Cardicor

Beta-blockers work by blocking beta receptors that are found in various parts of the body. Blocking beta receptors prevents the action of two chemicals, called noradrenaline and adrenaline, which are produced naturally by the body. These are often referred to as the 'fight or flight' chemicals, because they are responsible for the body's reaction to stressful situations.

Beta receptors are found in the heart. When they are blocked by bisoprolol, this reduces the effect of adrenaline and noradrenaline on the heart. As a result, the heart beats more slowly and with less force. This reduces the pressure at which the blood is pumped out of the heart and around the body, which in turn reduces the blood pressure.

The actions described above decrease the effort that the heart needs to make to pump blood around the body. This means that bisoprolol can be used to treat chronic heart failure, where the pumping action of the heart has become less effective. Bisoprolol is used in addition to standard heart failure medicines such as ACE inhibitors, diuretics and digoxin.

When starting treatment for heart failure your dose of bisoprolol will be increased gradually, usually over a couple of months. You will need to be monitored by your doctor for about four hours when you first start treatment.

What is it used for?

- Chronic, stable moderate to severe heart failure in addition to standard medicines

Warning!

- This medicine may cause fatigue and dizziness. You should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
- Alcohol may enhance the blood pressure lowering effect of this medicine, which might make you feel dizzy or faint.
- You should not stop taking this medicine suddenly, as this might make your heart failure worse. When treatment with this medicine is stopped it should be done gradually, following the instructions given by your doctor.
- This medicine may mask some of the warning symptoms of low blood sugar, such as increased heart rate, tremor and nausea. People with diabetes should carefully monitor their blood sugar while taking this medicine.

Use with caution in

- People over 80 years of age
- Decreased kidney function
- Decreased liver function
- Congenital heart disease
- Heart valve disease
- People who have had a heart attack in the last three months
- Slowed conduction of electrical messages between the chambers of the heart (1st degree heart block)
- A severe form of angina pectoris, not caused by exertion (Prinzmetal's angina)
- Problems with blood circulation in the arteries of the extremities (peripheral arterial disease such as Raynaud's syndrome or intermittant claudication)
- Asthma
- Chronic obstructive pulmonary disease
- Diabetes
- Strict fasting
- History of psoriasis
- History of allergies
- People having desensitisation therapy for allergies
- Overactive thyroid gland

Not to be used in

- Acute or uncontrolled heart failure
- Failure of the heart to maintain adequate circulation of blood (cardiogenic shock)
- Serious defect in the heart's electrical message pathways (2nd or 3rd degree heart block), unless an artificial pacemaker is fitted
- A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)
- Failure of the electrical impulse that causes the heart to beat to leave the pacemaker of the heart, resulting in decreased heart function (sino-atrial heart block)
- Slow heart rate of less than 60 beats per minute (bradycardia)
- Low blood pressure (hypotension)
- Severe problems with blood circulation in the arteries of the extremities (peripheral arterial disease such as Raynaud's syndrome or intermittant claudication)
- Severe asthma
- Severe chronic obstructive pulmonary disease
- Untreated tumour of the adrenal gland (phaeochromocytoma)
- Increased acid levels in the blood (metabolic acidosis).
- There is insufficient information regarding the safety and efficacy of this medicine in children. It is not recommended for children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine may be harmful to a developing baby. It should not be used during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
- It is not known whether this medicine passes into breast milk. Breastfeeding is not recommended while taking this medicine. Seek medical advice from your doctor.

Label warnings

- Do not stop taking this medication except on your doctor's advice.

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