Control of patients receiving Obsidan should include monitoring the heart rate and blood pressure (at the beginning of treatment - every day, then once every 3-4 months), ECG.
In elderly patients it is recommended to monitor the kidney function (1 time in 4-5 months).
In the case of an increasing bradycardia (less than 50 beats per minute), arterial hypotension (systolic blood pressure less than 100 mmHg), atrioventricular blockade, bronchospasm, ventricular arrhythmias, severe violations of the liver and / or kidney function in elderly patients, it is necessary reduce the dose of the drug or discontinue treatment.
The patient should be taught how to calculate the heart rate and instructed about the need for medical advice at a heart rate of less than 50 beats per minute.
It is recommended to stop therapy with the development of depression caused by the use of beta-blockers.
Patients who use contact lenses should take into account that, on the background of treatment, tear fluid production can be reduced.
Before appointment, Obsidan, patients with heart failure (early stages) should use digitalis and / or diuretics.
Treatment of coronary heart disease and persistent arterial hypertension should be long-lasting - Adzidan's intake is possible for several years.
Termination of treatment is carried out gradually, under the supervision of a doctor: a sharp cancellation can dramatically increase myocardial ischemia, anginal syndrome, worsen tolerance to physical exertion.
Abolition is carried out gradually, reducing the dose for 2 weeks or more (reduce dose by 25% every 3-4 days).
In patients with diabetes, the drug is administered under the control of blood glucose (1 time in 4-5 months).
With thyrotoxicosis, Obsidan can mask certain clinical signs of hyperthyroidism (for example, tachycardia). Sharp abolition in patients with thyrotoxicosis is contraindicated, since it can strengthen symptoms.
With the appointment of beta-blockers, patients receiving hypoglycemic drugs should be careful, because during prolonged interruptions in eating can develop hypoglycemia. And such her symptoms as tachycardia or tremor will be masked by the action of the drug. Patients should be instructed that the main symptom of hypoglycemia during treatment with beta-blockers is increased sweating.
With caution, appoint together with hypoglycemic agents (the risk of hypoglycemia in the background of insulin therapy and hyperglycemia - against oral hypoglycemic agents).
With the simultaneous administration of clonidine, his reception may be terminated only a few days after the withdrawal of Obsidan.
When pheochromocytoma is prescribed only in combination with alpha-blockers.
It can not be used simultaneously with antipsychotic drugs (neuroleptics) and tranquilizers.
Drugs that reduce catecholamine stocks (for example, reserpine) can enhance the action of beta-blockers, so patients taking a combination of drugs should be under constant observation of the doctor for the diagnosis of arterial hypotension and bradycardia.
Against the background of treatment Obsidan should avoid intravenous injection of verapamil, diltiazem.
Carefully apply together with psychotropic drugs, for example, MAO inhibitors, with their course use for more than 2 weeks.
A few days before the general anesthesia with chloroform or ether, it is necessary to stop taking the drug (increased risk of oppression of myocardial function and development of arterial hypotension).
In "smokers" the effectiveness of beta-blockers is lower.
During treatment it is not recommended to take ethanol (possibly a sharp drop in blood pressure).
It is necessary to cancel the drug before examining the content in the blood and urine of catecholamines, normetanephrine and vinylamidic acid; titers of antinuclear antibodies.
During treatment, avoid using natural licorice; food rich in protein, can increase bioavailability.