BIBLOC H 5 mg. 12.5 mg. 30 tablets
Bizoprololov hemifumarate beta-blocking specific receptors in the heart (kardioselektivnost) and leads to a slow heart rate, decreased contractility of the heart .
BIBLOC H 5 mg. / 12.5 mg. 30 tablets
WHAT BIBLOC H 5 MG / 12,5 MG FILM AND WHAT IT IS USED
Bizoprololov hemifumarate belongs to the group of medicines known as beta-receptor blockers.
Bizoprololov hemifumarate beta-blocking specific receptors in the heart (kardioselektivnost) and leads to a slow heart rate, decreased contractility of the heart, reducing the impulse conduction from the atria to the camera and reduces the activity of certain substances in the body that increase blood pressure (low renin activity).
Hydrochlorothiazide belongs to a group of medicines called diuretics (thiazide diuretics) resulted in increased excretion of water and electrolytes (increased urine output).
The combined preparation Bibloc H is applied in the treatment of high blood pressure (essential hypertension).
Your doctor will prescribe Bibloc H in cases in which treatment with bisoprolol or hydrochlorothiazide has proved insufficient.
2 BEFORE YOU TAKE BIBLOC H 5 MG / 12,5 MG FILM
Do not take Bibloc H 5 mg / 12,5 mg film-coated tablets
if you are allergic (hypersensitive) to hydrochlorothiazide or other thiazide, bisoprolol or other beta-receptor blockers, sulfonamides, or any of the other ingredients of Bibloc H;
if you suffer from weakness of the heart muscle (acute heart failure) or weakness of your heart muscle is not compensated (decompensated heart failure);
if you have shock due to heart attack;
if you have serious heart rhythm disturbances (second or third degree AV block without pacemaker syndrome sick sinus or disturbance of impulse conduction between the sinus node and atrium (sinoatrial block));
you have a very slow heart rate (resting heart rate below 60 beats / minute) before treatment;
if you have high acidity of the blood (metabolic acidosis);
if you have severe bronchospasm (e. severe asthma, severe chronic obstructive pulmonary disease);
if you have severe problems with blood circulation (which can cause the fingers and toes to tingle or you have pale or blue) (Raynaud's syndrome);
if you have a hormone-producing tumor near the kidney (phaeochromocytoma) and not being treated for it (see. also section "Take special care with Bibloc H 5 mg / 12.5 mg tablets");
if you have severe renal impairment with many broken or complete absence of urine (creatinine clearance below 30 ml / minute) or acute inflammation of the kidneys (glomerulonephritis);
if you suffer from liver failure and loss of consciousness (hepatic coma and coma) or severe liver problems;
if you are not responding to the treatment of potassium deficiency (hypokalemia), severe deficiency of sodium (severe hyponatremia) or increased blood calcium levels (hypercalcemia);
if you have gout;
at the same time taking floctafenine or sultopride;
if you are pregnant after the third month (it is also better to avoid Bibloc H and in early pregnancy - see pregnancy.)
Take special care with Bibloc H 5 mg / 12,5 mg film-coated tablets
if you have a stable heart failure. If necessary, you should begin treatment with bisoprolol alone;
if you suffer from asthma or chronic obstructive pulmonary disease, which causes symptoms (bronchospasm);
if you will receive general anesthesia (treatment with inhaled anesthetics). Tell the anesthetist that you are taking Bibloc H;
if you have a minor breach of conduct impulses from the atria to the cameras (first degree AV block);
if you suffer from diabetes because there is a risk of severe conditions of hypoglycaemia (requires regular monitoring of blood glucose) in case of continuous strict fasting (because of a strong reduction in the levels of blood sugar);
hormonoprodutsirasht if you have an adrenal gland tumor (pheochromocytoma). Before treatment with H Bibloc Your doctor will prescribe a treatment called. alpha-receptor blockers;
if you have a low volume of circulating blood (hypovolemia);
if you have a mild dysfunction of liver or renal function;
if you suffer from peripheral arterial vascular disease. May appear amplified complaints, especially early in treatment;
if you have chest pain that is caused by spasm of the coronary vessels even at rest (Prinzmetal angina);
if you have mild impairment of renal function and concomitant impairment of liver function. Hydrochlorothiazide is ineffective in the presence of renal insufficiency (glomerular filtration rate below 30 ml / min and / or serum creatinine above 159 mol / l) and in this respect is even harmful as it further reduces the rate of formation of urine;
if being treated for weight loss or prevention of allergic or have ever had a severe allergic reaction. Beta-receptor blockers such as bizoprololov hemifumarate can increase sensitivity to substances that cause allergies and severity of acute generalized allergic reactions;
if you suffer from psoriasis or have a family history of psoriasis. Drugs such Bibloc H containing beta-receptor blockers occasionally trigger psoriasis can lead to worsening of the disease or the occurrence of such a psoriatic skin rashes;
if you wear contact lenses you should have in mind the possibility of reducing the formation of tears;
if you have an overactive thyroid;
if you are elderly;
if you have a higher content of uric acid in the blood (hyperuricemia), as the risk of gout attacks can be increased;
if you have an adrenal gland tumor (pheochromocytoma) and being treated for it;
cases of acute inflammation of the gallbladder (cholecystitis) in patients with gallstones should be reported;
Hydrochlorothiazide in your product may result in your skin to become hypersensitive to sunlight or artificial UV light. Stop taking this product and tell your doctor if you experience rash, itchy spots or sensitive skin during treatment (see. Also Section 4).
In the course of long-term treatment with H Bibloc your doctor will perform regular tests of serum electrolytes (particularly potassium, sodium and calcium), creatinine and urea, blood fats (cholesterol and triglycerides) and uric acid.
In the course of treatment with H Bibloc you have to ensure adequate intake of fluids and food rich in potassium (such as bananas, vegetables and nuts) due to increased loss of potassium. Potassium loss can be reduced or prevented by concomitant treatment with potassium-sparing diuretics.
You should tell your doctor if you are pregnant or think you may be pregnant. Bibloc H is not recommended in early pregnancy, and must be taken after the third month of pregnancy because it may cause serious harm to your baby if used at that stage (see pregnancy).
Athletes should be aware that this product contains an active substance that may cause a positive reaction in anti-doping tests.
Taking Bibloc H 5 mg / 12,5 mg film-coated tablets
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Your doctor is important to know whether you are taking the following medicines:
flokrafenin and sultopriod (see. also section "Do not take Bibloc H 5 mg / 12,5 mg tablets");
insulin or oral glucose-lowering drugs;
analgesics and anti-inflammatory drugs (e. salicylates, indomethacin);
other medicines that lower blood pressure (eg. ACE inhibitors, vasodilators, calcium channel blockers of nifedipinov type), some sleeping pills (barbiturates), or medicines to treat mental disorders (phenothiazines, tricyclic antidepressants), other beta-blockers (eg. in some eye drops);
antiarrhythmics (eg. disopyramide, quinidine, amiodarone, sotalol, "calcium channel blockers of the verapamil or diltiazem type");
reserpine, alpha-methyldopa, guanfacine or clonidine (if necessary, your doctor will gradually reduce the dose of clonidine only a few days after the application of H Bibloc is stopped);
Certain medicines for cough, nasal drops and eye containing noradrenaline, adrenaline or other sympathomimetics;
monoamine oxidase (MAO) inhibitors (except MAO-B) inhibitors;
drugs used for gout, cardiac glycosides, drugs to treat migraine which contain ergotamine or drugs leading to increased loss of potassium (glucocorticoids, ACTH, carbenoxolone, amphotericin B, other drugs with diuretic such as furosemide, some laxatives);
anesthetics and curare-like muscle relaxants (please tell the anesthetist that you are being treated with Bibloc H);
agents that may induce torsade de pointes (e. astemizole, intravenous erythromycin, halofantrine, pentamidine, sparfloxacin, terfenadine, vincamine;
lithium, rifampicin, cimetidine, lidocaine, cholestyramine or colestipol, parasimpatikomimetichni agents (including tacrine);
drugs used to treat cancer (e. cyclophosphamide, fluorouracil, methotrexate).
Taking Bibloc H 5 mg / 12,5 mg film-coated tablets with food and drink
The blood pressure lowering effect of Bibloc H can be enhanced by alcohol consumption.
Pregnancy and lactation
You should tell your doctor if you are pregnant or think you may be pregnant. Your doctor will normally advise you to stop taking Bibloc H before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead Bibloc Bibloc N. N is not recommended in early pregnancy, and must not taken after the third month of pregnancy because it may cause serious harm to your baby if used after the third month of pregnancy.
Tell your doctor if you are breast-feeding or about to start breast-feeding. Bibloc H is not recommended for mothers who are breast feeding, and your doctor may choose another treatment for you if you want to breast-feed, especially if your baby is newborn, or was born prematurely.
Ask your doctor or pharmacist before taking any medicine.
Driving and using machines
Because the effects of the drug are different in each case, the reactions to such an extent can be changed as to impair the ability to drive, operate machinery or work in potentially hazardous situations. This usually happens at the beginning of treatment, the dose is increased after a change of the product in relation to alcohol use.
Important information about some of the ingredients of Bibloc H 5 mg / 12,5 mg film-coated tablets
This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, contact your doctor before taking this medicine.
3 HOW TO TAKE BIBLOC AND 5 MG / 12,5 MG FILM
Always take Bibloc H exactly as prescribed by your doctor. If you are not sure, ask your doctor or pharmacist.
Unless otherwise prescribed by the doctor, the usual dose is:
1 tablet Bibloc H once daily (equivalent to 5 mg bizoprololov hemifumarate and 12,5 mg hydrochlorothiazide).
If the reduction of blood pressure is not sufficient, the dose can be increased to 2 tablets QD Bibloc H (which is equivalent to 10 bizoprololov hemifumarate and 25 mg of hydrochlorothiazide).
In the presence of renal and / or hepatic function should not take more than 1 tablet Bibloc H once daily (equivalent to 5 mg bizoprololov hemifumarate and 12,5 mg hydrochlorothiazide).
Swallow the tablets for purposes breakfast with sufficient fluid. The tablet is not designed for separation.
Your doctor will determine the duration of treatment. This will depend on the nature and severity of the disease. Do not change the dosage of H Bibloc without consulting your doctor.
Please tell your doctor or pharmacist if you feel that the effects of H Bibloc are too strong or too weak.
If you take more than you should Bibloc H 5 mg / 12,5 mg film-coated tablets
Please immediately contact your doctor.
In case of overdose or life-threatening drop in heart rate (pulse) and / or blood pressure treatment Bibloc H should be immediately discontinued. Overdose often leads to severe depression of cardiac function with a slow heart rate. Bronchospasm can lead to respiratory distress. In addition, fluid loss can lead to thirst, weakness and dizziness, muscle pain, increased heart rate and circulatory collapse, acute renal failure, heart rhythm disturbance and constipation to intestinal obstruction in severe cases.
If you forget to take Bibloc H 5 mg / 12,5 mg film-coated tablets
Do not take a double dose to make up for the missed dose and take your normal dose the next morning.
If you stop taking Bibloc H 5 mg / 12,5 mg film-coated tablets
Do not suddenly stop long-term treatment with H Bibloc without consulting your doctor. At the end of therapy the dose should always be gradually reduced (eg. Within 7-10 days).
It should be borne in mind especially in patients with coronary artery disease (ischemic heart disease), as the abrupt cessation of treatment can lead to severe deterioration.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4 POSSIBLE SIDE EFFECTS
Like all medicines Bibloc H 5 mg / 12,5 mg tablets can cause side effects.
Basis for evaluation of adverse reactions to form the following frequencies:
Very common:> 1/10;
Common:> 1/100 to <1/10;
Uncommon:> 1/1000 - <1/100;
Rare:> 1/10000 - <1/1000;
Very rare: <1/10000, including isolated cases.
Rare: shortage of blood platelets (thrombocytopenia), reduced the number of white blood cells (leucopenia);
Very rare bone marrow failure to create enough white blood cells (agranulocytosis).
The body's ability to break down food
Common: elevated levels of uric acid in the blood (hyperuricemia), which in susceptible individuals can lead to attacks of gout, increases of blood fats (cholesterol, triglycerides), and glucose, glucose in the urine, impaired fluid content and electrolytes (especially low potassium and low sodium, low magnesium and reduced chloride and increased calcium in the blood), excessive acidity in your blood;
Diabetes, which is still undeveloped (latent diabetes mellitus) may become manifest, and also there may be a deterioration of already known diabetes (manifest diabetes mellitus);
After a long, rigorous fasting or severe physical exertion may occur conditions of low blood sugar (hypoglycemia) if concomitant Bibloc N. warning symptoms of low blood sugar - especially increased heart rate (tachycardia) and trembling fingers (tremor) - may be masked.
Psychiatric disorders and central nervous system
Common: fatigue, exhaustion, dizziness, headache. These symptoms are particularly common at the beginning of treatment. They are usually mild and disappear within 1-2 weeks;
Uncommon: sleep disorder, depression;
Rare: nightmares, hallucinations.
Rare: visual disturbances, decreased tears (must be given to patients who wear contact lenses);
Very rare: conjunctivitis.
Rare: hearing impairment.
Heart, blood vessels and circulation
Common: feeling of coldness in the extremities;
Uncommon: severe reduction in heart rate (bradycardia), breach of conduct impulses from the upper chambers (atrioventricular conduction disturbance pulse) or worsening weakness of the heart muscle (heart failure) a sudden drop in blood pressure when standing up from a lying position (orthostatic hypotension);
Very rare: chest pain.
Breathing and chest
Uncommon: risk of obstruction of breathing due to bronchospasm (particularly in patients with bronchial asthma or obstructive airways disease);
Rare: allergic rhinitis.
Stomach, intestines and digestion
Common: nausea, vomiting, diarrhea, constipation;
Uncommon: loss of appetite, abdominal pain, an increase in blood levels of certain enzymes called amylases, inflammation of the pancreas (pancreas).
Rare: jaundice (jaundice), inflammation of the liver (hepatitis), increased levels of enzymes that reflect liver function, blood.