Zebeta Uses

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What is Zebeta?

Zebeta is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Zebeta is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

Zebeta is available only with your doctor's prescription.

Zebeta indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Zebeta, a type of medication known as a beta-blocker, is used to treat high blood pressure. Beta-blockers lower blood pressure by decreasing the force and rate of heart contractions, which reduces the heart’s demand for oxygen. Zebeta can be used alone or in combination with other high blood pressure medications.

How should I use Zebeta?

Use Zebeta as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Zebeta.

Uses of Zebeta in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Use: Labeled Indications

Hypertension: Management of hypertension. Note: Beta-blockers are not recommended as first-line therapy (ACC/AHA [Whelton 2017]).

Off Label Uses

Acute MI

According to the American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of ST-elevation myocardial infarction (STEMI) and the ACC/AHA guidelines for the management of non-ST-elevation ACS (NSTE-ACS), oral beta-blockers should be initiated within the first 24 hours unless the patient has signs of heart failure, evidence of a low-output state, an increased risk for cardiogenic shock, or other contraindications. However, recommendations do not specify any particular beta-blocking agent for optimal treatment of NSTE-ACS. Thus, clinicians must use practical experience to determine proper therapy in managing patients.

Based on the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) 2013 heart failure guidelines, the use of 1 of the 3 beta-blockers (ie, Zebeta, carvedilol, or extended-release metoprolol succinate) is effective and recommended for all patients with recent or remote history of MI or ACS and reduced ejection fraction (rEF) to reduce mortality, for all patients with rEF to prevent symptomatic heart failure (HF) even if no history of MI, and for all patients with current or prior symptoms of HF with reduced ejection fraction (HFrEF), unless contraindicated to reduce morbidity and mortality.

Ventricular arrhythmias

Based on the American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guideline for management of patients with ventricular arrhythmias and prevention of sudden cardiac death, beta-blockers are effective for control of ventricular arrhythmias and ventricular premature beats.

Zebeta description

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Zebeta is a cardioselective β1-adrenergic blocking agent used for secondary prevention of myocardial infarction (MI), heart failure, angina pectoris and mild to moderate hypertension. Zebeta is structurally similar to metoprolol, acebutolol and atenolol in that it has two substituents in the para position of the benzene ring. The β1-selectivity of these agents is thought to be due in part to the large substituents in the para position. At lower doses (less than 20 mg daily), Zebeta selectively blocks cardiac β1-adrenergic receptors with little activity against β2-adrenergic receptors of the lungs and vascular smooth muscle. Receptor selectivity decreases with daily doses of 20 mg or greater. Unlike propranolol and pindolol, Zebeta does not exhibit membrane-stabilizing or sympathomimetic activity. Zebeta possesses a single chiral centre and is administered as a racemic mixture. Only l-Zebeta exhibits significant β-blocking activity.

Zebeta dosage

Treatment should always be started gradually with low doses and then increased slowly. The dosage should be determined on an individual basis in each case, particularly depending on the pulse rate and success of treatment.

Essential Hypertension: Recommended Dose: 5 mg once daily (equivalent to 1 film-coated tablet of Zebeta 5 mg or ½ film-coated tablet of Zebeta 10 mg).

In milder forms of hypertension (diastolic blood pressure up to 105 mmHg), treatment with Zebeta 2.5 mg once daily (equivalent to ½ film-coated tablet of Zebeta 5 mg) may be sufficient.

If required, the dose may be increased to Zebeta 10 mg once daily (equivalent to 2 film-coated tablets of Zebeta 5 mg or 1 film-coated tablet of Zebeta 10 mg).

Further dose increase is justified only in exceptional cases.

Maximum Recommended Dose: 20 mg once daily.

Coronary Heart Disease (Angina Pectoris): Recommended Dose: 5 mg once daily (equivalent to 1 film-coated tablet of Zebeta 5 mg or ½ film-coated tablet of Zebeta 10 mg).

If required, the dose may be increased to Zebeta 10 mg once daily (equivalent to 2 film-coated tablets of Zebeta 5 mg or 1 film-coated tablet of Zebeta 10 mg).

Further dose increase is justified only in exceptional cases.

Maximum Recommended Dose: 20 mg once daily.

Treatment with Zebeta 5 mg or 10 mg should not be stopped abruptly, particularly in patients with coronary heart disease, since this may lead to acute worsening of patient's condition. If discontinuation of treatment is necessary, the dose should be reduced gradually (eg, divided into halves weekly).

Hepatic and/or Renal Dysfunctions: In patients with mild or moderate hepatic and/or renal dysfunction, dose adjustment is not necessary in general. In patients with advanced renal insufficiency (CrCl <20 mL/min) and in patients with severe hepatic dysfunction, daily dose of Zebeta 10 mg should not be exceeded.

Stable Chronic Heart Failure: Standard treatment of chronic heart failure is performed with an ACE inhibitor (or another vasodilator if ACE inhibitors are not tolerated), a β-blocker, diuretics, and if necessary, cardiac glycosides. The patients should have stable chronic heart failure (without acute heart failure) at the beginning of Zebeta treatment.

Recommendation: It is recommended that the treating physician should be experienced in management of chronic heart failure.

Transient exacerbation of heart failure, hypotension or bradycardia may occur during and after titration phase.

Titration Phase: Treatment of chronic heart failure with Zebeta requires gradual dose titration.

Treatment with Zebeta must be initiated with gradual dose increase according to the following scheme: 1.25 mg once daily for 1 week (other dose strengths are available for this dosage). If this dose is well tolerated, increase to 2.5 mg once daily for 1 week; then, increase to 3.75 mg once daily for 1 week (other dose strengths are available for this dosage). If this dose is well tolerated, increase to 5 mg once daily for 4 week; then, increase to 7.5 mg once daily for 4 weeks (other dose strength are available for this dosage). If this dose is well tolerated, increase to 10 mg daily as maintenance dose.

Maximum Recommended Dose: Zebeta 10 mg once daily.

Close monitoring of vital functions (heart rate, blood pressure) as well as for signs of worsening heart failure is recommended during the titration phase. Symptoms may already occur on the first day when starting treatment.

Dose Adjustment: If the highest recommended dosage is not tolerated, gradual reduction may be considered.

In case of transient exacerbation of heart failure, hypotension or bradycardia, the dosage of the adjuvant medication should be re-assessed. Transient reduction or discontinuation of Zebeta may also be necessary.

When the patient's condition has stabilized again, resumption of treatment and/or increase in the Zebeta dose should always be considered.

If discontinuation of treatment is considered, the dose should be reduced gradually, since abrupt withdrawal may lead to acute exacerbation of the disease.

Treatment of stable chronic heart failure with Zebeta is generally long-term treatment.

Treatment with Zebeta should not be discontinued abruptly, since this might lead to a transitory worsening of heart failure. If discontinuation of treatment is necessary, the dose should be gradually decreased (eg, divided into halves weekly).

Renal or Hepatic Insufficiency: There are no pharmacokinetic studies in patients with chronic heart failure, and with impaired liver or renal function. Increase of the dose in these patients should therefore be made with additional caution.

Elderly: No dose adjustment is necessary.

Children: There is no pediatric experience with Zebeta; therefore, its use cannot be recommended for children.

Administration: The film-coated tablets are to be taken unchewed together with sufficient liquid, preferably on an empty stomach in the morning or together with breakfast.

Duration of Use: The duration of use is not limited. It depends on the type and severity of the disease.

Zebeta interactions

See also:
What other drugs will affect Zebeta?

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Zebeta may potentiate the effect of other antihypertensive drugs concurrently administered. Concomitant therapy of Zebeta and reserpine, α-methyldopa, clonidine and guanfacine, may cause a considerable decrease in heart rate.

In concomitant treatment with clonidine, clonidine should not be discontinued unless administration of Zebeta has been terminated for a few days.

The concurrent use of nifedipine may potentiate the antihypertensive effect of Zebeta. In concurrent use of Zebeta and calcium antagonists of the verapamil and diltiazem type or other antiarrhythmic agents, careful monitoring of the patient is indicated, as this can cause hypotension, bradycardia and other conditions of arrhythmia. The IV administration of calcium antagonists and antiarrhythmic agents is therefore not recommended during treatment with Zebeta.

The concurrent use of Zebeta and rifampicin can slightly reduce the half-life of Zebeta. An increase in dose is generally not necessary.

The concurrent use of Zebeta and insulin or oral blood sugar-reducing drugs may potentiate the effect of the latter. The symptoms of hypoglycemia (in particular tachycardia) are masked or mitigated. Blood sugar levels should be monitored regularly.

As cardiac output may be impaired under anesthesia, prior to an operation, the anesthetist should be informed if the patient is being treated with Zebeta.

Zebeta side effects

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What are the possible side effects of Zebeta?

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Applies to Zebeta: oral tablet

As well as its needed effects, Zebeta (the active ingredient contained in Zebeta) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking Zebeta, check with your doctor immediately:

Less common:

Rare

If any of the following symptoms of overdose occur while taking Zebeta, get emergency help immediately:

Symptoms of overdose:

Minor Side Effects

Some Zebeta side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common:

Zebeta contraindications

See also:
What is the most important information I should know about Zebeta?

Do not skip doses or stop taking Zebeta without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using Zebeta.

Zebeta can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It can increase some of the side effects of Zebeta.

Zebeta is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Active ingredient matches for Zebeta:

Bisoprolol

Bisoprolol FUMARATE 5mg

Bisoprolol fumarate in United States.


Unit description / dosage (Manufacturer)Price, USD
Tablet; Oral; Bisoprolol Fumarate 10 mg
Tablet; Oral; Bisoprolol Fumarate 5 mg
30 tablet in 1 bottle
Zebeta tablet, film coated 5 mg/1 (Teva Women's Health, Inc. (US))
Zebeta tablet, film coated 10 mg/1 (Teva Women's Health, Inc. (US))

List of Zebeta substitutes (brand and generic names):

Teva-bisoprolol tablet 5 mg (Teva Canada Limited (Canada))
Teva-bisoprolol tablet 10 mg (Teva Canada Limited (Canada))
Trubis 2.5 mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.05
Trubis 5 mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.06
TRUBIS 2.5 MG TABLET 1 strip / 10 tablets each (Torrent Pharmaceuticals Ltd.)$ 0.48
TRUBIS 5 MG TABLET 1 strip / 10 tablets each (Torrent Pharmaceuticals Ltd.)$ 0.63
Trubis 2.5mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.05
Trubis 5mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.06
Vasoten 5 mg x 10 x 10's (Synmosa)
Vasoten film-coated tab 5 mg 10 x 10's (Synmosa)
Zabesta 2.5mg TAB / 10 (US Vitamins Limited)$ 0.47
Zabesta 5mg TAB / 10 (US Vitamins Limited)$ 0.63
2.5 mg x 10's (US Vitamins Limited)$ 0.67
5 mg x 10's (US Vitamins Limited)$ 0.63
Zabesta 5 mg Tablet (US Vitamins Limited)$ 0.08
Zabesta 2.5 mg Tablet (US Vitamins Limited)$ 0.07
ZABESTA 2.5 MG TABLET 1 strip / 10 tablets each (US Vitamins Limited)$ 0.67
ZABESTA 5 MG TABLET 1 strip / 10 tablets each (US Vitamins Limited)$ 0.91
ZABESTA tab 2.5 mg x 10's (US Vitamins Limited)$ 0.61
ZABESTA tab 5 mg x 10's (US Vitamins Limited)$ 0.83
Zabesta 2.5mg Tablet (US Vitamins Limited)$ 0.07
Zabesta 5mg Tablet (US Vitamins Limited)$ 0.10
Tablet; Oral; Bisoprolol Fumarate 10 mg
Tablet; Oral; Bisoprolol Fumarate 5 mg

References

  1. DailyMed. "BISOPROLOL FUMARATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "BISOPROLOL". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "BISOPROLOL". http://www.drugbank.ca/drugs/DB00612 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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