Bidop tablets 10mg, No. 28

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen. Individual. For oral administration, the daily dose is 2.5-10 mg, the frequency of administration is 1 time / day. The maximum daily dose is 10 mg.

active substance: bisoprolol fumarate

Acute heart failure, chronic heart failure in the stage of decompensation, cardiogenic shock, collapse, AV block II and III degree (without a pacemaker), SSSU; sinoatrial block, severe bradycardia (heart rate <50 beats / min), Prinzmetal's angina, marked decrease in blood pressure (systolic blood pressure <90 mm Hg), severe forms of bronchial asthma and COPD in history, late stages of peripheral circulation disorders, Raynaud's disease , pheochromocytoma (without the simultaneous use of alpha-blockers), metabolic acidosis, concomitant use of MAO inhibitors (with the exception of MAO inhibitors of type B), children and adolescents under 18 years of age, hypersensitivity to bisoprolol and other beta-blockers.

pharmachologic effect

Selective beta1-blocker without intrinsic sympathomimetic activity, does not have membrane stabilizing activity. Reduces the activity of plasma renin, reduces myocardial oxygen demand, reduces heart rate (at rest and during exercise) and cardiac output, while the stroke volume does not significantly decrease. Inhibits AV conduction. It has antianginal and hypotensive effects. In high doses (200 mg or more), it can cause blockade and? 2-adrenergic receptors, mainly in the bronchi and vascular smooth muscles.

The hypotensive effect is associated with a decrease in the minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (it is of greater importance for patients with initial renin hypersecretion), restoration of sensitivity in response to a decrease in blood pressure and an effect on the central nervous system.

The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in heart rate and a decrease in contractility, an increase in diastole, and an improvement in myocardial perfusion.

The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased cAMP content, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers, and a slowdown in AV conduction (mainly in the antegrade and, to a lesser extent, in the retrograde directions) through the AV node) and along additional paths.

Indications of the active substances of the drug

Arterial hypertension, prevention of angina attacks, chronic heart failure.

Dosage regimen

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen. Individual. For oral administration, the daily dose is 2.5-10 mg, the frequency of administration is 1 time / day. The maximum daily dose is 10 mg.

Side effect

From the nervous system: weakness, fatigue, dizziness, headache, sleep disorders, mental disorders (depression, rarely hallucinations), feeling of cold and paresthesia in the extremities.

On the part of the cardiovascular system: orthostatic hypotension, bradycardia, impaired AV conduction, the appearance of symptoms of heart failure, aggravation of intermittent claudication and the main clinical symptoms in Raynaud's syndrome.

From the side of the organ of vision: a decrease in the secretion of lacrimal fluid, conjunctivitis.

From the digestive system: diarrhea, constipation, nausea, abdominal pain.

From the musculoskeletal system: muscle weakness, muscle cramps.

On the part of the skin and subcutaneous tissues: itching; in some cases - increased manifestations of psoriasis, the appearance of psoriasis-like rashes.

On the part of the respiratory system: in predisposed patients, symptoms of bronchial obstruction may appear.

Others: sweating, hot flashes, impaired potency, decreased glucose tolerance in patients with diabetes mellitus, allergic reactions.

Contraindications for use

Acute heart failure, chronic heart failure in the stage of decompensation, cardiogenic shock, collapse, AV block II and III degree (without a pacemaker), SSSU; sinoatrial block, severe bradycardia (heart rate <50 beats / min), Prinzmetal's angina, marked decrease in blood pressure (systolic blood pressure <90 mm Hg), severe forms of bronchial asthma and COPD in history, late stages of peripheral circulation disorders, Raynaud's disease , pheochromocytoma (without the simultaneous use of alpha-blockers), metabolic acidosis, concomitant use of MAO inhibitors (with the exception of MAO inhibitors of type B), children and adolescents under 18 years of age, hypersensitivity to bisoprolol and other beta-blockers.

Application during pregnancy and lactation

Use during pregnancy and lactation is not recommended and is possible when the expected benefit to the mother outweighs the potential risk of side effects in the fetus and child.

In exceptional cases of use during pregnancy, bisoprolol should be canceled 72 hours before the expected date of delivery due to the possibility of bradycardia, arterial hypotension, hypoglycemia and respiratory depression in the newborn. If cancellation is not possible, then it is necessary to carefully monitor the condition of the newborn within 72 hours after delivery.

If it is necessary to use bisoprolol during lactation, breastfeeding should be discontinued.

Application for violations of liver function

Do not exceed a dose of 10 mg / day in severe liver dysfunction.

Application for impaired renal function

Do not exceed a dose of 10 mg / day in case of renal failure (CC less than 20 ml / min).

Application in children

Not recommended for use in children.

special instructions

It is used with caution in psoriasis and with indications of psoriasis in a family history, diabetes mellitus in the decompensation phase, with a predisposition to allergic reactions. With pheochromocytoma, the use of bisoprolol is possible only after taking alpha-blockers. Avoid sudden cancellation of bisoprolol, the course of treatment should be completed slowly with a gradual dose reduction. Before surgery, the anesthesiologist should be informed about bisoprolol treatment.

Bisoprolol at a dose of more than 10 mg / day should be used only in exceptional cases.

Do not exceed this dose in renal failure (CC less than 20 ml / min) and severe liver dysfunction.

Avoid drinking alcohol during treatment.

Influence on the ability to drive vehicles and use mechanisms

It is used with caution in patients whose activities are associated with the need for concentration of attention and high speed of psychomotor reactions.

Drug interaction With the simultaneous use of antacids and antidiarrheals, it is possible to reduce the absorption of beta-blockers.

With the simultaneous use of antiarrhythmic drugs, a sharp decrease in blood pressure, a decrease in heart rate, the development of arrhythmias and / or heart failure are possible.

With the simultaneous use of antihypertensive drugs, an increase in the antihypertensive effect is possible.

With the simultaneous use of cardiac glycosides, conduction disturbances are possible.

With the simultaneous use of sympathomimetics (including those included in the composition of cough suppressants, nasal drops, eye drops), the effectiveness of bisoprolol decreases.

With the simultaneous use of verapamil, diltiazem, a sharp decrease in blood pressure, a decrease in heart rate, the development of arrhythmias and / or heart failure are possible.

With the simultaneous use of guanfacine, severe bradycardia, conduction disturbances are possible.

With the simultaneous use of insulin, hypoglycemic agents for oral administration, the effect of insulin or other hypoglycemic agents is enhanced (regular monitoring of plasma glucose levels is required).

With the simultaneous use of clonidine, severe bradycardia, arterial hypotension, conduction disturbances are possible.

In the case of a sudden withdrawal of clonidine in patients receiving bisoprolol, a sharp increase in blood pressure is possible.

With the simultaneous use of nifedipine, other calcium channel blockers, dihydropyridine derivatives, the antihypertensive effect of bisoprolol is enhanced.

With the simultaneous use of reserpine, alpha-methyldopa, severe bradycardia is possible.

With the simultaneous use of rifampicin, a slight decrease in T1 / 2 of bisoprolol is possible.

With the simultaneous use of derivatives of ergotamine (including agents for the treatment of migraines containing ergotamine), symptoms of impaired peripheral circulation increase.