Active Ingredient: Bisoprolol
Treatment of stable chronic heart failure with reduced systolic ventricular function in addition to ACE inhibitors, and diuretics, and optionally cardiac glycosides.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Oral, 1.25 milligrams bisoprolol, once daily, over the duration of 1 week. Afterwards, oral, 2.5 milligrams bisoprolol, once daily, over the duration of 1 week. Afterwards, oral, 3.75 milligrams bisoprolol, once daily, over the duration of 1 week. Afterwards, oral, 5 milligrams bisoprolol, once daily, over the duration of 4 weeks. Afterwards, oral, 7.5 milligrams bisoprolol, once daily, over the duration of 4 weeks. Afterwards, oral, 10 milligrams bisoprolol, once daily. The maximum allowed total dose is 10 milligrams bisoprolol daily.
Standard treatment of CHF consists of an ACE inhibitor (or an angiotensin receptor blocker in case of intolerance to ACE inhibitors), a 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 daily.
Close monitoring of vital signs (heart rate, blood pressure) and symptoms of worsening heart failure is recommended during 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.
The reintroduction and/or uptitration of bisoprolol should always be considered when the patient becomes stable again.
If discontinuation is considered, gradual dose decrease is recommended, since abrupt withdrawal may lead to acute deterioration of the patients condition.
Treatment of stable chronic heart failure with bisoprolol is generally a long-term treatment.
It should be taken in morning and it can be taken with food.
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