Ancor 2.5mg Tablet 1 Strip

✔️ Pharmacology

Absorption and Distribution:

• Well absorbed (>90%) from the gastrointestinal tract with 88% bioavailability.
• Food intake does not affect absorption.

Metabolism and Elimination:

• Metabolized primarily by CYP3A4 in the liver, with minor involvement of CYP2D6.
• Cleared equally via renal excretion and hepatic metabolism.
• Half-life: 10–12 hours.

✔️ Possible side effects include

• Common: Fatigue, dizziness, headache, nausea, vomiting, diarrhea, constipation, abdominal pain.
• Other: Cold or numb extremities, muscle weakness or cramps, bradycardia, bronchospasm (in asthma or COPD patients).

✔️ Dosage & Administration

• Adults: Start with 5 mg once daily, alone or with a diuretic. Increase to 10–20 mg daily if needed, with 2-week intervals for dose adjustment.
• Children: Safety and effectiveness not established.
• Renal/Hepatic Impairment: Start with 5 mg daily; adjust the dose with caution due to the risk of accumulation.
• Elderly: No dose adjustment is needed unless significant renal or hepatic dysfunction is present.

✔️ Interaction Information

• Class I Antiarrhythmic Drugs (e.g., quinidine, disopyramide, propafenone):
  May prolong AV conduction time and increase the negative inotropic effect, leading to further slowing of heart function.
• Catecholamine-depleting Drugs (e.g., reserpine, guanethidine):
  Can cause excessive sympathetic activity reduction, potentially resulting in severe bradycardia or hypotension.
• Clonidine Withdrawal:
  May worsen rebound hypertension if β-blockers are not withdrawn several days prior to stopping clonidine.
• Digitalis Glycosides:
  Concurrent use may increase the risk of bradycardia due to additive effects on slowing heart rate.
• NSAIDs (e.g., ibuprofen, naproxen):
  Can reduce the antihypertensive effect of β-blockers, possibly reducing treatment efficacy.

✔️ Do not use in patients with:

• Cardiogenic shock.
• Overt heart failure.
• Second- or third-degree A-V block.
• Sinus bradycardia.
• Right ventricular failure due to pulmonary hypertension.

✔️ Precautions & Warnings

• Use with caution in patients with renal or hepatic impairment.
• Patients with a history of severe anaphylactic reactions may be less responsive to epinephrine while on β-blockers.
• Pregnant women should use Ancor only if the benefits outweigh the risks.

✔️ Pregnancy & Lactation

• Pregnancy: Bisoprolol is not teratogenic but may be fetotoxic at high doses. Use only if necessary.
• Lactation: Small amounts may be excreted in human milk; breastfeeding is not recommended during treatment.

✔️ Storage Instructions

• Store in a dry place, away from light and heat.
• Keep out of reach of children.