Effects of this medicine

Before using this medicine, be sure to tell your doctor and pharmacist

• If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
  If you have: bronchial asthma, bronchospasm, diabetic ketoacidosis, metabolic acidosis, arrhythmia, cardiogenic shock, decompensated heart failure, right-sided heart failure secondary to pulmonary hypertension, untreated pheochromocytoma, long fasting state, malnutrition, disorders in liver/kidney, peripheral circulatory disorder, or hypotension.

• If you are pregnant, possibly pregnant or breastfeeding.

• If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Dosing schedule (How to take this medicine)

• Your dosing schedule prescribed by your doctor is ((        to be written by a healthcare professional))

• For treatment of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy: In general, for adults, start with 1/2 tablet (1.25 mg of the active ingredient) at a time, twice a day after meals. If tolerated, this dose will be increased step by step, each time after more than a week of assessment. The dose will be reduced if intolerable. Dose adjustment is made in incremental steps without exception. Single dose is usually 1/2 tablet (1.25 mg), 1 tablet (2.5 mg), 2 tablets (5 mg) or 4 tablets (10 mg). In any case, the medicine is taken twice a day after meals. The standard maintenance dose is 1-4 tablets (2.5 to 10 mg) at a time, twice a day after meals. According to your age and symptoms, you may be ordered to start with even smaller doses. Depending on how you will respond to the medicine, maintenance dose will be suitably adjusted.
  For treatment of tachycardiac atrial fibrillation: In general, for adults, start with 2 tablets (5 mg of the active ingredient) at a time, once a day. If the effect is insufficient, this dose will be increased to 4 tablets (10 mg) or to 8 tablets (20 mg) step by step, at a time, once a day. The dose may be adjusted according to your age and symptom, and maximum dose should not exceed 8 tablets (20 mg) at a time, once a day.
  In any case, strictly follow the instructions.

• If you miss a dose, take the missed dose as soon as possible. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. You should never take two doses at one time.

• If you accidentally take more than your prescribed dose, consult with your doctor or pharmacist.

• Do not stop taking this medicine unless your doctor instructs you to do so.

Precautions while taking this medicine

• You may feel dizzy or light-headed, especially when starting/increasing dose.
  Do not drive a car or operate dangerous machinery while you take the medicine.

Possible adverse reactions to this medicine

• shortness of breath, dizziness, loss of consciousness [severe bradycardia, complete atrioventricular block, cardiac failure and cardiac arrest]
• facial pallor, cold sweats, lightheadedness [shock]
• general fatigue, loss of appetite, yellowing of the skin/white of eyes [liver dysfunction, jaundice]
• general fatigue, decreased urine output, swollen limbs/face [acute renal failure]
• fever, general malaise, rash on the skin/eyes and in mouth [toxic epidermal necrosis, oculomucocutaneous syndrome]
• breathing difficulty, lightheadedness, swelling around eyes/lips [anaphylaxis]

Storage conditions and other information

• Keep out the reach of children. Store away from direct sunlight, heat and moisture.
• Discard the remainder. Do not store them.

For healthcare professional use only : Day Month Year