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.

Release form

The release of the drug is implemented in tablets, in the amount of 14 pieces inside the cell plate. Inside a separate box there are 1, 2 or 4 cell packs.

Pharmacodynamics

The drug is a selective β1-blocker, not having 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.

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

In case of exceeding the recommended dose, the drug also causes a β2-adreno-blocking effect.

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

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

The antianginal effect develops by reducing the oxygen demand of myocardial tissues, slowing the heart rate and reducing its contractility, and besides improving the myocardial blood supply processes and diastole prolongation. Increased ventricular diastolic pressure, as well as stretching of the ventricular muscles, potentiates oxygen demand.

The antiarrhythmic effect develops after the elimination of the causes provoking the appearance of arrhythmia (an increase in blood pressure, tachycardia, activation of the sympathetic system and an increase in cAMP), a decrease in pacemaker speed and a slowdown of AV conduction processes.

The drug differs from non-selective β-adrenergic blocker subtypes in that the administration of its medium medication portions 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 detain sodium ions. The power of the atherogenic effect is comparable to that of propranolol.

Pharmacokinetics

Absorption of drugs is 80-90%, the consumption of food has no effect on its degree. Blood Cmax values are recorded after 2-3 hours. Synthesis with blood protein - within 28-32%.

Bad penetrates through the BBB and the placenta. 50% undergoes intrahepatic transformation; at the same time almost inactive metabolic products are formed.

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

[1], [2]

Dosing and administration

Tablets consumed inside, in the morning. It is necessary to do this on an empty stomach, without chewing the medicine. Selection of portions is carried out separately for each patient - by the attending doctor.

In the case of increased values of blood pressure, and in addition to prevent the exacerbation of angina attacks (stable form of the disease), an initial dose of 5 mg is applied daily 1-fold. If necessary, it can be increased to 10 mg (the same frequency of administration). A maximum of 20 mg of the substance per day is allowed.

In people with disorders of renal activity or hepatic function in a severe degree, the maximum dosage per day should be 10 mg.

[11], [12]

Use Bidopa during pregnancy

Prescribing Bidop during pregnancy is allowed only in the case of vital indications. You also need to take into account all the risks.

It can not be entered during breastfeeding.

Contraindications

Among the contraindications:

• shock or collapse;
• heart failure with an acute degree;
• pulmonary puffiness;
• sinoatrial blockade;
• 2-3rd degree AV block (electrostimulator absent);
• CHF of a decompensated nature in the chronic stage, at which inotropic treatment is necessary;
• SSSU;
• reduced blood pressure;
• combination with MAOI (except for B-type substances);
• Asthma or severe COPD;
• cardiomegaly, not accompanied by heart failure;
• pronounced bradycardia;
• late phases of changes in peripheral blood flow processes;
• pheochromocytoma (co-administration of α-blockers is not carried out);
• Raynaud's syndrome;
• metabolic acidosis;
• intolerance to the elements of the drug or other β-blockers;
• hypolactasia, lactase deficiency and glucose-galactose malabsorption.

Caution is required when used in people with chronic liver failure or kidney failure, psoriasis, diabetes, myasthenia, and in addition, first-degree AV-blockade, depression, hyperthyroidism, allergic reactions in history and spontaneous angina; in addition, it is carefully prescribed to older people and those who diets.

[3], [4], [5], [6]

Side effects Bidopa

Administration of the medication may cause some side effects:

• disorders of the sense organs: reduction of salivation, dry ocular mucosa, conjunctivitis, and visual disturbance;
• problems with the work of the National Assembly: a feeling of confusion, anxiety, weakness or fatigue, depression, asthenia, dizziness, hallucinations and headaches. In addition, seizures, nightmares, tremors, paresthesias of the limbs and sleep disorders may appear;
• blood circulation disorders: severe decrease in blood pressure, orthostatic collapse, conduction disorder in the area of myocardial tissue, sinus bradycardia, symptoms of CHF, AV blockade, angiospasm and arrhythmias, as well as pain in the sternum and reduction in myocardial contractility;
• lesions affecting respiratory activity: difficulty in respiratory processes when using large portions of drugs, or in people with a predisposition to bronchospasm and laryngism, as well as nasal congestion;
• disorders of the digestive function: constipation, nausea, diarrhea, dryness of the oral mucosa, pain in the abdominal area, vomiting. In addition, hepatitis, taste receptor or liver function disorder, hyperbilirubinemia, increased values of liver enzymes and hypertriglyceridemia;
• hormonal disorders: hyperglycemia, hypothyroid manifestations and hypoglycemia (in people who use insulin);
• dermatological lesions: alopecia, psoriasis-like symptoms, hyperhidrosis, psoriasis in the acute phase, skin hyperemia and exanthema;
• problems with hematopoietic processes: leukopathy or thrombocytopenia and agranulocytosis;
• allergy symptoms: rash, hives or itching;
• other symptoms: weakening of potency, withdrawal syndrome, decrease in libido, arthralgia, and in addition, torcalgia or lumbalgia;
• effects on the fetus: bradycardia, hypoglycemia, and in addition the slowing of intrauterine growth processes.

[7], [8], [9], [10]

Overdose

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

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

In the case of AV blockade, you need to enter up to 2 mg of epinephrine or atropine in / in the way. A pacemaker may also be temporarily installed.

For ventricular extrasystoles, lidocaine is used;

With a decrease in blood pressure values (with the condition that there are no signs of pulmonary edema), plasma-substituting fluids are injected intravenously. If required, dobutamine, dopamine or epinephrine may be used.

In cases of insufficiency in the work of the heart, SG, diuretic drugs and glucagon are used.

Diazepam is used intravenously to eliminate seizures.

Spasms of the bronchi are relieved by inhalation of β2-adrenostimulants.

[13], [14],

Interactions with other drugs

Radiopaque substances containing iodine and administered intravenously increase the risk of anaphylactic signs.

Allergens and allergenic extracts used for immunotherapy for scarification tests increase the likelihood of the development of systemic manifestations of allergy in severe cases (in individuals who use bisoprolol).

Phenytoin introduced by IV method, as well as drugs for inhalation anesthesia, increase the cardiodepressive activity of the drug and the risk of lowering blood pressure levels.

Bidop may mask signs of developing hypoglycemia.

The drug increases the blood values of xanthines (except for theophylline) and lidocaine.

Reserpine, SG, amiodarone, guanfacine with methyldopa, agents that block the slow channels Ca, and other antiarrhythmic drugs potentiate the possibility of development or aggravation of the flow of bradycardia with AV-blockade or cardiac arrest.

Sympatholytics, clonidine with nifedipine and hydralazine, and in addition, diuretic drugs, along with other antihypertensive drugs, when combined with Bidop, can provoke a strong drop in blood pressure indicators.

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

Tetracyclics and tricyclics, ethyl alcohol, hypnotics or sedatives, and antipsychotics - potentiate the overwhelming effect on the performance of NA.

Rifampicin reduces the half-life of bisoprolol.

It is prohibited to combine the drug with an MAOI (except for B-type substances), because this causes a significant stimulation of antihypertensive activity. Between the reception Bidopa and use of MAO should take at least 14 days.

Ergotamine increases the likelihood of changes in peripheral blood flow.

Sulfasalazine increases the plasma performance of bisoprolol.

[15]

Storage conditions

Bidop must be kept in a dark and dry place, closed from the possible penetration of children. Temperature indicators - standard.

[16]

Shelf life

Bidop allowed to apply within 36 months from the date of manufacture of pharmaceutical agents.

Application for children

It is forbidden to use in pediatrics (people under the age of 18).

[17], [18]

Analogs

Analogs 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, Tyres, Bisoprolol-OBL, Kordinorm and Coronal with Hypertension.

[19], [20],

Reviews

Bidop gets pretty good reviews from commentators on the forums. It effectively reduces the pressure and significantly reduces the manifestations of coronary artery disease. But it should be noted that negative signs are comparable in their severity with therapeutic effects and are quite common.

It is necessary to take into account the fact that in 20% of people with angina pectoris there is a lack of effect from the use of β-adrenergic blockers (due to increased left ventricular diastolic volume and coronary atherosclerosis in a pronounced form).