Cardicor

What is it?

A eardioselective β-blocker available as film-coated tablets in different strengths, containing bisoprolol fumarate. Round, white tablets contain 1.25mg or 2.5mg; off-white tablets contain 3.75mg; pale yellow tablets contain 5mg; yellow tablets contain 7.5mg; heart-shaped, orange tablets contain 10mg.

Medical Uses

In conjunction with ACE inhibitors, diuretics and possibly cardiac glycosides; for chronic moderate to severe heart failure in which there is lowered, systolic ventricular function and where the condition is stable.

Dosage

Starting dose, one 1.25mg tablet each day in the morning, swallowed whole, for 7 days. If well tolerated, dose increased by 1.25mg in second and consecutive weeks until a single daily, morning dose of 5mg is achieved. Continue for 4 weeks and then, dose can be similarly increased at weekly intervals, if required. Maximum daily dose is 10mg.

Special Care

Pregnancy, breastfeeding, liver or kidney disease, history of bronchospasm, diabetes, insufficient cerebrovascular circulation, weakness, atopy (inherited tendency to develop immediate allergic responses), anaesthesia (drug may need to be withdrawn before planned surgery), thyrotoxic crisis. Treatment should only be initiated under supervision of experienced physician and patient should be monitored for 4 hours after first dose. Drug should be stopped gradually.

Avoid Use

Children, various heart conditions (sinus bradycardia, 2nd or 3rd degree AV block, Prinzmetal's angina, right ventricular failure resulting from pulmonary hypertension, cardiogenic shock, significantly enlarged heart), severe peripheral arterial disease, metabolic acidosis, phaeochromocytoma which has not been treated.

Possible Drug and Food Interactions

Cardiac depressant anaesthetics, class II calcium antagonists, verapamil, diltiazem, class I antiarrhythmics, clonidine withdrawal, CNS depressants, hypoglycaemics, other antihypertensives, rifampicin, ibuprofen, sympathomimetics, reserpine, indomethacin, ergot alkaloids warfarin, cimetidine, theophylline.

Known Side Effects

Bronchospasm, low blood pressure, cold hands and feet, slow heart beat, tiredness on exertion, sleep disturbance, heart failure, thrombocytopaenia (reduced platelets in blood), gastrointestinal upset, hair loss. If skin rash or unexplained dry eyes arise, gradually withdraw drug. Any adverse effects should be reported to the Committee on the Safety of Medicines (CSM).