Betaksolol (When ATH C07AB05)
When ATH:
C07AB05
Characteristic.
Betaxolol hydrochloride - a white crystalline powder. Soluble in water, ethanol, methanol and chloroform.
Pharmacological action.
Protivoglaukomnoe, gipotenzivnoe, antianginalnoe, antiarrhythmic.
Application.
Pills: arterial hypertension, angina; akathisia, neuroleptic-induced; eye drops: otkrыtougolynaya glaucoma, ocular hypertension, condition after laser trabeculoplasty, long-term antihypertensive therapy after surgical ophthalmologic intervention.
Contraindications.
Hypersensitivity, sinusovaya bradycardia (less than 45-50 beats. / min), sick sinus syndrome, AV block II-III degrees, hypotension (Sad below 100 mm Hg. Art.), cardiogenic shock, acute and refractory to treatment of severe heart failure, severe obstructive respiratory failure.
Restrictions apply.
Chronic obstructive pulmonary disease, unstable angina, tendency to bradycardia, AV block I degrees, the peripheral blood circulation, diabetes decompensated, gipoglikemiâ, pheochromocytoma, of the liver and kidneys, hyperthyroidism, muscular weakness, advanced age, childhood (Safety and efficacy have not determined).
Pregnancy and breast-feeding.
Maybe, if the effect of therapy outweighs the potential risk to the fetus.
Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
At the time of treatment should stop breastfeeding.
Side effects.
From the nervous system and sensory organs: asthenia (7,1%), headache (6,5%), dizziness (4,5%), drowsiness (2,8%), insomnia (1,2%), anxiety (0,8%), depression (0,8%), impaired concentration, nightmares, syncope, stupor, hallucinations, amnesia, emotional lability, sensitivity disorders, paraesthesia, neuralgia, neuropathy; pain and tinnitus, vestibular disorders, partial loss of hearing, tremor.
With the genitourinary system: impotence (1,2%), dizurija, oligurija, proteinuria, swelling, cystitis, počečnaâ how, decreased libido, menstrual disorders, pain and fibrocystic changes in the breast (female), prostatitis, Peyronie's disease.
From the digestive tract: dyspepsia (4,7%), diarrhea (2%), nausea (1,6%), dry mouth, anorexia, dysphagia, vomiting, constipation, abdominal pain.
From the respiratory system: upper respiratory tract infection (2,6%), dyspnoea (2,4%), chest pain (2,4%), pharyngitis (2%), rhinitis (1,4%), sinusitis, cough, breathlessness, bronchospasm, respiratory insufficiency.
Cardio-vascular system and blood (hematopoiesis, hemostasis): bradycardia (8,1%), symptomatic - 0,8%, heartbeat, OF блокада, gipotenziya, hypertension, violation of the trophic infarction, myocardial infarction, heart failure, exacerbation of intermittent claudication, thrombosis, anemia, leukocytosis, thrombocytopenia, purpura.
On the part of the musculoskeletal system: arthralgia (3,1%), Tendinitis, myalgia.
For the skin: rash (1,2%), alopecia, eczema, эritema, exacerbation of psoriasis, hypertryhoz, prurigo.
Other: allergic reactions, increasing the concentration of lactate dehydrogenase, liver enzymes (IS, GOLD), Acidosis, hypercholesterolemia, giperglikemiâ, hyperlipidemia, hyperuricemia, kaliopenia, gipotermiя, weight change, withdrawal.
When using eye drops: lacrimation (immediately after instillation), discomfort or foreign body in the eye, dry eyes, blurred vision, pain, photophobia, anizokorija, reduction in sensitivity or spotted coloration of the cornea, keratit, эritema, itch, systemic reactions.
Cooperation.
Increases (mutually) the likelihood of violations of automaticity, conductivity and contractility of the heart on the background of amiodarone, diltiazema, verapamil, quinidine medicines, the risk of hypotension and cardiac decompensation - against the background of dihydropyridine calcium antagonists, especially in patients with latent cardiac insufficiency. NSAIDs, glucocorticoids, Estrogens, enveloping and antacids weaken hypotensive effect; tricyclic antidepressants (imipramine) - Increase (may develop orthostatic hypotension). Potentiates the effect of non-depolarizing muscle relaxants, lidocaine inhibits the metabolism in the liver. Cimetidine and phenothiazines increase the concentration in plasma. With simultaneous systemic and local (as eyedrops) the use of beta-blockers may develop additive effects (on intraocular pressure or system).
Overdose.
Symptoms: dizziness, bradycardia, arrhythmia, gipotenziya, acute heart failure, bronchospasm, gipoglikemiâ, convulsions, in severe cases - collapse.
Treatment: gastric lavage and appointment of absorbent; symptomatic treatment: atropyn (I / 1-2 mg), beta-agonists (Isoprenaline), sedativnыe (diazepam, Lorazepam), cardiac (doʙutamin, Dopamine, epinephrine, norepinephrine) preparations, glucagon and Others Message. With heart block can transvenous pacing. Hemodialysis maloeffyektivyen.
Dosing and Administration.
Inside, morning. When hypertension by 10 mg dose. If after 7-14 days effect is insufficient, the dose can be increased to 20 mg and after another 1-2 weeks before 40 mg in a single step. For patients with impaired renal function, dialysis, and elderly patients - the initial dose 5 mg, single, if necessary increase at 5 mg every 14 days before 20 mg (no more).
When glaucoma: instillation in the conjunctival sac 1 drop 2 once a day (During the first month under the control of intraocular pressure).
Precautions.
Treatment is carried out under regular medical supervision. May mask the symptoms of hyperthyroidism and hypoglycemia (patients with diabetes, receiving antidiabetic drugs). It reduces the compensatory cardiovascular reactions in response to the use of general anesthetics and iodine-containing contrast agents. Before surgery using general anesthesia should stop the drug or choose an anesthetic with the least negative inotropic effects. Elderly patients are at increased risk of hypothermia, mental disorders, side effects of the cardiovascular system. In violation of liver and kidney function is recommended in the first clinical observation 4 day. Against the background of aggravated allergic history may increase the severity of hypersensitivity reactions and the lack of therapeutic effect of conventional doses of epinephrine. It is recommended that the use of alcohol at the time of treatment. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention. Discontinuation of therapy should be gradual for about 2 Sun.
Cautions.
During treatment, you can change the results of laboratory tests (false positive reaction in the analysis of doping, increase titer of antinuclear antibodies and others.).
Cooperation
Active substance | Description of interaction |
Amiodarone | FMR: synergism. Increases (mutually) the likelihood of violations of automaticity, conduction and myocardial contractility. |
Atenolol | FMR: synergism. Increases (mutually) effect. Beta-blockers, given by mouth, incl. atenolol and acebutolol, together with beta-blockers, used in ophthalmology (eye drops), incl. with betaxolol, enhance the reduction of intraocular pressure; while the effects of systemic beta-adrenergic blockade, usually, increase. |
Bisoprolol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |
Glipizide | FMR: synergism. Against the background of enhanced effect of betaxolol (possible masking of the early symptoms of hypoglycemia). |
Diltiazem | FMR: synergism. Strengthens (mutually) hypotensive effect; increasing negative effect on the heart rate, AV conduction and / or cardiac contractility, the possibility of excessive bradycardia, OF блокада (up to heart failure). |
Imipramine | FMR: synergism. Enhances the hypotensive effect (may develop orthostatic hypotension). |
Indomethacin | FMR: antagonizm. Reduces hypotensive effect (It inhibits the synthesis of prostaglandins in the kidneys and inhibits sodium and fluid). |
Insulin dvuhfaznыy [human genetic engineering] | FMR: synergism. Against the background of enhanced effect of betaxolol (can disguise the early symptoms of hypoglycemia). |
Klonidin | FMR. Compounding bradycardia and AV block increases the probability. |
Lidokain | FKV. Against the backdrop of slowing betaxolol biotransformation and increases the risk of manifestation of toxic effects. |
Metoprolol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |
Nadolol | FMR: synergism. Increases (mutually) effect. Beta-blockers, given by mouth, incl. nadolol, together with beta-blockers, used in ophthalmology (eye drops), incl. ʙetaksolol, enhance the reduction of intraocular pressure; while the effects of systemic beta-adrenergic blockade, usually, increase. |
Nifedipine | FMR: synergism. Strengthens (mutually) hypotensive effect; increased negative impact on the heart rate, AV conduction and / or cardiac contractility, possible development of congestive heart failure, excessive hypotension, angina attack, severe bradycardia, AV blockade (up to heart failure). |
Octreotide | FMR: synergism. Perhaps increased therapeutic and side (chrezmernaya bradycardia, Arrhythmia, conduction disorders) Effects; the combined reduction of the dose required appointment. |
Pindolol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |
Propranolol | FMR: synergism. Strengthens (mutually) effects. Beta-blockers, given by mouth, incl. propranolol, together with beta-blockers, used in ophthalmology (eye drops), incl. ʙetaksololom, enhance the reduction of intraocular pressure; while the effects of systemic beta-adrenergic blockade, usually, increase. |
Risperidone | FMR: synergism. Enhances the hypotensive effect. |
Rifampicin | FKV. It accelerates biotransformation and lowers blood. |
Sotalol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |
Timolol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |
Quinidine | FMR: synergism. Increases (mutually) the likelihood of violations of automaticity, conduction and myocardial contractility. |
Epinephrine | FMR: antagonizm. Against the background of weakened effect of betaxolol. Patients with atopic or severe anaphylactic reactions history, against the background of beta-blockers, used in ophthalmology, incl. ʙetaksolola, possible lack of response to conventional, used to treat anaphylactic reactions, dose. |
Esmolol | FMR: synergism. Strengthens (mutually) effects (the combined system is contraindicated). Against the background of betaxolol (eye drops) more pronounced decreases intraocular pressure. |