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nerve impulses, especially in the heart. As a result, bisoprolol slows down the heart rate and makes the heart more efficient at pumping blood around the body. Heart failure occurs when the heart muscle is weak and unable to pump enough blood to supply the body’s needs. Bisodac is used to treat stable chronic heart failure. It is used in combination with other medicines suitable for this condition (such as ACE-inhibitors, diuretics, and heart glycosides).2. Before you take BisodacDo not take BisodacDo not take Bisodac if one of the following conditions applies to you: • allergy (hypersensitivity) to bisoprolol or to any of the other ingredients (see section 6 ‘What Bisodac contains’) • severe asthma • severe blood circulation problems in your limbs (such as Raynaud’s syndrome), which may cause your fingers and toes to tingle or turn pale or blue • untreated phaeochromocytoma, which is a rare tumour of the adrenal gland • metabolic acidosis, which is a condition when there is too much acid in the blood.Do not take Bisodac if you have one of the following heart problems: • acute heart failure • worsening heart failure requiring injection of medicines into a vein, that increase the force of contraction of the heart • slow heart rate • low blood pressure • certain heart conditions causing a very slow heart rate or irregular heartbeat • cardiogenic shock, which is an acute serious heart condition causing low blood pressure and circulatory failure.Warnings and precautions If you have any of the following conditions tell your doctor before taking Bisodac; he or she may want to take special care (for example give additional treatment or perform more frequent checks): • diabetes • strict fasting • certain heart diseases such as disturbances in heart rhythm, or severe chest pain at rest (Prinzmetal’s angina) • kidney or liver problems • less severe blood circulation problems in your limbs • chronic lung disease or less severe asthma • history of a scaly skin rash (psoriasis) • tumour of the adrenal gland (phaeochromocytoma) • thyroid disorder.In addition, tell your doctor if you are going to have: • desensitization therapy (for example for the prevention of hay fever), because Bisodac may make it more likely that you experience an allergic reaction, or such reaction may be more severe • anaesthesia (for example for surgery), because Bisodac may influence how your body reacts to this situation. If you have chronic lung disease or less severe asthma please inform your doctor immediately if you start to experience new difficulties in breathing, cough, wheezing after exercise, etc. when using Bisodac. Children and adolescents Bisodac is not recommended for use in children or adolescents. Other medicines and Bisodac Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Do not take the following medicines with Bisodac without special advice from your doctor: • certain medicines used to treat irregular or abnormal heartbeat (Class I antiarrhythmic medicines such as quinidine, disopyramide, lidocaine, phenytoin; flecainide, propafenone) • certain medicines used to treat high blood pressure, angina pectoris or irregular heartbeat (calcium antagonists such as verapamil and diltiazem) • certain medicines used to treat high blood pressure such as clonidine, methyldopa, moxonodine, rilmenidine. However, do not stop taking these medicines without checking with your doctor first. Check with your doctor before taking the following medicines with Bisodac; your doctor may need to check your condition more frequently: • certain medicines used to treat high blood pressure or angina pectoris (dihydropyridine-type calcium antagonists such as felodipine and amlodipine) • certain medicines used to treat irregular or abnormal heartbeat (Class III antiarrhythmic medicines such as amiodarone) • beta-blockers applied locally (such as timolol eye drops for glaucoma treatment) • certain medicines used to treat for example Alzheimer’s disease or glaucoma (parasympathomimetics such as tacrine or carbachol) or medicines that are used to treat acute heart problems (sympathomimetics such as isoprenaline and dobutamine) • antidiabetic medicines including insulin • anaesthetic agents (for example during surgery) • digitalis, used to treat heart failure • non-steroidal anti-inflammatory medicines (NSAIDs) used to treat arthritis, pain or inflammation (for example ibuprofen or diclofenac) • any medicine, which can lower blood pressure as a desired or undesired effect such as antihypertensives, certain medicines for depression (tricyclic antidepressants such as imipramine or amitriptyline), certain medicines used to treat epilepsy or during anaesthesia (barbiturates such as phenobarbital), or certain medicines to treat mental illness characterized by a loss of contact with reality (phenothiazines such as levomepromazine) • mefloquine, used for p
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