Bidop
Bidop: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Bidop
ATX code: C07AB07
Active ingredient: bisoprolol (bisoprolol)
Producer: Gedeon Richter-RUS, JSC (Russia), Niche Generics (Ireland)
Description and photo updated: 28.08.
Prices in pharmacies: from 82 rubles.
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Bidop - selective beta 1 -adrenergic blocker; a drug that has antianginal, hypotensive and antiarrhythmic effects.
Release form and composition
Dosage form - tablets: round, convex on both sides, marked "B1" in the center above the risk (14 pcs. In a blister, in a cardboard box 1, 2 or 4 blisters and instructions for use of Bidop):
- 5 mg: light yellow with yellow blotches, with the number 5 under the line;
- 10 mg: light brown with brown spots, with the number 10 under the line.
Active ingredient: bisoprolol fumarate, in 1 tablet - 5 or 10 mg.
Auxiliary components: crospovidone, magnesium stearate, microcrystalline cellulose, lactose monohydrate, and dye: tablets 5 mg - yellow pigment PB-22812 (87% is lactose monohydrate, 13% is iron oxide yellow), 10 mg tablets - beige pigment РВ-27215 (60% is lactose monohydrate, 38% is iron oxide yellow, 2% is iron oxide red).
Pharmacological properties
Pharmacodynamics
Bisoprolol - the active substance of Bidop, is a selective β 1 -adrenergic blocker. It has no membrane stabilizing effect and internal sympathomimetic activity. The substance is characterized by only a slight affinity for β 2 -adrenoceptors of smooth muscles of the bronchi and blood vessels, as well as for β 2 -adrenergic receptors involved in the regulation of metabolism. Thus, in general, bisoprolol does not affect metabolic processes and airway resistance, in which β 2 -adrenergic receptors are involved.
The selective effect of bisoprolol on β 1 -adrenergic receptors persists even when used outside the therapeutic range.
The substance has no pronounced negative inotropic effect. The development of the maximum effect is observed 3-4 hours after oral administration. Even in the case of using Bidop once a day, its therapeutic effect lasts for 24 hours, which is provided by a 10-12-hour half-life from blood plasma. The maximum reduction in blood pressure is usually achieved 14 days after starting treatment.
Bisoprolol reduces the activity of the SAS (sympathoadrenal system) by blocking β 1 -adrenergic receptors of the heart.
In patients with ischemic heart disease without signs of chronic heart failure, a single oral administration of Bidop reduces the stroke volume of the heart, slows down the heart rate, and, as a result, leads to a decrease in the ejection fraction and myocardial oxygen demand.
With prolonged therapy, the initially increased total peripheral vascular resistance decreases. A decrease in renin activity in blood plasma is regarded as one of the components of the hypotensive action of β-blockers.
Pharmacokinetics
Bisoprolol is almost completely absorbed (over 90%) from the gastrointestinal tract. Bioavailability after oral administration is approximately 90% (associated with low metabolism during the first passage through the liver). Food intake does not affect bioavailability.
Bisoprolol is characterized by linear kinetics, while its plasma concentration in the blood is proportional to the dose taken in the range of 5–20 mg. C max (maximum concentration of the substance) in blood plasma is reached in 2-3 hours.
Bisoprolol is distributed quite widely. The volume of distribution is 3.5 l / kg. The level of binding to blood plasma proteins is approximately 30%.
Metabolism occurs through the oxidative pathway, in the future bisoprolol is not subjected to conjugation. All metabolites are polar (water-soluble) and are excreted by the kidneys. The main metabolites, which are found in urine and blood plasma, do not show pharmacological activity. Information obtained from studies with human liver microsomes shows that the substance is metabolized primarily by the CYP3A4 isoenzyme (approximately 95%), and the CYP2D6 isoenzyme plays an insignificant role.
The clearance of bisoprolol is determined by the equilibrium state between excretion unchanged by the kidneys (approximately 50%) and the metabolism occurring in the liver (approximately 50%), with the formation of metabolites, which are subsequently also excreted by the kidneys. The total ground clearance is 15 l / h. T 1/2 (half-life) from blood plasma - from 10 to 12 hours.
Indications for use
- treatment of arterial hypertension;
- prevention of attacks of stable angina pectoris in ischemic heart disease.
Contraindications
Absolute:
- chronic decompensated heart failure requiring inotropic therapy;
- acute heart failure;
- sinoatrial blockade;
- severe arterial hypotension (systolic blood pressure less than 100 mm Hg, especially in myocardial infarction);
- cardiomegaly (no signs of heart failure);
- atrioventricular block II-III degree without a pacemaker;
- severe bradycardia (heart rate less than 60 beats / minute);
- sick sinus syndrome;
- collapse;
- shock, including cardiogenic;
- late stages of peripheral circulatory disorders;
- pulmonary edema;
- Raynaud's syndrome;
- pheochromocytoma (without the combined use of alpha-blockers);
- severe forms of bronchial asthma and a history of chronic obstructive pulmonary disease;
- metabolic acidosis;
- glucose-galactose malabsorption, lactose intolerance or lactase deficiency;
- age up to 18 years;
- lactation (or you should stop breastfeeding);
- simultaneous administration of monoamine oxidase (MAO) inhibitors (with the exception of MAO-B inhibitors);
- hypersensitivity to the components of Bidop or other beta-blockers.
Relative (require special care and careful monitoring during treatment):
- diabetes;
- thyrotoxicosis;
- myasthenia gravis;
- a history of allergic reactions;
- atrioventricular block I degree;
- liver failure;
- chronic renal failure (creatinine clearance less than 20 ml / minute);
- depression, including a history);
- psoriasis;
- Prinzmetal's angina;
- elderly age;
- period of adherence to a strict diet;
- pregnancy (Bidop can be used only if the expected benefit outweighs the potential risks).
Bidop, instructions for use: method and dosage
Bidop tablets should be taken orally 1 time a day, in the morning on an empty stomach: swallow whole with water.
The initial dose is usually 5 mg, then, if necessary, it is increased to 10 mg.
The maximum allowable dose is 20 mg.
Patients with severe renal impairment (creatinine clearance less than 20 ml / minute) and liver should not exceed a daily dose of 10 mg.
Side effects
- from the cardiovascular system: very often (≥ 1/10) - sinus bradycardia, palpitations; often (> 1/100, ≤ 1/10) - a pronounced decrease in blood pressure, manifestations of angiospasm (paresthesias, coldness of the lower extremities, increased impairment of peripheral circulation, Raynaud's syndrome); infrequently (≥ 1/1000, ≤ 1/100) - chest pain, weakening of myocardial contractility, arrhythmias, myocardial conduction disorder, orthostatic hypotension, atrioventricular block (up to the development of complete transverse blockade and cardiac arrest), chronic heart failure (shortness of breath, swelling of the ankles and feet);
- on the part of the organ of vision: rarely (≥ 1/10 000, ≤ 1/1000) - visual impairment, dryness and soreness of the eyes, decreased secretion of tear fluid; very rarely (≤ 1/10 000) - conjunctivitis;
- from the central nervous system: infrequently - anxiety, headache, weakness, dizziness, depression, asthenia, fatigue, sleep disorders, confusion or short-term memory loss; rarely - nightmares, hallucinations, tremors, myasthenia gravis, convulsions (including in the calf muscles); with intermittent claudication and Raynaud's syndrome - paresthesia in the limbs;
- from the respiratory system: infrequently - difficulty breathing; when high doses are prescribed and / or in predisposed patients - laryngospasm, bronchospasm; rarely - nasal congestion;
- from the endocrine system: hypoglycemia (with insulin-dependent diabetes mellitus), hyperglycemia (with non-insulin-dependent diabetes mellitus), hypothyroid state;
- from the digestive system: often - constipation or diarrhea, nausea, dryness of the oral mucosa, abdominal pain, vomiting; rarely - changes in taste, liver dysfunction (yellowness of the skin or sclera, dark urine, cholestasis), hepatitis;
- on the part of the skin: rarely - skin hyperemia, increased sweating; very rarely - exacerbation of psoriasis symptoms, psoriasis-like skin reactions, exanthema, alopecia;
- laboratory parameters: rarely - hypertriglyceridemia, hyperbilirubinemia, increased activity of hepatic transaminases; in some cases - leukopenia, agranulocytosis, thrombocytopenia (unusual bleeding and hemorrhage);
- allergic reactions: rarely - skin rashes, itching, urticaria;
- others: infrequently - arthralgia; rarely - decreased potency, weakened libido, withdrawal syndrome (increased blood pressure, increased angina attacks), back pain;
- effect on the fetus: intrauterine growth retardation, bradycardia, hypoglycemia.
Overdose
The main symptoms: severe bradycardia, AV blockade, a marked decrease in blood pressure, bronchospasm, hypoglycemia, acute heart failure.
The sensitivity to a single, high dose is highly variable among individual patients. It has been suggested that patients with chronic heart failure are highly sensitive.
Therapy: cancellation of Bidop. Symptomatic treatment is prescribed:
- marked decrease in blood pressure: intravenous administration of vasopressor drugs and plasma-substituting solutions;
- severe bradycardia: intravenous atropine. If the effect is insufficient, it is possible to use a drug with a positive chronotropic effect with caution. In some cases, temporary installation of an artificial pacemaker may be required;
- exacerbation of the course of chronic heart failure: intravenous administration of diuretics, drugs with a positive inotropic effect, as well as vasodilators;
- AV blockade: constant medical supervision is required, β-adrenomimetics (epinephrine) are prescribed, if necessary, an artificial pacemaker is installed;
- hypoglycemia: intravenous glucose (dextrose);
- bronchospasm: the use of bronchodilators, including β 2 -adrenomimetics and / or aminophylline.
special instructions
Monitoring of patients receiving Bidop includes regular measurement of heart rate (HR) and blood pressure (at the beginning of therapy - daily, then - once every 3-4 months), electrocardiogram, as well as in patients with diabetes mellitus - determination of glucose concentration in blood (1 time in 4–5 months), in the elderly - monitoring of renal function (1 time in 4–5 months).
Patients should be trained in the method of calculating heart rate and warned about the need to immediately consult a doctor if the heart rate is less than 50 beats per minute during the check.
In patients with a burdened bronchopulmonary history, it is recommended to conduct a study of the function of external respiration before prescribing Bidop.
Patients with bronchospastic diseases in case of intolerance and / or ineffectiveness of other antihypertensive drugs can be prescribed cardioselective adrenergic blockers. Overdose is dangerous for the development of bronchospasm.
In about 20% of patients with angina, beta-blockers are ineffective for the following reasons: severe coronary atherosclerosis with a low ischemic threshold (heart rate less than 100 beats per minute), increased left ventricular end-diastolic volume, which disrupts subendocardial blood flow.
If an effective alpha-blockade is not previously achieved, when using Bidop in patients with pheochromocytoma, there is a risk of developing paradoxical arterial hypertension.
In smokers, the effectiveness of Bidop decreases.
Bisoprolol can mask clinical signs of thyrotoxicosis, for example, tachycardia, as a result of which, after discontinuation of Bidop, the symptoms of the disease may increase.
Bidop can also mask tachycardia caused by hypoglycemia in diabetic patients.
Against the background of a burdened allergic history, an increase in the severity of hypersensitivity reactions and the lack of effect from conventional doses of epinephrine (adrenaline) is possible.
You can not abruptly stop treatment due to the risk of developing severe arrhythmias and myocardial infarction. Cancellation should be carried out gradually, reducing the dose for at least 2 weeks (by 25% every 3-4 days).
Bidop can reduce the production of tear fluid, which should be considered by patients who use contact lenses.
If clonidine is prescribed simultaneously with the drug, it should be discontinued several days after Bidop is discontinued.
If a planned operation is prescribed, Bidop should be canceled 48 hours before general anesthesia. If the surgical intervention is unscheduled, it is necessary to inform the doctor about taking Bidop so that he selects a remedy for general anesthesia with a minimally negative inotropic effect.
Patients receiving drugs that reduce the supply of catecholamines (for example, reserpine) should be under constant supervision, since they can increase the effect of the beta-blocker.
Treatment should be discontinued or the dose should be reduced in elderly people if they develop increasing bradycardia (less than 50 beats per minute), a pronounced decrease in blood pressure (systolic blood pressure below 100 mm Hg), development of atrioventricular blockade, ventricular arrhythmias, bronchospasm, severe disorders kidney and liver function.
With the development of depression, Bidop is canceled.
Bisoprolol can distort the results of tests for the content of normetanephrine, catecholamines and vanillyl mandelic acid in urine and blood, as well as for the determination of antinuclear antibody titers.
Influence on the ability to drive vehicles and complex mechanisms
Bidop can cause side effects from the nervous system, especially at the beginning of treatment, therefore it is recommended to be careful when driving a car and performing potentially hazardous types of work that require speed of reactions and increased attention.
Application during pregnancy and lactation
- pregnancy: Bidop should only be used under medical supervision;
- lactation period: therapy is contraindicated.
Pediatric use
Patients under 18 years of age are not prescribed Bidop.
With impaired renal function
In chronic renal failure (in patients with creatinine clearance less than 20 ml / min) Bidop should be used with caution.
The maximum daily dose for patients with impaired renal function is 10 mg.
For violations of liver function
In severe liver dysfunctions, Bidop tablets should be used with caution.
The maximum daily dose for patients with impaired hepatic function is 10 mg.
Use in the elderly
In elderly patients, therapy should be carried out under medical supervision.
Drug interactions
- means for inhalation anesthesia (derivatives of hydrocarbons), phenytoin administered intravenously: the severity of the cardiodepressive effect and the likelihood of a decrease in blood pressure increase;
- intravenous iodine-containing X-ray contrast agents: the risk of anaphylactic reactions increases;
- lidocaine, xanthines (with the exception of theophylline): their clearance decreases and the concentration in blood plasma increases;
- insulin and oral forms of hypoglycemic drugs: their effectiveness changes, clinical signs of developing hypoglycemia are masked (tachycardia, increased blood pressure);
- non-steroidal anti-inflammatory drugs, estrogens, glucocorticosteroids: the hypotensive effect is weakened;
- nifedipine, sympatholytics, diuretics, clonidine, hydralazine and other antihypertensive drugs: a significant or even excessive decrease in blood pressure is possible;
- non-depolarizing muscle relaxants: their effect is prolonged;
- coumarins: their anticoagulant effect is enhanced;
- ethanol, tri- and tetracyclic antidepressants, hypnotics and sedatives, antipsychotics: depression of the central nervous system increases;
- non-hydrogenated ergot alkaloids: the risk of developing peripheral circulatory disorders increases;
- ergotamine: the likelihood of developing peripheral circulatory disorders increases;
- rifampicin: the half-life of bisoprolol decreases;
- cardiac glycosides, slow calcium channel blockers, methyldopa, guanfacine, reserpine, amiodarone and other antiarrhythmics: the risk of developing or worsening bradycardia, atrioventricular blockade, heart failure and cardiac arrest increases;
- allergen extracts for skin tests and allergens used for immunotherapy: increases the risk of severe systemic allergic reactions or anaphylaxis;
- MAO inhibitors (with the exception of MAO-B): the hypotensive effect of Bidop is significantly enhanced (an interval of at least 14 days should be observed between taking drugs).
Analogs
Bidop's analogues are: Aritel, Cordinorm, Coronal, Bisoprolol, Corbis, Bisokard, Bisogamma, Biprol, Bisomor, Concor, Niperten.
Terms and conditions of storage
Store in a dark, dry place out of reach of children at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Bidop
Reviews of Bidop characterize it as an effective drug. Patients note that the cost of the product is cheaper than analogues. The development of adverse reactions is rarely reported.
Price for Bidop in pharmacies
The approximate price for Bidop is:
- 5 mg - 112 rubles, 139-187 rubles. or 233-275 rubles. (14, 28 or 56 tablets, respectively);
- 10 mg - 145 rubles, 201–258 rubles. or 359-413 rubles. (14, 28 or 56 tablets, respectively).
Bidop: prices in online pharmacies
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Drug name Price Pharmacy |
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Bidop Cor 2.5 mg tablets 28 pcs. 82 RUB Buy |
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Bidop KOR 2.5mg tablets 28 pcs. 114 RUB Buy |
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Bidop tablets 5mg 28 pcs. RUB 138 Buy |
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Bidop 5 mg tablets 28 pcs. RUB 138 Buy |
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Bidop Cor 2.5 mg tablets 56 pcs. 168 RUB Buy |
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Bidop 10 mg tablets 28 pcs. 207 r Buy |
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Bidop 5 mg tablets 56 pcs. 230 RUB Buy |
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Bidop tablets 10mg 28 pcs. 259 r Buy |
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Bidop 5 mg tablets 56 pcs. 274 r Buy |
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Bidop tablets 5mg 56 pcs. 294 r Buy |
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Bidop 10 mg tablets 56 pcs. 361 RUB Buy |
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Bidop tablets 10mg 56 pcs. 427 r Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
