautions:
Hepatic insufficiency, chronic renal failure
Myasthenia
Thyrotoxicosis
Diabetes mellitus
Atrioventricular block I stage
Depression (including a history of Psoriasis srdlp
Special instructions
Monitoring of patients taking Aritel should include measurement of heart rate and blood pressure (at the beginning of treatment daily, then once every 3-4 months), ECG, determination of blood glucose in patients with diabetes mellitus (1 time in 4 5 months). In elderly patients, it is recommended to monitor renal function (1 time in 4-5 months).
Before starting treatment, it is recommended to study the function of external respiration in patients with a history of bronchopulmonary burden.
With the simultaneous administration of clonidine, its administration can be stopped only a few days after the cancellation of Aritel.
Composition
1 tablet contains:
Active substances:
Bisoprolol fumarate 5 mg.
Excipients:
Potato starch – 24 mg
Colloidal silicon dioxide (aerosil) – 1.8 mg
Magnesium stearate – 0.6 mg
Lactose monohydrate (milk sugar) – 63.1 mg
Povidone – 4.5 mg 21 mg microcrystal microcrystall.
Dosage and administration of
Aritel is taken orally, in the morning on an empty stomach, without chewing, 5 mg once. If necessary, increase the dose to 10 mg once a day. The maximum daily dose is 20 mg / day.
In patients with impaired renal function with creatine clearance less than 20 ml / min or with severe impaired liver function, the maximum daily dose is 10 mg.
Side effects of
From the central nervous system: increased fatigue, weakness, dizziness, headache, sleep disorders, depression, anxiety, confusion or short-term memory loss, hallucinations, asthenia, myasthenia gravis, paresthesia in the limbs (in patients with intermittent “Lameness and Raynaud’s syndrome), tremor.
On the part of the sensory organs: impaired vision, decreased secretion of lacrimal fluid, dry and sore eyes, conjunctivitis.
From the cardiovascular system: sinus bradycardia, palpitations, impaired myocardial conduction, AV block (up to the development of complete transverse blockade and cardiac arrest), arrhythmias, weakened myocardial contractility, development (worsening) of chronic heart failure (ankle swelling, dyspnea stop ), decreased blood pressure, orthostatic hypotension, the manifestation of angiospasm (increased impairment of peripheral circulation, cooling of the lower extremities, Raynaud’s syndrome), chest pain.
From the digestive system: dry oral mucosa, nausea, vomiting, abdominal pain, constipation or diarrhea, impaired liver function (dark urine, yellowness of the sclera or skin, cholestasis), taste changes.
From the respiratory system: nasal congestion, difficulty breathing when prescribed in high doses (loss of selectivity) and / or in predisposed patients – laryngo- and bronchospasm.
From the endocrine system: hyperglycemia (in patients with non-insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), hypothyroid state.
Allergic reactions: pruritus, rash, urticaria.
From the skin: increased sweating, flushing of the skin, exanthema, psoriasis-like skin reactions, exacerbation of symptoms of psoriasis.
Laboratory indicators: thrombocytopenia (unusual bleeding and hemorrhage), agranulocytosis, leukopenia, changes in liver enzyme activity (increased ALT, AST), bilirubin levels, triglycerides.
Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia.
Other: back pain, arthralgia, weakening of libido, decreased potency, “withdrawal” syndrome (increased angina attacks, increased blood pressure).
Drug Interactions
Allergens used for immunotherapy or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol.
Iodine-containing radiopaque drugs for intravenous administration increase the risk of anaphylactic reactions.
Phenytoin when administered intravenously, drugs for inhalation general anesthesia (hydrocarbon derivatives) increase the severity of cardiodepressive action and the likelihood of lowering blood pressure.
Aritel alters the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, increased blood pressure). It reduces the clearance of lidocaine and xanthines (except diphillin) and increases their plasma concentration, especially in patients with initially increased theophylline clearance under the influence of smoking.
Non-steroidal anti-inflammatory drugs (delayed Na + and blockade of prostaglandin synthesis by the kidneys), glucocorticosteroids and estrogens (delayed Na + ions) weaken the hypotensive effect.
Cardiac glycosides, methyldopa, reserpine and guanfacine, slow calcium channel blockers (verapamil, diltiazem), amiodoron and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV blockade, heart failure and heart failure.
Nifedipine can lead to a significant decrease in blood pressure.
Diuretics, clonidine, sympatholytics, hydralazine and other antihypertensive drugs can lead to an excessive decrease in blood pressure.
Extends the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.
Three – and tetracyclic antidepressants, antipsychotic drugs (antipsychotics), ethanol, sedative and hypnotic drugs increase CNS depression.
The simultaneous use with MAO inhibitors is not recommended due to a significant increase in the antihypertensive effect, the break in treatment between taking MAO inhibitors and bisoprolol should be at least 14 days.
Non-hydrogenated ergot alkaloids increase the risk of peripheral circulation disorders.
Ergotamine increases the risk of developing peripheral circulatory disorders sulfasalazine increases the plasma concentration of bisoprolol rifampicin shortens the elimination half-life.
Overdose
Symptoms: arrhythmia, ventricular extrasystole, severe bradycardia, AV block, marked decrease in blood pressure, chronic heart failure, cyanosis of fingernails or palms of the fingers, difficulty breathing, bronchospasm, dizziness, fainting, convulsions.
Treatment: gastric lavage and the administration of adsorbing drugs symptomatic therapy: with developed AV blockade, intravenous (iv) 1 2 mg of atropine, epinephrine or temporary pacemaker with ventricular extrasystole – lidocaine (class Ia drugs are not used) with a decrease in blood pressure – the patient should be in the Trendelenburg position if there are no signs of pulmonary edema, – intravenously plasma-replacing solutions, with inefficiency – the introduction of epinephrine, dopamine, dobutamine (to maintain chronotropic and inotropic action and elimination of a marked decrease in blood pressure) in heart failure – cardiac glycosides, diuretics, glucagon in convulsions – intravenous diazepam in bronchospasm – beta2 – inhalation stimulants.
Storage Conditions
In a dry, dark place at a temperature not exceeding 25 ° C, out of the reach of children.
Deystvuyuschee substances
bisoprolol
Us pharmacy vacation
Prescription
Form of Treatment
tablets
Appointment
for Adults on purpose doctor
Indications
Hypertension, Arrhythmia, Heart failure
Possible product names
ARITEL 0.005 N30 TABLE P / O
Aritel 5mg Tab. p / pl / rev X30 (R)
ARITEL TAB P / O CAPTURE. 5MG No. 30
Aritel tab p / p / o 5mg N30
Aritel tab p / pl / o 5mg x 30
Kanonfarma, Russia
