Bidop

Bidop has antiarrhythmic, antianginal, and antihypertensive properties.

Indications Bidopa

It is used in the following cases:

• prevention of exacerbation of angina attacks (stable form of pathology);
• increased blood pressure readings.

Release form

The release of the medicinal product is realized in tablets, in the amount of 14 pieces inside a cell plate. Inside a separate box there are 1, 2 or 4 cell packages.

Pharmacodynamics

The drug is a selective β1-adrenoblocker that does not have sympathomimetic activity; in addition, it does not have a membrane-stabilizing effect. The drug reduces renin activity, reduces the oxygen demand of myocardial cells, as well as its contractility.

By inhibiting β1-adrenoreceptors in small portions inside the myocardium, the drug weakens the catecholamine-stimulated binding of cAMP from the ATP element. At the same time, it reduces the intracellular transport of calcium ions, has a negative bathmo-, ino-, chrono- and dromotropic effect, and in addition, slows down the ongoing conduction processes with excitability.

If the recommended dose is exceeded, the drug also causes a β2-adrenergic blocking effect.

At the initial stage of drug use, on the first day, the resistance exerted by the peripheral vascular walls is potentiated, approaching the initial level after 1-3 days. In the case of long-term therapy, this indicator decreases.

Antihypertensive activity occurs due to a decrease in the minute volume, weakening of the RAS function, sympathetic stimulation of peripheral vessels, as well as due to the restoration of the response to a decrease in blood pressure values and the effect on the work of the nervous system. With increased blood pressure values, the therapeutic effect develops over a period of 5 days, and a stable effect is noted after 2 months.

The antianginal effect develops by reducing the oxygen demand of myocardial tissues, slowing the heart rate and reducing its contractility, and in addition, improving the processes of myocardial blood supply and prolonging diastole. An increase in ventricular diastolic pressure values, as well as stretching of the ventricular muscles, potentiates the oxygen demand.

The antiarrhythmic effect develops after eliminating the causes that provoke the appearance of arrhythmia (increased blood pressure, tachycardia, activation of the sympathetic system and increased cAMP levels), reducing the speed of pacemakers and slowing down the processes of AV conduction.

The drug differs from non-selective subtypes of β-adrenoblockers in that the introduction of its average medicinal doses does not have a strong effect on organs with β2-adrenoreceptors (pancreas, uterus, skeletal muscles and peripheral arterial muscles with bronchi) and carbohydrate metabolism. Also, the drug does not retain sodium ions. The power of the atherogenic effect is comparable to the action of propranolol.

Pharmacokinetics

The absorption of the drug is 80-90%, the use of food products does not affect its degree. Blood Cmax values are recorded after 2-3 hours. Synthesis with blood protein is within 28-32%.

Poorly penetrates the blood-brain barrier and placenta. 50% undergoes intrahepatic transformation; in this case, almost inactive metabolic products are formed.

Half-life is up to 12 hours. 98% is excreted through the kidneys; less than 2% of the substance is excreted with bile.

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Dosing and administration

The tablets are taken orally in the morning. This should be done on an empty stomach, without chewing the medicine. The portions are selected separately for each patient - by the attending physician.

In case of increased blood pressure values, and also to prevent exacerbation of angina attacks (stable form of the disease), the initial dose of 5 mg is used once daily. If necessary, it can be increased to 10 mg (similar frequency of administration). The maximum per day allowed is 20 mg of the substance.

For people with severe renal or hepatic impairment, the maximum daily dosage should be 10 mg.

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Use Bidopa during pregnancy

Prescribing Bidop during pregnancy is allowed only in case of vital indications. All existing risks must also be taken into account.

Do not administer during breastfeeding.

Contraindications

Among the contraindications:

• shock state or collapse;
• acute heart failure;
• pulmonary edema;
• sinoatrial block;
• 2-3 degree AV block (no pacemaker);
• CHF of a decompensated nature in the chronic stage, which requires inotropic treatment;
• SSSU;
• decreased blood pressure;
• combination with MAOIs (except for B-type substances);
• asthma or severe COPD;
• cardiomegaly not accompanied by heart failure;
• having a pronounced form of bradycardia;
• late phases of changes in peripheral blood flow processes;
• pheochromocytoma (co-administration of α-blockers is not performed);
• Raynaud's syndrome;
• metabolic acidosis;
• intolerance to the components of the drug or other β-blockers;
• hypolactasia, lactase deficiency and glucose-galactose malabsorption.

Caution is required when used in people with chronic liver or kidney failure, psoriasis, diabetes mellitus, myasthenia, as well as first-degree AV block, depression, hyperthyroidism, a history of allergic reactions and spontaneous angina; in addition, caution is prescribed to the elderly and those on a diet.

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Side effects Bidopa

The administration of the drug may cause some side effects:

• disturbances in the functioning of the sensory organs: decreased salivation, dry eye mucosa, conjunctivitis and visual impairment;
• problems with the functioning of the nervous system: a feeling of confusion, anxiety, weakness or fatigue, depression, asthenia, dizziness, hallucinations and headaches. In addition, convulsions, nightmares, tremors, paresthesia in the limbs and sleep disorders may occur;
• circulatory disorders: a sharp decrease in blood pressure, orthostatic collapse, conduction disorders in the area of myocardial tissue, sinus bradycardia, the occurrence of CHF symptoms, AV block, angiospasm and arrhythmia, as well as pain in the sternum and a decrease in the contractility of the myocardium;
• lesions affecting respiratory activity: difficulty breathing when using large doses of drugs or in people with a predisposition to bronchospasms and laryngospasms, as well as with nasal congestion;
• digestive disorders: constipation, nausea, diarrhea, dry mouth, abdominal pain, vomiting. In addition - hepatitis, taste buds or liver dysfunction, hyperbilirubinemia, increased liver enzyme levels and hypertriglyceridemia;
• hormonal disorders: hyperglycemia, hypothyroid manifestations and hypoglycemia (in people using insulin);
• dermatological lesions: alopecia, psoriasis-like symptoms, hyperhidrosis, psoriasis in the acute phase, skin hyperemia and exanthema;
• problems with hematopoietic processes: leukopenia or thrombocytopenia and agranulocytosis;
• signs of allergy: rash, hives or itching;
• other symptoms: decreased potency, withdrawal syndrome, decreased libido, arthralgia, and also thoracic or lumbago;
• effects on the fetus: bradycardia, hypoglycemia, and also slowing of intrauterine growth processes.

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Overdose

Symptoms of poisoning: arrhythmia, a sharp drop in blood pressure, ventricular extrasystole, bradycardia with AV block and CHF. Cyanosis in the area of the hands, difficulty breathing, convulsions, bronchial spasms, hypoglycemia and dizziness with fainting are also noted.

To eliminate the disorders, gastric lavage is performed, followed by the use of enterosorbents, and then symptomatic procedures are performed.

In case of AV block, up to 2 mg of epinephrine or atropine should be administered intravenously. A pacemaker may also be temporarily installed.

For ventricular extrasystoles, lidocaine is used;

When blood pressure values decrease (provided there are no signs of pulmonary edema), plasma-substituting fluids are administered intravenously. If necessary, dobutamine, dopamine, or epinephrine can be used.

In cases of heart failure, CG, diuretics and glucagon are used.

To relieve convulsions, diazepam is used intravenously.

Bronchial spasms are relieved by inhaling β2-adrenergic stimulants.

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Interactions with other drugs

Radiocontrast agents containing iodine and administered intravenously increase the risk of developing anaphylactic symptoms.

Allergens and allergen extracts used in immunotherapy for scarification tests increase the likelihood of developing severe systemic allergic reactions (in individuals using Bisoprolol).

Intravenous phenytoin, as well as drugs for inhalation anesthesia, increase the cardiodepressant activity of the drug and the risk of a decrease in blood pressure.

Bidop may mask signs of developing hypoglycemia.

The drug increases blood levels of xanthines (except theophylline) and lidocaine.

Reserpine, SG, amiodarone, guanfacine with methyldopa, agents that block slow Ca channels, and other antiarrhythmic drugs potentiate the possibility of developing or worsening the course of bradycardia with AV block or cardiac arrest.

Sympatholytics, clonidine with nifedipine and hydralazine, as well as diuretics along with other antihypertensive medications when combined with Bidop can cause a sharp drop in blood pressure.

The drug prolongs the effect of non-depolarizing muscle relaxants, and at the same time the anticoagulant effect of coumarin agents.

Tetracyclics and tricyclics, ethyl alcohol, sleeping pills or sedatives and antipsychotics - potentiate the suppressive effect on the functioning of the nervous system.

Rifampicin reduces the half-life of bisoprolol.

It is prohibited to combine the drug with MAOIs (except for B-type substances), because this causes significant stimulation of antihypertensive activity. At least 14 days should pass between taking Bidopa and using MAOIs.

Ergotamine increases the possibility of changes in peripheral blood flow processes.

Sulfasalazine increases plasma levels of bisoprolol.

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Storage conditions

Bidop should be kept in a dark and dry place, out of reach of children. Temperature indicators are standard.

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Shelf life

Bidop is approved for use within 36 months from the date of manufacture of the pharmaceutical product.

Application for children

Not for use in pediatrics (people under 18 years of age).

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Analogues

Analogues of the therapeutic drug are such drugs as Aritel Cor, Biprol, Bisomor with Aritel, Bisogamma and Bidop Cor, and in addition to this Concor Cor, Biol, Corbis with Bisoprolol, Bisocard and Bisoprolol-Teva. Also on the list are Concor, Tirez, Bisoprolol-OBL, Cordinorm and Coronal with Niperten.

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Reviews

Bidop gets pretty good reviews from forum commentators. It effectively reduces blood pressure and significantly reduces the manifestations of coronary heart disease. But it should be noted that the negative signs are comparable in severity to the therapeutic effect and are quite common.

It is also necessary to take into account that 20% of people with angina pectoris experience no effect from the use of β-blockers (due to increased left ventricular diastolic volume and severe coronary atherosclerosis).