Bivotenz Valium 5mg 30 units 1 + 1

Description

Composition
Active substance:
1 tablet contains: nebivolol hydrochloride – 5.45 mg which corresponds nebivolol base – 5.00 mg.
Product form:
Tablets of 5 mg. At 7, 10, 14, 20, 30 tablets in blisters of PVC film and aluminum foil printed patent. At 7, 10, 14, 20, 28, 30, 40, 50 or 100 tablets in cans or in cans PET polymer for medicaments. One jar or 1, 2, 3, 4, 5, 8, 9, 10 or 12 contour cell packages together with instructions for use placed in a cardboard box (pack). Equipment is allowed to 2 or 3 cartons (packs) in multipacks (transportation) of paperboard for consumer packaging.
Contraindications
– Hypersensitivity to Nebivolol or other ingredients and other beta-blockers; – severe hepatic dysfunction; – acute heart failure; – chronic heart failure decompensation (requires inotropic therapy); – cardiogenic shock; – sick sinus syndrome, including the sinoatrial block; – atrioventricular block II and III degree (without artificial vo turer rhythm); – bronchospasm and bronchial asthma in history; – pheochromocytoma (without simultaneous application of alpha blockers); – metabolic acidosis; – bradycardia (heart rate less than 60 beats / min); – severe hypotension (systolic blood pressure less than 90 mmHg..); – depression; – severe peripheral circulatory disorders ( “pereme- MANUFACTURER Company” Ozone “zhayuschayasya” claudication, Raynaud’s syndrome); – myasthenia – simultaneous reception floctafenine, sultopride (see “Interaction with other drugs.”); – the age of 18 years (effectiveness and safety have been established); – lactose intolerance, lactase deficiency or malabsorption glyukozogalaktoznaya.
Dosage
5 mg
Indications
– arterial hypertension; – Ischemic heart disease: prevention of attacks of angina pectoris; – Chronic heart failure (in a combination therapy).
pharmachologic effect
Pharmacological group:
Beta selective adrenoblokator. ATC code S07AV12.
Pharmacological properties:
Cardioselective beta adrenoblokator with vasodilating properties. Nebivolol has antihypertensive, antianginal and antiarrhythmic action. It slows the heart rate (HR) and reducing high blood pressure (BP) at rest, during exercise, reducing left ventricular end-diastolic pressure, improving the diastolic function of the heart, decreases total peripheral vascular resistance increases the ejection fraction. Competitive and selectively blocks synaptic and post-synaptic beta-adrenergic receptors, making them inaccessible to catecholamines, modulates the release of endothelial nitric oxide vasodilating factor. Nebivolol is a racemate consisting of two enantiomers: D-nebivolol (SRRR-nebivolol) and L-nebivolol (RSSS- nebivolol), which combines two pharmacological activities: – D-nebivolol is a highly selective and competitive blocker beta – adrenergic receptors (affinity to beta , -adrenoreceptors 293 times higher than adrenoretseptoram beta2); – L-nebivolol has a vasodilator effect by modulation of release of vasodilating factor from the vascular endothelium. Antihypertensive effect is also due to a decrease in activity of the renin-angiotensin-aldosterone system (RAAS) (not directly correlate with changes in the activity of renin in blood plasma). Stable antihypertensive effect develops after 1-2 weeks of regular drug administration, and in some cases – after 4 weeks, stable operation is noted after 1-2 months. This effect is maintained during prolonged therapy. Reducing myocardial oxygen demand (slowing the heart rate, decrease in preload and afterload), nebivolol reduces the number and severity of angina attacks and increases exercise tolerance. Antiarrhythmic effect due to suppression of pathological cardiac automaticity (including pathological focus) and atrioventricular conduction slowing.
Conditions of supply of pharmacies
Prescription.
Dosing and Administration
Inside, in the same time regardless of mealtime, liquid squeezed a sufficient amount of liquid. A tablet can be divided into four equal parts by Phillips risk. Arterial hypertension and coronary heart disease average daily dosage is 2.5-5 mg (1/2 tablets – 1 tablet of 5 mg), 1 time / day. Optimal effect becomes pronounced within 1-2 weeks of treatment, in some cases – in 4 weeks. If necessary, the dose may be increased to the maximum daily 10 mg (2 tablets of 5 mg per one dose). Perhaps the use of the drug in monotherapy or in combination with other antihypertensive agents. Chronic heart failure (CHF) Treatment of CHF stable to start with a gradual increase in the dose to achieve the individual optimal maintenance dose. Patients should not be attacks of acute heart failure in the last 6 weeks. It is recommended to perform the treatment under close medical supervision. Patients who take diuretics, cardiac glycosides, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor antagonists II, dosing preparations should be stabilized for 2 weeks prior to drug therapy Bivotenz. Start treatment CHF beta-adrenoceptor blockers is necessary if the patient is clinically stable over the past 2 weeks. Selection of doses in the beginning of therapy should be implemented according to the following scheme, keeping 2-week intervals: a dose of 1.25 mg / day (1/4 5 mg tablets) could be increased to 2.5 mg / day (1/2 5 mg tablets), further – up to 5-10 mg / day (1-2 tablets 5 mg). The patient must be under the supervision of a physician during the 2 hours after the first dose and after each successive dose increases. The maximum daily dose – 10 mg. Each increase in the dose should be administered no less than 2 weeks, depending on individual tolerability. During titration we recommend regular monitoring of blood pressure, heart rate and symptoms of congestive heart failure. During titration, in case of worsening heart failure or intolerance to the drug flow it is recommended to reduce the dose of the drug Bivotenz or, if necessary, immediately stop taking it (in the case of pronounced hypotension, worsening of heart failure at a flow with acute pulmonary edema, in the case of Nogo kardiogen- shock, symptomatic bradycardia or atrioventricular block). Treatment of CHF is generally stable long. Treatment with Bivotenz not recommended to stop abruptly (if it is not necessary), as this may lead to a temporary exacerbation of heart failure flow. If you want to stop taking the drug, the removal is carried out gradually, reducing the dose within a week, twice. Patients with renal impairment (creatinine clearance less than 20 mL / min): an initial dose of 2.5 mg / day (2.1 to 5 mg tablets). When necessary, the daily dose can be increased up to 5 mg. In patients with renal impairment (creatinine clearance less than 20 mL / min.) Increase in the dose should be carried out with extreme caution. Elderly: For patients older than 65 years of the initial dose is 2.5 mg / day (2.1 to 5 mg tablets). When necessary, the daily dose can be increased up to 5 mg. However, taking into vnima- of limited experience with the drug in elderly patients, it is necessary to be careful and conduct a thorough examination of patients over the age of 65 years. In elderly patients the need for a dose adjustment is not available, so you need to individually select the dose, gradually increasing it to the maximum tolerated dose.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist