Bidop Cor
Bidop Cor: 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 Cor
ATX code: C07AB07
Active ingredient: bisoprolol (Bisoprolol)
Manufacturer: Gedeon Richter-RUS, CJSC (Russia); Niche Generics, Limited (Ireland)
Description and photo update: 2019-11-07
Prices in pharmacies: from 82 rubles.
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Bidop Cor is a drug from the group of selective β 1 -adrenergic blockers.
Release form and composition
The drug is produced in the form of tablets: white, oblong, on both sides with a risk, on one side of the tablet to the left of the risks there is a BI marking, to the right of the risks - the figure 2.5 (14 pcs. In blisters made of polyvinyl chloride film and aluminum foil, in a cardboard box 1, 2 or 4 blisters and instructions for use Bidop Cor).
Composition for 1 tablet:
- active ingredient: bisoprolol (in the form of bisoprolol fumarate) - 2.5 mg;
- auxiliary components: magnesium stearate, lactose monohydrate, crospovidone, microcrystalline cellulose.
Pharmacological properties
Pharmacodynamics
Bisoprolol belongs to selective β 1 -adrenergic blockers. It does not have its own sympathomimetic activity and does not have a membrane stabilizing effect. The drug has a small affinity for β 2 -adrenergic receptors of smooth muscle fibers of blood vessels and bronchi and for β 2 -adrenergic receptors, which are involved in the regulation of metabolism. That is, in general, Bidop Cor does not affect the processes in which β 2 -adrenergic receptors are involved. Outside of therapeutic doses, the selective effect of bisoprolol on β 1 -adrenergic receptors also persists.
A single dose of the drug in patients with coronary artery disease (ischemic heart disease) without symptoms of CHF (chronic heart failure) helps to reduce the stroke volume of the heart and heart rate and, as a result, lowers the ejection fraction of the heart and reduces the need for oxygen in the heart muscle. As a result of long-term treatment, the initially high total peripheral vascular resistance decreases.
Pharmacokinetics
The absorption of bisoprolol is almost complete (over 90%). Bioavailability after oral administration is approximately 90% (no more than 10% of the drug is exposed to the effect of primary passage through the liver). Food intake does not alter the bioavailability of bisoprolol. Pharmacokinetics is linear, with the plasma concentration of the active substance proportional to the oral dose in the dose range of 5–20 mg. In the blood plasma, the maximum concentration of bisoprolol is observed 2-3 hours after oral administration of the drug.
The distribution of the substance is quite wide. Bisoprolol is about 30% bound to plasma proteins. The volume of distribution is 3.5 l / kg.
The metabolism of the drug occurs along the path of oxidation without subsequent conjugation. The resulting metabolites are water-soluble and excreted by the kidneys. They have no pharmacological activity. The main isoenzyme involved in the metabolism of bisoprolol is the CYP3A4 isoenzyme (about 95% of the drug is metabolized with its participation). The isoenzyme CYP2D6 also plays a small role in metabolism.
About 50% is excreted by the kidneys unchanged. The same amount of the drug (approximately 50%) is excreted in the form of metabolites. The total clearance is 15 l / h, and the half-life is 10–12 hours.
Indications for use
Bidop Cor is used in patients over 18 years of age for the treatment of CHF.
Contraindications
Absolute:
- severe arterial hypotension (systolic blood pressure less than 100 mm Hg);
- sinoatrial (sinoauricular) block;
- cardiogenic shock (extreme degree of left ventricular failure);
- severe bradycardia (heart rate less than 60 beats per minute);
- atrioventricular (AV) blockade of II or III degree in patients without an artificial pacemaker;
- acute heart failure or decompensated CHF, requiring inotropic treatment;
- sick sinus syndrome (weakening of the automatic function of the right atrial node);
- Raynaud's syndrome or severe disorders of peripheral circulation in the arteries;
- severe forms of chronic obstructive pulmonary disease or bronchial asthma;
- metabolic acidosis;
- pheochromocytoma (if α-blockers are not used at the same time);
- lactase deficiency, glucose-galactose malabsorption syndrome, lactose intolerance;
- children and adolescents up to 18 years old;
- hypersensitivity to bisoprolol, as well as to any auxiliary component of the drug.
Relative (Bidop Cor 2.5 mg tablets are used with caution):
- severe liver dysfunction;
- severe renal failure (in patients with creatinine clearance less than 20 ml / min);
- vasospastic angina (Prinzmetal's angina);
- restrictive cardiomyopathy;
- AV block I degree;
- heart valve disease or congenital heart defects with severe hemodynamic disturbances;
- CHF with myocardial infarction in the last 3 months before starting bisoprolol therapy;
- diabetes mellitus with severe fluctuations in blood glucose levels;
- type 1 diabetes mellitus;
- hyperthyroidism;
- psoriasis;
- desensitizing therapy;
- adherence to a strict diet.
Bidop Cor, instructions for use: method and dosage
Bidop Cor is taken orally with a small amount of water or other liquid. The tablet should not be powdered or chewed. Bidop Cor should be taken in the morning, once a day (before, during or after breakfast).
The standard treatment regimen for CHF includes taking the following drugs: ACE (angiotensin-converting enzyme) inhibitors or angiotensin II receptor antagonists (if ACE inhibitors are not suitable), diuretics, β-blockers and cardiac glycosides (optional). Before the introduction into the Bidop Cora regimen, it is recommended to carry out a special dose titration phase, and then regularly monitor the patient's condition. A necessary condition under which bisoprolol can be taken is the presence of stable CHF without exacerbation symptoms.
Below is a standard titration scheme, however, it should be borne in mind that the patient may require a different dose selection regimen depending on the tolerance of Bidop Cora.
The initial dose of Bidop Cora is 1.25 mg (0.5 tablets) once a day. Then, given the tolerance of the prescribed dose, it is gradually increased to 2.5 mg (1 tablet), 3.75 mg (1.5 tablets), 5 mg (2 tablets), 7.5 mg (3 tablets) and 10 mg (4 tablets) once a day. Dose increments should be at least 2 weeks. If the drug is poorly tolerated, a reverse dose reduction is possible. The maximum dose of Bidop Bark for the treatment of CHF is 10 mg per day.
During dose selection, it is recommended to regularly monitor blood pressure, heart rate and the severity of CHF symptoms. From the first day of drug therapy, an aggravation of the course of CHF is possible.
With poor tolerance of the maximum daily dose of bisoprolol, it can be gradually reduced. In the event of bradycardia, arterial hypotension or temporary worsening of the course of CHF during the titration of Bidop Cora doses or later, it is recommended to adjust the doses of concomitant medications. Sometimes a temporary reduction in the dose of bisoprolol or its complete cancellation is required.
The course of treatment is usually long.
In patients with mild to moderate renal impairment or impaired liver function, as well as in the elderly, dose adjustment is usually not required. In severe liver disease or severe renal impairment (creatinine clearance value less than 20 ml / min) Bidop Cor should be used with caution and in a daily dose of not more than 10 mg.
Side effects
- gastrointestinal tract: often - vomiting, nausea, constipation or diarrhea; rarely - hepatitis;
- cardiovascular system: very often - bradycardia; often - a significant decrease in blood pressure, a feeling of numbness or coldness in the arms and legs, aggravation of CHF symptoms; infrequently - orthostatic hypotension, violation of atrioventricular conduction;
- respiratory system: infrequently - bronchospasm in patients with a history of indications of airway obstruction or bronchial asthma; rarely - allergic rhinitis;
- nervous system and psyche: often - headache, dizziness; infrequently - insomnia, depression; rarely - nightmares, loss of consciousness, hallucinations;
- sensory organs: rarely - hearing impairment, decreased lacrimation (it is necessary to take into account patients who wear contact lenses); very rarely - conjunctivitis;
- musculoskeletal system: infrequently - muscle cramps, muscle weakness;
- skin and subcutaneous fat: rarely - skin hyperemia, rash, itching; very rarely - pathological hair loss, psoriasis-like rash, or worsening of psoriasis symptoms;
- reproductive system: rarely - erectile dysfunction;
- data from instrumental and laboratory studies: rarely - increased activity of liver enzymes (alanine aminotransferase and aspartate aminotransferase), hypertriglyceridemia;
- other reactions: increased fatigue, asthenic syndrome.
Overdose
The most common symptoms of an overdose of Bidop Cortex include: severe bradycardia, bronchospasm, atrioventricular block, hypoglycemia, a significant decrease in blood pressure, acute heart failure. The range of sensitivity of individual patients to a single ultra-high dose of the drug varies greatly. Probably, people with CHF are especially sensitive to bisoprolol.
In case of an overdose, the drug should be discontinued and the patient should be prescribed the necessary supportive symptomatic treatment (depending on the disorders that have occurred):
- significant drop in blood pressure: vasopressor drugs and plasma-substituting solutions are administered intravenously;
- severe bradycardia: intravenous administration of atropine is recommended (if the effect obtained is insufficient, careful administration of a drug with a positive chronotropic effect is possible); may require setting a pacemaker (temporary);
- exacerbation of CHF: vasodilators, diuretics and drugs with a positive inotropic effect are administered intravenously;
- atrioventricular blockade: it is recommended to administer epinephrine (or other β-adrenomimetics) and constant monitoring of the patient; if necessary, put an artificial pacemaker;
- bronchospasm: bronchodilators are used, including aminophylline and / or β 2 -adrenomimetics;
- hypoglycemia: intravenous glucose is administered.
special instructions
Without consulting a doctor, you must not change the recommended dose or abruptly stop treatment with the drug, as this can cause a temporary deterioration in cardiac activity. You should not suddenly cancel Bidop Cor, especially in people with coronary artery disease. If there is a need to discontinue therapy, the dose of bisoprolol is gradually reduced.
At the beginning of treatment, patients should be under constant supervision.
In chronic obstructive pulmonary disease or bronchial asthma, it is recommended to use bronchodilator drugs simultaneously with bisoprolol. In people with bronchial asthma, airway resistance may increase, so the dose of β 2 -adrenomimetics should be increased.
All β-blockers are capable of increasing the patient's sensitivity to allergens and increasing the severity of anaphylactic reactions (since adrenergic compensatory regulation is weakened under the influence of β-blockers). The introduction of adrenaline (epinephrine) does not always give the expected result.
Bidop Cor can cause a blockade of β-adrenergic receptors when the patient is introduced into general anesthesia, therefore, before the planned surgical operation, the drug should be gradually withdrawn and completed 48 hours before the administration of the drug for general anesthesia. The anesthesiologist should be warned about taking bisoprolol.
Patients with pheochromocytoma (malignant or benign tumor of the adrenal glands) can be prescribed Bidop Cor only simultaneously with α-blockers.
Bisoprolol may mask the symptoms of hyperthyroidism.
Influence on the ability to drive vehicles and complex mechanisms
According to the studies, in patients with coronary artery disease, the drug does not affect psychomotor functions. However, one should take into account the patient's individual reaction to Bidop Cor, especially at the beginning of therapy, with each dose change and in the case of simultaneous alcohol consumption.
Application during pregnancy and lactation
During pregnancy, Bidop Cor can be used only in cases where the expected benefit to the mother is higher than the possible risk of adverse reactions in the fetus.
β-blockers usually reduce placental blood flow and can affect the growth and development of the fetus, therefore, in pregnant women taking bisoprolol, it is necessary to monitor the blood flow in the uterus and placenta, as well as monitor the development of the fetus. If pregnancy and / or fetal adverse events occur, alternative therapeutic measures should be taken.
Newborns whose mothers took β-blockers should be carefully examined, since symptoms of hypoglycemia and bradycardia may appear in the first 3 days of life.
There are no data on the penetration of bisoprolol into breast milk, therefore, Bidop Cora is not recommended during lactation. Otherwise, breastfeeding should be stopped.
Pediatric use
Bidop Cor is not used in children and adolescents under the age of 18 years. This is due to the lack of clinical experience with drug therapy in this age group.
With impaired renal function
In patients with severe renal failure (creatinine clearance less than 20 ml / min), bisoprolol is used with caution, carefully selecting the dose.
For violations of liver function
Patients with severely impaired liver function Bidop Cor is prescribed with caution.
Use in the elderly
In the elderly, Bidop Cor is used in usual doses.
Drug interactions
Tolerance and effectiveness of bisoprolol may change in the case of simultaneous use with other drugs and in situations where the interval between taking two drugs was quite short. It is necessary to inform the doctor about the use of other drugs, even if they are available without a prescription.
Bidop Cor is not recommended to be combined with the following drugs:
- blockers of slow calcium channels (verapamil and diltiazem): a decrease in the contractility of the heart muscle and a violation of atrioventricular conduction (risk of a significant drop in blood pressure and AV blockade);
- class I antiarrhythmics (lidocaine, flecainide, quinidine, propafenone, disopyramide, phenytoin): AV conductivity and myocardial contractility may decrease;
- centrally acting antihypertensive drugs (methyldopa, rilmenidine, clonidine, moxonidine): a decrease in cardiac output, a decrease in heart rate and vasodilation (due to a decrease in central sympathetic tone) is possible.
Combinations to be considered and used with caution:
- blockers of slow calcium channels, which are derivatives of dihydropyridine (felodipine, nifedipine, amlodipine): the risk of arterial hypotension may increase, as well as subsequent deterioration of myocardial contractility;
- class III antiarrhythmics (amiodarone, etc.): it is possible to increase the violation of atrioventricular conduction;
- local β-blockers (eye drops used for glaucoma): the degree of manifestation of systemic actions of bisoprolol may increase (decrease in heart rate, decrease in blood pressure);
- parasympathomimetic agents: the risk of bradycardia increases and the violation of AV conduction increases;
- drugs for general anesthesia: it is possible to increase the risk of cardiodepressive action and, as a result, arterial hypotension;
- oral hypoglycemic agents and insulin: the hypoglycemic effect of the listed agents may increase;
- cardiac glycosides: an increase in the time of the impulse and the development of bradycardia is possible;
- β-adrenergic agonists (dobutamine, isoprenaline): the effects of bisoprolol and β-adrenergic agonists may decrease;
- non-steroidal anti-inflammatory drugs: it is possible to reduce the antihypertensive effect of Bidop Bark;
- adrenergic agonists that affect α-adrenergic receptors and β-adrenergic receptors (epinephrine, norepinephrine): the vasoconstrictor effects of these drugs may increase, which leads to an increase in blood pressure;
- monoamine oxidase inhibitors (except for monoamine oxidase B inhibitors): an increase in the hypotensive effect of bisoprolol is possible, as well as the development of a hypertensive crisis;
- mefloquine: the risk of bradycardia may increase;
- antihypertensive drugs and other drugs that potentially reduce blood pressure (phenothiazines, barbiturates, tricyclic antidepressants, etc.): can enhance the antihypertensive effect of bisoprolol;
- Ergotamine derivatives: existing disorders of peripheral circulation are aggravated;
- rifampicin: slightly reduces the half-life of bisoprolol (no dose adjustment is required).
Analogs
The analogues of Bidop Cora are Aritel Cor, Aritel, Biol, Bidop, Biprol plus, Biprol, Bisomor, Bisogamma, Concor, Corbis, Concor Cor, Bisoprolol, Cordinorm Cor, Cordinorm, Niperten, Coronal, Tirez, etc.
Terms and conditions of storage
Keep out of the reach of children. Store under normal conditions at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Bidop Kore
There are very few reviews of Bidop Kore. More often, patients share their impressions of a similar drug, but with a higher dosage of bisoprolol (Bidop tablets 5 mg and 10 mg). Both drugs are prescribed by doctors to treat diseases of the cardiovascular system. They well reduce high blood pressure, and also have antiarrhythmic activity and a pronounced antianginal effect. Tablets are convenient to take, and Bidop Cor, due to its low dosage, is suitable for dose titration at the beginning of therapy. The drugs are available at a price cheaper than some analogues.
The main disadvantage is the possible side effects.
Price for Bidop Cor in pharmacies
2.5 mg tablets in packs of 28 pcs. you can buy for 95-120 rubles. Price for Bidop Cor 2.5 mg in packs of 56 pcs. is 170-175 rubles.
Bidop Cor: 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 Cor 2.5 mg tablets 56 pcs. 168 RUB Buy |
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!
