Bisogamma tablets instructions for use
Bisogamma is an antihypertensive drug belonging to the group of B1-adrenoblockers, which has antihypertensive, antiarrhythmic and antianginal effect and is used to treat arterial hypertension and other heart diseases.
The main component of Bisogamma is bisoprolol. He is a selective (selective) blocker of B1-adrenergic receptors of the heart and has practically no effect on B2 adrenergic receptors.
In the initial period of therapy there is an increase in the total resistance of blood vessels, which returns to normal values within 72 hours, and a decrease occurs for a long time.
The hypotensive effect is due to the fact that:
- Decreases the minute volume of blood;
- The sympathetic system of blood vessels is activated;
- The production of renin and angiotensin decreases;
- The sensitivity to pressure reduction is restored;
- There is an effect on the nervous system.
Antianginal effect is observed due to a decrease in oxygen demand of the myocardium, which is due to the fact that:
- Frequency of cuts is cut;
- Reduced myocardial contractility;
- The diastolic period is prolonged;
- Increases myocardial perfusion.
Anti-arrhythmic effect of Bisogamma occurs due to:
- Oppression of factors causing arrhythmia;
- Decrease in the rate of excitation of drivers of the heart rhythm;
- Inhibition of atrioventricular conduction.
Form of issue and composition
Bisogamma is available in the form of tablets with a dosage of 5 and 10 mg. Owns the trademark of the German company Worwag Pharma GmbH & Co. KG. KG, which has 3 manufacturing plants:
- C. Magistra C & C in Romania;
- Mauermann-Arzneimittel Franz Mauermann OHG in Germany;
- Artesan Pharma is also in Germany.
- Bisoprolol fumarate;
- Various auxiliary substances.
The drug refers to selective B1-adrenergic blocking drugs, is made from chemical raw materials, is released strictly according to the prescription of the doctor if a prescription is available.
Indications for use
- arterial hypertension;
- Stable angina in ischemic heart disease;
- Period after a heart attack;
- Heart failure in chronic form.
- Hypersensitivity reactions to the active ingredient or excipients of the drug;
- Decrease in the heart rate is less than 50 beats per minute;
- The weakness of the sinus node;
- Atrioventricular and other heart block;
- Shock cardiogenic type;
- An unstable form of angina pectoris;
- Heart failure, characterized by an acute severe form, which can not be treated or decompensated;
- A heart attack in an acute period;
- Pressure less than 100 mm;
- Massive circulatory disturbances in peripheral vessels;
- Pronounced violations of the respiratory function, accompanied by obstruction of the airways, pulmonary edema, bronchial asthma;
- Kidney tumors;
- Increase in the size of the heart muscle
- Taking certain antidepressants;
- Depressive state;
- Children under 18 years.
The use of the drug is limited in persons suffering from:
- Manifestations of bradycardia, heart block or circulatory disorders in peripheral vessels;
- Diabetes mellitus,
- Thyrotoxic goiter;
- Functional hepatic or renal disorders;
- Myasthenia gravis;
- Depressive conditions in the anamnesis;
- Predisposition to allergic manifestations in the anamnesis;
- Old age of the patient.
During pregnancy and during breastfeeding, the use of the drug is possible in those cases when the benefits for the mother will be greater than the risk for the child.
Mode of application
According to the instructions, Bisogamma is taken with a dosage of 5 mg, if necessary, increased to 10 mg. The maximum allowed daily amount is 20 mg.
However, it is correct to select the dose by titration method depending on the individual perception of the patient's body and the reaction to the substance. Begin treatment with the drug at a dosage of 1.25 with a gradual uniform increase in the dose every 2 weeks.
There is a titration process under the constant control of heart rate and blood pressure. If the condition associated with the next increase in dosage worsens, it can be corrected by the use of diuretics or pressure reducing drugs from other groups or back to reduce.
Therapy with B1-blockers is of a long duration, the treatment is prescribed by a doctor.
Bisogamma side effects are dose-dependent. If the doses exceed the recommended therapeutic levels, it is possible to intensify the negative effects:
- Central and peripheral nervous system: dizziness, sleep disturbance, asthenia, depressive state, fatigue, decreased concentration and attention, mental abilities, emotional instability, crawling sensations, convulsions , sensory disturbances (inflammation, dryness, soreness of the eyes), and others;
- From the side of the heart, blood vessels, hematopoiesis system: a marked decrease in the heart rate, tachyarrhythmia, blockade, lowering of arterial pressure, pain in the chest area, spasms of vessels of different localization, and others;
- The digestive tract: nausea, vomiting, loose stools, indigestion, constipation, hepatic disorders manifested by jaundice or darkening of urine;
- Respiratory system: bronchial or laryngeal spasm, inflammation or infection of the respiratory tract, nasal congestion;
- Skin reactions: rashes, redness of the skin, hair loss, dermatitis, itching, excessive sweating and others;
- Metabolic disorders: increase or decrease in glucose concentration, hypothyroidism ;
- Influence on fetal development: delay in development, decrease in glucose level, decrease in heart rate;
- Other negative effects: back pain, convulsions, decreased potency, withdrawal syndrome.
Specific guidance and drug interaction
- At the beginning of therapy, careful monitoring of the patient's condition is required when taking bisoprolol;
- If there are diseases of the respiratory system in the anamnesis, it is desirable to investigate the patient's respiratory function before using the drug;
- With severe atherosclerosis of the coronary arteries, bisoprolol is ineffective;
- Smoking reduces the effect of bisoprolol;
- When using contact lenses, it must be taken into account that it is possible to reduce the production of tear fluid;
- On the background of Bisogamma, there may be an increase in pressure in patients suffering from pheochromocytoma;
- Bisoprolol may conceal certain symptoms (tachycardia) in thyrotoxicosis and diabetes mellitus;
- Clonidine can be withdrawn only a few days after discontinuation of bisoprolol;
- 2 days before the planned surgery, Bisogamma must be canceled. If the drug was taken before the operation, the anesthetic is selected with a negative inotropic effect;
- Reserpine and others, similar in mechanism of action, the agents can enhance the effect of bisoprolol;
- As in the case of an overdose of the drug, the development of bronchospasm may be possible, patients with a tendency to spasm of the respiratory system B1-adrenergic blockers are prescribed only if other agents are ineffective;
- With the development of a depressed state, treatment is stopped;
- With the development of bradycardia or cardiac blockade, the dosage should be reduced or canceled;
- Interrupt drastic treatment is not possible because of the risk of developing severe complications. Up to a heart attack;
- It is necessary to observe increased caution when driving a vehicle or performing work with increased attention and speed of reaction.
For all Bisogamma analogues, bisoprolol is the active substance. The drugs are available in a dosage of 2.5, 5, 10 mg. The name of preparations with a dosage of 2.5 mg is usually supplemented with the word Kor. Bioavailability and efficacy of the agent depends on the quality of the raw materials, the degree of purification and the dosage form. Foreign manufacturers are in high demand, but at the same time they have a higher price than domestic ones.
- Biprol and Biprol Cor, manufacturer: Niche Generics (Ireland);
- Biol, Salutas Pharma (Germany);
- Bisocard, producer: ICN Polfa Rzeszow (Poland);
- Bisomor is also available in ampoule form with a dose of active substance 50 mg, Edge Pharma Private Limited (India)
- Bisoprolol - LEXMM, manufacturer: Antibiotice SA (Romania);
- Bisoprolol - Ratiofarm, Merckle (Germany)
- Bisoprolol - Teva, Teva Pharmaceutical Works Private Co.Ltd (Hungary);
- Concor and Concor Cor, Merck KGaA (Germany);
- Corbis, Unichem Laboratories (India);
- Cordinorm and Cordinorm Cor, Catalent Germany Schorndorf GmbH (Germany);
- Coronale, Zentiva as (Slovak Republic);
- Tirez, Alkaloid AD (Republic of Macedonia).
- Aritel and Aritel Cor, Canonfarma Production CJSC;
- Bisoprolol is a drug with the same active ingredient. It is produced by many domestic manufacturers. These are: North Star, Biokom ZAO, Lekpharm (Republic of Belarus), VERTEKS, Atoll LLC, Ozon LLC, Rafarma ZAO, Izvarino Pharma LLC; Irbit Chemical Plant;
- Bisoprolol - OBL, Obolenskoe - pharmaceutical company;
- Bisoprolol - Lugal, Lugansk HFZ PAO;
- Bisoprolol - Prana, Pranapharm;
- Bisoprolol - NW, the North Star;
- Niperten, KRKA-Rus.
Terms and conditions of storage
Shelf life Bisogamma 3 years. The storage location must be out of reach of children, the temperature should not exceed 25 degrees. Application after the expiry date is prohibited.
Bisogamma tablets 5mg, 30 pcs. - from 110 to 143 rubles.
Bisogamma tablets 10mg, 30 pcs. - from 160 to 220 rubles.