Lodoz®

Lodoz is recommended to be taken in the morning (during meals). pills should be swallowed whole with a small amount of liquid and not chewed.

The initial dose corresponds to 1 tablet (2.5 mg of bisoprolol / 6.25 mg of hydrochlorothiazide) 1 time / In case of insufficient efficacy of treatment, increase the dose to 1 tablet (5 mg of bisoprolol / 6.25 mg of hydrochlorothiazide) 1 time / If necessary, the dose can be increased to 1 tablet (10 mg of bisoprolol / 6.25 mg of hydrochlorothiazide) 1 time /
In patients with impaired liver function or moderate renal dysfunction (CC> 30 ml / min), a dose change is not required.

It is not recommended to use Lodoz during pregnancy because it contains a diuretic from the thiazide group.

It is currently unknown whether bisoprolol is excreted in breast milk. Diuretics from the thiazide group are excreted in breast milk. Breastfeeding during treatment with the drug Lodoz is contraindicated.

Do not suddenly stop treatment, especially in patients with coronary artery disease. The dose is recommended to be reduced gradually over 2 weeks. If necessary, at the same time, initiate appropriate therapy to prevent strokes.
If it is necessary to administer the drug to patients with asthma or COPD, the treatment should be started with the minimum initial dose. Before starting therapy, it is recommended to conduct functional respiratory tests. If bronchospasm develops during therapy, beta-adrenomimetics should be prescribed.
Patients with chronic heart failure should be prescribed the drug with caution and under the supervision of a physician, in minimal doses.
It is necessary to reduce the dose of the drug for heart rate at rest. Given the negative dromotropic effect of beta-blockers, they should be prescribed with caution in patients with AV-blockade I degree.
In patients with peripheral circulatory disorders (Raynaud's disease), beta-blockers may cause exacerbation of the disease.
Patients with pheochromocytoma should not be given Lodoz until treatment with alpha-blockers is performed. Need to control blood pressure.
In older patients, treatment should begin with a low dose of the drug, careful monitoring of the patient’s condition is necessary.
Patients taking Lodoz should be warned about the possibility of hypoglycemia and the need for regular monitoring of blood glucose levels. Bisoprolol may mask the symptoms of hypoglycemia (tachycardia, palpitations, and sweating).
During therapy with beta-blockers, exacerbation of the course of psoriasis is possible.Bisoprolol should be administered only when necessary.
With indications of anaphylactic reactions in history, regardless of the cause of their occurrence, especially when taking floctaphenin, or during desensitization therapy, treatment with beta-adrenergic blockers may aggravate the occurrence of these reactions and cause the development of resistance to treatment with epinephrine (adrenaline) in usual doses.
Athletes should be informed that Lodoz contains an active substance that can give positive results when conducting doping tests.
Precautions Associated with the Use of Hydrochlorothiazide:
Before starting further regularly during therapy and control of sodium levels in the blood is necessary. Reduction of sodium at the beginning of treatment may be asymptomatic, so regular monitoring is necessary. Special attention is required in the presence of risk factors, for example, patients of old age, patients with cirrhosis of the liver.
It is necessary to control blood potassium in high-risk patients, for example, in elderly patients, in patients receiving thiazide and thiazide-like diuretics, as well as in patients with cirrhosis, accompanied by edema, ascites, in patients with coronary artery disease or heart failure, extended QT interval.
Hypokalemia increases the risk of arrhythmias, the toxicity of cardiac glycosides. The first determination of the level of potassium in the blood must be carried out during the first week of therapy with Lozodom.
Thiazide diuretics can reduce urinary calcium excretion, resulting in minor and temporary hypercalcemia. Temporary hypercalcemia may be associated with undiagnosed hyperparathyroidism. Before the study of the function of the parathyroid glands, treatment with thiazides should be discontinued.
It is necessary to control the level of glucose in the blood of patients with diabetes mellitus, especially in the case of hypokalemia.
In patients with hyperuricemia, the risk of developing gout attacks is increased: the dose of the drug must be selected individually.
Thiazide diuretics are effective in normal kidney function or slightly reduced kidney function (QC 220 µmol / L). In elderly patients, the content of serum creatinine can be calculated taking into account the age, body weight and sex of the patient using the Cockroft formula:
For men:
QC (ml / min) = [140-age] x body weight (kg) / 72 x serum creatinine (mg / dL)
For women: the obtained value is 0.85
Hypovolemia (loss of fluid and sodium), resulting from the use of diuretics at the beginning of therapy, leads to a decrease in glomerular filtration, which leads to an increase in the level of urea and creatinine in the blood in patients with normal renal function.
Temporary impaired renal function occurs without consequences in patients with normal renal function. In patients with impaired renal function, it is possible to enhance existing disorders.
In the case of the appointment of the drug with another antihypertensive agent is recommended to reduce the dose at the beginning of treatment.
Use in pediatrics: The efficacy and safety of the drug in children and adolescents under the age of 18 years have not been established, so the use of the drug is contraindicated.
Influence on ability to drive motor transport and control mechanisms: use with caution when driving and working with mechanisms in connection with the possibility of dizziness.

Symptoms: excessive decrease in blood pressure, bradycardia. In newborns from mothers who received treatment with beta-blockers, may develop an overdose, manifested by decompensation of cardiac activity.
Treatment: in the case of severe bradycardia or an excessive decrease in blood pressure, the following drugs are injected into / in: atropine 1-2 mg; glucagon at a dose of 1 mg slowly bolus and then, if necessary, in the form of an infusion at a dose of 1-10 mg / h; then, if necessary, either epinephrine (adrenaline) at a dose of 15-85 µg is administered, the administration can be repeated, its total amount should not exceed 300 µg, or dopamine at a dose of 2.5-10 µg / kg / min.
In case of overdose in newborns, manifested by decompensation of cardiac activity, glucagon is prescribed at the rate of 0.3 mg / kg; epinephrine (adrenaline) and dobutamine (usually in high doses) must be monitored in the ICU of newborns. Prolonged treatment is carried out under the supervision of a specialist.