Bisoprolol fumarate tablets (Maintea) are a selective beta 1 receptor blocker primarily used for the treatment of hypertension and chronic heart failure. The following provides a detailed explanation of its clinical application guidelines from the aspects of indications, usage and dosage, precautions, etc.

1. Indications

(1) Hypertension: It can be used as a first-line antihypertensive drug alone or in combination with other antihypertensive drugs.

(2) Chronic stable heart failure: It needs to be used in combination with other standard heart failure treatment drugs.

2. Usage and dosage

(1) Hypertension treatment

The initial dose is usually 5mg once daily, and the maximum dose does not exceed 20mg/day. Elderly patients or those with liver and kidney dysfunction should start with 2.5mg.

(2) Heart Failure Treatment

It is necessary to start from a very low dose (1.25mg/day) and double the dose every 2-4 weeks to the target maintenance dose of 10mg/day. Strict monitoring of blood pressure and heart rate changes is required.

3. Adjustment for special populations

(1) Liver dysfunction: The dose is halved for Child Pugh B patients and contraindicated for C patients.

(2) Renal insufficiency: The maximum dose should not exceed 10mg/day when GFR<20ml/min.

(3) Elderly people: It is recommended to start with 2.5mg.

4. Notes

(1) The medication needs to be gradually stopped to avoid rebound.

(2) It may cover the symptoms of hypoglycemia, and patients with diabetes need to be alert.

(3) Prohibited for patients with acute heart failure, cardiogenic shock, and severe bradycardia.

(4) Asthma patients should use with caution as it may induce bronchospasm.

5. Adverse reaction monitoring

(1) Common symptoms include fatigue, dizziness, and bradycardia.

(2) Regularly monitor liver and kidney function, blood glucose, and electrocardiogram.

(3) Immediate discontinuation of medication is required if grade II or above atrioventricular block occurs.