Atenolol Belupo pills coated with a film shell 25mg N30
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Active ingredients
Atenolol
Release form
Pills
Composition
Atenolol 25 mg Auxiliary substances: microcrystalline cellulose, lactose monohydrate, povidone, corn starch, talc, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate. The composition of the shell: hypromellose 5 spz, hypromellose 15 spz, talc, titanium dioxide, disodium edetate dihydrate.
Pharmacological effect
It has antianginal, antihypertensive and antiarrhythmic effects. Does not possess membrane stabilizing and internal sympathomimetic activity. Reduces catecholamine-stimulated cAMP formation from ATP. In the first 24 hours after oral administration, on the background of a decrease in cardiac output, there is a reactive increase in the total peripheral vascular resistance, the severity of which gradually decreases within 1–3 days. The hypotensive effect is associated with a decrease in cardiac output, a decrease in the activity of the renin-angiotensin system, the sensitivity of the baroreceptors and an effect on the central nervous system. The hypotensive effect is manifested in both a decrease in systolic and diastolic blood pressure, a decrease in stroke and minute volumes. In moderate therapeutic doses, it does not affect the tone of the peripheral arteries. The antihypertensive effect lasts 24 hours, with regular use it stabilizes by the end of the second week of treatment. The antianginal effect is determined by a decrease in myocardial oxygen demand as a result of a decrease in heart rate (lengthening diastole and an improvement in myocardial perfusion) and contractility, and also a decrease in myocardial sensitivity to the effects of sympathetic stimulation. Trimming heart rate at rest and during exercise. By increasing the end-diastolic pressure in the left ventricle and increasing the stretching of the muscle fibers of the ventricles can increase the need for oxygen, especially in patients with chronic heart failure. The antiarrhythmic effect is manifested in the suppression of sinus tachycardia and is associated with the elimination of arrhythmogenic sympathetic effects on the cardiac conduction system, a decrease in the rate of propagation of excitation through the sinoatrial node and an extension of the refractory period.Inhibits the conduction of impulses in the antegrade and to a lesser extent in the retrograde directions through the AV node and along additional pathways. A negative chronotropic effect appears after 1 h after ingestion, reaches a maximum after 2-4 h, lasts up to 24 h. Reduces the sinus node automatism, slows heart rate, slows AV-conductivity, reduces myocardial contractility, reduces myocardial oxygen demand. Reduces the excitability of the myocardium. When used in moderate therapeutic doses, it has a less pronounced effect on the smooth muscles of the bronchi and peripheral arteries than non-selective beta-blockers.
Indications
- arterial hypertension . - prevention of angina attacks (with the exception of Prinzmetal stenocardia). - Heart rhythm disorders: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular extrasystoles. - acute myocardial infarction with stable hemodynamic parameters.
Contraindications
- Hypersensitivity to the drug. - cardiogenic shock. - AV blockade II and III degree. - severe bradycardia (heart rate less than 45-50 beats / min.). - SSSU. - Sinoauricular blockade. - acute or chronic heart failure (decompensated). - Cardiomegaly without signs of heart failure. - Prinzmetal angina pectoris. - arterial hypotension (in the case of use in myocardial infarction, systolic blood pressure less than 100 mm Hg). - lactation period. - simultaneous administration of MAO inhibitors. - age up to 18 years (efficacy and safety have not been established). With care: diabetes. metabolic acidosis. hypoglycemia. allergic reactions in history. chronic obstructive pulmonary disease (including pulmonary emphysema). AV blockade I degree. chronic heart failure (compensated). obliterating diseases of peripheral vessels (intermittent claudication, Raynaud's syndrome). pheochromocytoma. liver failure . chronic renal failure. myasthenia gravis thyrotoxicosis. depression (including in the anamnesis). psoriasis. pregnancy elderly age.
Use during pregnancy and lactation
Pregnant women should be prescribed atenolol only in cases where the benefits to the mother outweigh the potential risk to the fetus.If necessary, the use of atenolol during lactation should decide on the termination of breastfeeding (atenolol is excreted in breast milk).
Dosage and administration
Inside Assign inside before a meal, without chewing, with a small amount of liquid. Hypertension: treatment starts with 50 mg of Atenolol Belupo 1 time / day. To achieve a stable hypotensive effect requires 1-2 weeks of admission. With insufficient severity of the hypotensive effect, the dose is increased to 100 mg in a single dose. A further increase in the dose is not recommended, since it is not accompanied by an increase in the clinical effect. Angina: the initial dose is 50 mg / day. If during the week the optimal therapeutic effect is not reached, increase the dose to 100 mg / day. In the presence of renal failure, a dose adjustment is recommended depending on creatinine clearance (CK). In patients with renal failure with CC values above 35 ml / min / 1.73 m2 (normal values are 100-150 ml / min / 1.73 m2), there is no significant cumulation of Atenolol Belupo. Patients on hemodialysis, Atenolol Belupo is prescribed 50 mg / day immediately after each session of dialysis, which should be carried out in a hospital, as there may be a decrease in blood pressure. For elderly patients, the initial single dose is 25 mg (can be increased under the control of blood pressure, heart rate). Acute myocardial infarction with stable hemodynamic parameters - 100 mg 1 time / day or 50 mg 2 times / day for 6-9 days or until discharge from the hospital (under the control of blood pressure, ECG, blood glucose level). Increasing the daily dose of more than 100 mg is not recommended, because the therapeutic effect is not enhanced, and the likelihood of side effects increases.
Side effects
Since the cardiovascular system: the development (aggravation) of symptoms of chronic heart failure (swelling of the ankles, stop. Dyspnea), impaired atrioventricular conduction, arrhythmia, bradycardia, marked reduction of blood pressure, orthostatic hypotension, palpitations, impaired myocardial conduction, weakening of myocardial myocardial infarction, myocardial contractility, myocardial contractility, myocardial infarction angiospasm (cooling of the lower limbs, Raynaud's syndrome), vasculitis, chest pain. CNS and peripheral nervous system: dizziness,decreased ability to concentrate, slower reaction, drowsiness or insomnia, depression, hallucinations, fatigue, headache, weakness, nightmarish dreams, anxiety, confusion or short-term memory loss, paresthesia in the limbs (in patients with intermittent claudication and Raynaud's syndrome), muscle weakness, convulsions. On the part of the digestive system: dry mouth, nausea, vomiting, diarrhea, abdominal pain, constipation, change in taste. On the part of the respiratory system: dyspnea, bronchospasm, apnea, nasal congestion. Hematological reactions: platelet purpura, anemia (aplastic), thrombosis. On the part of the endocrine system: gynecomastia, reduced potency, decreased libido, hyperglycemia (in patients with insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), a hypothyroid state. Metabolic reactions: hyperlipidemia. Skin reactions: urticaria, dermatitis, pruritus, photosensitivity, increased sweating, skin flushing, exacerbation of the course of psoriasis, reversible alopecia. Sense organs: blurred vision, decreased secretion of tear fluid, dry and sore eyes, conjunctivitis. Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia. From the laboratory indicators: agranulocytosis, leukopenia, increased activity of liver enzymes, hyperbilirubinemia, thrombocytopenia (unusual bleeding and hemorrhage). Others: back pain, arthralgia, withdrawal syndrome (increased angina attacks, increased blood pressure). The frequency of side effects increases with increasing dose of the drug.
special instructions
Since the cardiovascular system: the development (aggravation) of symptoms of chronic heart failure (swelling of the ankles, stop. Dyspnea), impaired atrioventricular conduction, arrhythmia, bradycardia, marked reduction of blood pressure, orthostatic hypotension, palpitations, impaired myocardial conduction, weakening of myocardial myocardial infarction, myocardial contractility, myocardial contractility, myocardial infarction angiospasm (cooling of the lower limbs, Raynaud's syndrome), vasculitis, chest pain. From the side of the central nervous system and peripheral nervous system: dizziness, decreased ability to concentrate, slower reaction, drowsiness or insomnia, depression, hallucinations,fatigue, headache, weakness, nightmares, anxiety, confusion or short-term memory loss, paresthesias in the limbs (in patients with intermittent claudication and Raynaud's syndrome), muscle weakness, convulsions. On the part of the digestive system: dry mouth, nausea, vomiting, diarrhea, abdominal pain, constipation, change in taste. On the part of the respiratory system: dyspnea, bronchospasm, apnea, nasal congestion. Hematological reactions: platelet purpura, anemia (aplastic), thrombosis. On the part of the endocrine system: gynecomastia, reduced potency, decreased libido, hyperglycemia (in patients with insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), a hypothyroid state. Metabolic reactions: hyperlipidemia. Skin reactions: urticaria, dermatitis, pruritus, photosensitivity, increased sweating, skin flushing, exacerbation of the course of psoriasis, reversible alopecia. Sense organs: blurred vision, decreased secretion of tear fluid, dry and sore eyes, conjunctivitis. Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia. From the laboratory indicators: agranulocytosis, leukopenia, increased activity of liver enzymes, hyperbilirubinemia, thrombocytopenia (unusual bleeding and hemorrhage). Others: back pain, arthralgia, withdrawal syndrome (increased angina attacks, increased blood pressure). The frequency of side effects increases with increasing dose of the drug.