Bisogamma tablets instructions for use
Bisogamma is an antihypertensive drug that belongs to the group of B1-adrenergic blockers, has a hypotensive, antiarrhythmic and antianginal effect and is used to treat hypertension and other heart diseases.
The main component of Bisogamma is bisoprolol. It is a selective (selective) blocker of B1-adrenoreceptors of the heart and has virtually no effect on B2 adrenoreceptors.
In the initial period of therapy, there is an increase in the total resistance of the vessels, which returns to normal values within 72 hours, and when taken for a long time, there is a decrease.
The antihypertensive effect is due to the fact that:
- minute blood volume decreases;
- the sympathetic system of the vessels is activated;
- reduced production of renin and angiotensin;
- sensitivity to pressure reduction is restored;
- there is an effect on the nervous system.
The antianginal effect is observed due to a decrease in myocardial oxygen demand, which is due to the fact that:
- frequency of contractions decreases;
- reduced myocardial contractility;
- the diastolic period is extended;
- myocardial perfusion increases.
The antiarrhythmic effect of Bisogamma occurs due to:
- oppression factors causing arrhythmia;
- reduce the rate of excitation of heart rate drivers;
- inhibition of atrioventricular conduction.
Release form and composition
Bisogamma is available in the form of tablets with a dosage of 5 and 10 mg. The trademark belongs to the German company Worwag Pharma GmbH & Co. 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 excipients.
The drug belongs to the selective B1-adrenoblokiruyuschim drugs, is made from chemical raw materials, released strictly on doctor's prescription with a prescription.
Indications for use
- arterial hypertension;
- stable angina with ischemic heart disease;
- the period after a heart attack;
- chronic heart failure.
- hypersensitivity reactions to the active ingredient or excipients of the drug;
- decrease in heart rate less than 50 beats per minute;
- weakness of the sinus node;
- atrioventricular and other heart blocks;
- cardiogenic shock;
- unstable form of angina pectoris;
- heart failure, characterized by acute severe form, not amenable to treatment or in the stage of decompensation;
- heart attack in the acute period;
- pressure less than 100 mm;
- massive circulatory disorders in peripheral vessels;
- severe violations of respiratory function, accompanied by obstruction of the respiratory tract, pulmonary edema, bronchial asthma;
- kidney tumors;
- increase in the size of the heart muscle
- taking some antidepressants;
- depressed state;
- children under 18 years old.
Use of the drug is limited to persons suffering from:
- manifestations of bradycardia, heart block or circulatory disorders in peripheral vessels;
- diabetes mellitus
- thyrotoxic goiter;
- functional hepatic or renal disorders;
- depressive conditions in the anamnesis;
- a tendency to allergic manifestations in history;
- old age of the patient.
During pregnancy and during breastfeeding, the use of the drug is possible in cases where the benefit to the mother will be greater than the risk to the baby.
Mode of application
According to the instructions, Bisogamm is started to be taken at 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 use of the drug in a dosage of 1.25 with a gradual evenly increasing dose every 2 weeks.
There is a titration process under constant control of heart rate and blood pressure. When the condition associated with the next increase in dosage deteriorates, it can be corrected using diuretics or pressure reducing agents from other groups or back to lower.
Therapy with B1-adrenergic blocking agents is long lasting, the course of treatment is prescribed by the doctor.
The side effects of Bisogamma are dose-dependent. At excess of doses above recommended therapeutic, strengthening of negative effects is possible:
- central and peripheral nervous system: dizziness, sleep disorders, asthenia, depression, fatigue, decreased concentration and attention, mental abilities, emotional instability, crawl sensations, convulsions , disorders of the senses (inflammation, dryness, sore eyes), other;
- from the side of the heart, blood vessels, hematopoietic system: a pronounced decrease in heart rate, tachyarrhythmia, blockade, lower blood pressure, pain in the chest, vascular spasms of various localization, and others;
- digestive tract: nausea, vomiting, diarrhea, dyspepsia, constipation, hepatic impairment, manifested by yellowness or darkening of urine;
- respiratory system: bronchospasm or laryngeal spasm, inflammation or infection of the airways, nasal congestion;
- skin reactions: rashes, skin redness, hair loss, dermatitis, itching, excessive sweating, and others;
- metabolic disorders: increase or decrease in glucose concentration, hypothyroidism ;
- impact on fetal development: developmental delay, decrease in glucose level, decrease in heart rate;
- other negative effects: back pain, convulsions, reduced potency, withdrawal syndrome.
Special instructions and drug interactions
- At the beginning of therapy, careful monitoring of the patient's condition is necessary when taking bisoprolol;
- If there is a history of diseases of the respiratory system, it is advisable to examine the patient's respiratory function before using the drug;
- in severe atherosclerosis of the coronary arteries, bisoprolol is ineffective;
- smoking reduces the effect of bisoprolol;
- when using contact lenses, it is necessary to take into account that reduction in the production of tear fluid is possible;
- while taking Bisogamma, pressure may increase in patients with pheochromocytoma;
- bisoprolol can hide some symptoms (tachycardia) with thyrotoxicosis and diabetes;
- clonidine can be canceled 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 anesthesia is selected with a negative inotropic effect;
- reserpine and other agents similar in their mechanism of action may enhance the effect of bisoprolol;
- since overdose of the drug may develop bronchospasm, patients with a tendency to spasms of the respiratory system B1-blockers are prescribed only with the ineffectiveness of other drugs;
- with the development of a depressive state, treatment is stopped;
- with the development of bradycardia or cardiac blockade, the dosage must be reduced or abolished;
- abruptly interrupt treatment can not be due to the risk of severe complications. Up to a heart attack;
- Great care must be taken when driving or performing work with increased attention and responsiveness.
All analogues Bisogamma active substance is bisoprolol. Drugs are available in dosages of 2.5, 5, 10 mg. The name of drugs with a dosage of 2.5 mg, as a rule, is supplemented with the word Cor. Bioavailability and efficacy depends on the quality of the raw materials, the degree of purification and dosage form. Foreign manufacturers are in great 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 the active substance 50 mg, Edge Pharma Private Limited (India)
- Bisoprolol - LEKSVM, manufacturer: Antibiotice SA (Romania);
- Bisoprolol - Ratiopharm, Merckle (Germany)
- Bisoprolol - Teva, Teva Pharmaceutical Works Private Co.Ltd (Hungary);
- Concor and Concor Cor, Merck KGaA (Germany);
- Korbis, Unichem Laboratories (India);
- Kordinorm and Kordinorm Kor, Catalent Germany Schorndorf GmbH (Germany);
- Coronal, Zentiva as (Slovak Republic);
- Tirez, Alkaloid AD (Republic of Macedonia).
- Aritel and Aritel Cor, Kanonfarma Production CJSC;
- Bisoprolol is a drug with the same active ingredient. It is produced by many domestic manufacturers. They are: North Star, Biocom CJSC, Lekpharm (Republic of Belarus), VERTEX, Atoll LLC, Ozon LLC, Rafarma JSC, Izvarino Pharma LLC; Irbit Chemicalfarm;
- Bisoprolol - OBL, Obolensky - pharmaceutical company;
- Bisoprolol - Lugal, Lugansk HFZ PJSC;
- Bisoprolol - Prana, Pranafarm;
- Bisoprolol - NW, North Star;
- Niperten, KRKA-Rus.
Terms and conditions of storage
Bisogamma shelf life is 3 years. Storage should be out of reach of children, the temperature should not exceed 25 degrees. Use after the expiration date is prohibited.
Bisogamma tablets 5mg, 30 pcs. - from 110 to 143 rubles.
Bisogamma tablets 10mg, 30 pcs. - from 160 to 220 rubles.