Caracal or bisoprolol which is better. Other foreign analogues. Chronic heart failure

pharmachologic effect

Selective beta 1 -blocker without internal sympathomimetic activity, does not have membrane stabilizing activity. Reduces plasma renin activity, reduces myocardial oxygen demand, reduces heart rate (at rest and during exercise) and cardiac output, while the stroke volume is not significantly reduced. Inhibits AV conduction. Provides antianginal and hypotensive action. In high doses (200 mg or more) it can cause blockade and β 2 -adrenergic receptors, mainly in the bronchi and vascular smooth muscles.

The hypotensive effect is associated with a decrease in the minute volume of blood, sympathetic stimulation peripheral vessels, a decrease in the activity of the renin-angiotensin system (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, a prolongation of diastole, and an improvement in myocardial perfusion.

The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity 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 pathways.

Pharmacokinetics

Absorption - 80-90%, food intake does not affect absorption.

Cmax in blood plasma is reached in 2-4 hours. Plasma protein binding is 26-33%. Bisoprolol to a small extent penetrates the BBB and the placental barrier; excreted in breast milk.

Metabolized in the liver.

T1 / 2 - 9-12 hours. Excreted by the kidneys - 50% unchanged, less than 2% - with bile.

Indications

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

Dosing regimen

Individual. For oral administration daily dose is 2.5-10 mg, the frequency of administration is 1 time / day. Maximum daily dose- 10 mg.

Side effect

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

From the side of cardio-vascular system: orthostatic hypotension, bradycardia, impaired AV conduction, the appearance of symptoms of heart failure, aggravation of intermittent claudication and major clinical symptoms with Raynaud's syndrome.

From the side of the organ of vision: decreased secretion of lacrimal fluid, conjunctivitis.

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

From the side musculoskeletal system: muscle weakness, muscle cramps.

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

From the side respiratory system: in predisposed patients, symptoms of bronchial obstruction may appear.

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

Contraindications for use

Acute heart failure, chronic heart failure in the stage of decompensation, cardiogenic shock, collapse, AV blockade II and III degree(without pacemaker), SSSU; sinoatrial blockade, severe bradycardia (heart rate<50 уд./мин), стенокардия Принцметала, выраженное снижение АД (систолическое АД <90 мм рт.ст.), тяжелые формы бронхиальной астмы и ХОБЛ в анамнезе, поздние стадии нарушения периферического кровообращения, болезнь Рейно, феохромоцитома (без одновременного применения альфа-адреноблокаторов), метаболический ацидоз, одновременный прием ингибиторов МАО (за исключением ингибиторов МАО типа В), детский и подростковый возраст до 18 лет, повышенная чувствительность к бисопрололу и к другим бета-адреноблокаторам.

Use 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 discontinued 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 stopped.

Overdose

Symptoms: hypoglycemia, arrhythmia, ventricular extrasystole, severe bradycardia, atrioventricular blockade, marked decrease in blood pressure, acute heart failure, cyanosis of fingernails or palms, difficulty breathing, bronchospasm, dizziness; fainting, convulsions.

Treatment: gastric lavage, administration of enterosorbents (activated charcoal) and symptomatic therapy:

With the development of atrioventricular blockade, 1-2 mg of atropine, epinephrine are administered intravenously or a pacemaker is temporarily placed;

With ventricular extrasystoles, lidocaine is administered (class IA drugs are not used);

With a pronounced decrease in blood pressure, the patient should be in the Trendelenburg position, if there are no signs of pulmonary edema - plasma-substituting solutions intravenously, if not effective, epinephrine (adrenaline), dopamine, dobutamine are administered (to maintain chronotropic and inotropic action and eliminate a pronounced decrease in blood pressure);

In heart failure, cardiac glycosides, diuretics are used;

With convulsions - intravenous diazepam, with bronchospasm - inhalation beta 2-sympathomimetics;

With hypoglycemia - in / in the introduction of a solution of dextrose (glucose);

With bradycardia - atropine, setting the pacemaker.

drug interaction

With the simultaneous use of antacids and antidiarrheals, a decrease in the absorption of beta-blockers is possible.

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 agents, 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 cough drops, 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 and conduction disturbances are possible.

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

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

In the event 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 T 1/2 of bisoprolol is possible.

With the simultaneous use of ergotamine derivatives (including drugs for the treatment of migraine containing ergotamine), the symptoms of peripheral circulatory disorders increase.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

In a dry, dark place at a temperature not exceeding 25°C. Keep out of the reach of children. Shelf life - 3 years.

Application for violations of liver function

A dose of 10 mg/day should not be exceeded in severe hepatic impairment.

Application for violations of kidney function

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

Use in elderly patients

Caution in elderly patients

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. To prevent sudden withdrawal of bisoprolol, the course of treatment should be completed slowly with a gradual decrease in dose. Before surgery, the anesthesiologist should be informed about the treatment with bisoprolol.

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

This dose should not be exceeded in case of renal insufficiency (CC less than 20 ml / min) and severe liver dysfunction.

Avoid drinking alcohol during treatment.

Influence on the ability to drive vehicles and control mechanisms

Use with caution in patients whose activities are associated with the need for concentration and high speed of psychomotor reactions.

Presented are analogues of the drug bisoprolol, in accordance with medical terminology, called "synonyms" - drugs that are interchangeable in terms of effects on the body, containing one or more identical active substances. When choosing synonyms, consider not only their cost, but also the country of origin and the reputation of the manufacturer.

Description of the drug

The hypotensive effect is associated with a decrease in the minute volume of blood, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (it is more important 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, a prolongation of 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 via additional pathways.

List of analogues

Note! The list contains bisoprolol synonyms that have a similar composition, so you can choose a replacement yourself, taking into account the form and dose of the medicine prescribed by your doctor. Give preference to manufacturers from the USA, Japan, Western Europe, as well as well-known companies from Eastern Europe: Krka, Gedeon Richter, Actavis, Egis, Lek, Geksal, Teva, Zentiva.

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The information on the page was verified by the therapist Vasilyeva E.I.

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Daniel bisoprolol

I am a hypertensive patient with experience, often suffering from arrhythmia. Therefore, in addition to pills to lower blood pressure, I drink stimulating heart rhythm. Cardinorm, they helped me well before. Last time it was not in the pharmacy and I was advised to buy Bisoprolol. During the week I never had an arrhythmia attack. The heart works like a clock. Side... I am a hypertensive patient with experience, often suffering from arrhythmia. Therefore, in addition to pills to lower blood pressure, I drink stimulating heart rhythm. Cardinorm, they helped me well before.
Last time it was not in the pharmacy and I was advised to buy Bisoprolol.
During the week I never had an arrhythmia attack. The heart works like a clock. There are no side effects.
Bisoprolol effectively helps to cope with the disease.
But before using it is better to consult a doctor.

Fox5 Ineffective drug for hypertension

I tried to take bisoprolol for high blood pressure for a week, but there was no effect as such. I had to return to the drug Concor, the cheap analogue of which is Bisoprolol. I thought that if an analogue came up, I would be able to save on the prevention of my hypertension, but it still can’t be completely cured, and you need to maintain normal pressure all the time. Took... I tried to take bisoprolol for high blood pressure for a week, but there was no effect as such. I had to return to the drug Concor, the cheap analogue of which is Bisoprolol. I thought that if an analogue came up, I would be able to save on the prevention of my hypertension, but it still can’t be completely cured, and you need to maintain normal pressure all the time. I took one tablet of 2.5 mg in the morning, there were no side effects, but the pressure did not stabilize either.

The doctor prescribed Bisoprolol for tachycardia. In general, the drug helps me well. The doctor who prescribed him said that as much as needed, so much to take. That is, no deadlines have been set. And then I recently read that Bisoprolol causes an addictive effect. And patients who took this Bisoprolol for a long time had problems ... The doctor prescribed Bisoprolol for tachycardia. In general, the drug helps me well. The doctor who prescribed him said that as much as needed, so much to take. That is, no deadlines have been set.
And then I recently read that Bisoprolol causes an addictive effect. And patients who took this bisoprolol for a long time had problems stopping its use. Now this is where it gets a little scary. The next time I visit a doctor, I will definitely ask about this issue.

A fairly inexpensive drug, actively used in modern medicine, is called "Bisoprolol". What are these pills for? The most accurate answer to this question is given by the instructions for the use of the drug, which is necessarily present in the package. However, if there is a desire to deal with this information without purchasing a medication, then this material is at your service.

"Bisoprolol": what are these pills from?

The drug was developed for use in arterial hypertension and heart attack, it also provides important assistance in coronary heart disease, chronic heart failure (CHF), angina pectoris, and heart complications after suffering a sore throat. As a rule, it is prescribed if there are violations of the heart rhythm with extrasystole, arrhythmia, thyrotoxicosis.

Analogues of "Bisoprolol" on sale are presented in a fairly wide variety. Drugs with the same name, but different manufacturers are quite different in price. The designations of the manufacturer can be added to the name: "Teva", "Vertex", "Northern Star". Depending on the number of tablets in the package, the characteristics of the composition, the manufacturer, one package costs from 20 to 200 rubles.

Is it possible to replace the drug with an analogue?

Analogues of "Bisoprolol" on sale are represented by the following names:

• "Biprol".
• "Bidop".
• Biol.

Some of them are sold at an affordable cost, like the drug in question, others are more expensive. If the doctor advised to use Bisoprolol, the effect of this drug will be greater than that of analogues. It is possible to replace the drug with similar drugs (generics) only with the consent of the attending physician. Self-replacement of one drug with another is categorically not recommended, especially from the point of view of the budget there is no benefit, and the tolerance of the body of "Bisoprolol" is better than many analogues.

How to use?

"Bisoprolol" belongs to the group of selective beta1-blockers. The tool is available in the form of tablets, each of which has a shell - a thin film that facilitates administration.

How to take "Bisoprolol" is described in detail in the instructions that come with the drug. It is usually drunk in the morning before breakfast on an empty stomach. The entire daily dose is used at a time, swallowed immediately, without chewing. As a rule, from 5 to 10 mg are prescribed per day. The daily dose of "Bisoprolol" for an adult should not be more than 20 mg. Special admission conditions have been developed for those who have been diagnosed with problems in the functioning of the kidneys and (or) liver (the largest daily dose is halved to 10 mg).

Application features

According to the instructions, "Bisoprolol" is recommended to be taken starting with a dose of 1.25 mg per day (for the treatment of CHF). It is kept throughout the first week of treatment. On the second week, the concentration is increased to 2.5 mg, after another week it is increased again, and the daily dose reaches 3.75 mg. Then for several weeks (from the fourth to the eighth), 5 mg are taken every day in the morning, and from the ninth to the twelfth - 7.5 mg. The next step is 10 mg in 24 hours. This dose is kept until the doctor recommends that the course of treatment be completed. The tool is designed for long-term therapy, often used for years, sometimes it is prescribed for lifelong use.

If during the treatment with "Bisoprolol" (according to the instructions) the patient noticed an improvement in the condition, the course should not be interrupted without the consent of the attending physician. You can check with the doctor whether it is realistic to stop treatment, but it is strictly forbidden to stop taking it without the consent of a specialist. The condition can not only return to the one that was before the start of therapy, but also become noticeably harder.

Diagnoses: when is "Bisoprolol" not prescribed?

Contraindications to the use of "Bisoprolol" include the following pathologies:

• bradycardia;
• chronic obstructive pulmonary disease (COPD);
• cardiomegaly;
• hypotension;
• cardiogenic shock;
• severe form of peripheral circulatory disorders.

Also, the agent is not used during the period of feeding an infant and when using monoamine oxidase (MAO) inhibitors, if they do not belong to the MAO-B group.

How it works?

As follows from the instructions for "Bisoprolol" (reviews confirm this), the remedy has a strong hypotensive effect, helps fight arrhythmia. The drug acts selectively and belongs to the class of beta1-blockers. It affects the beta1 receptors in the cardiac system, but at a relatively low dose, due to which the activity of catecholamines is inhibited, the generation of ATP and cAMP is reduced, and calcium metabolism is slowed down. The drug slows down the heart rate by inhibiting excitability and the ability of the myocardium to contract.

Features of efficiency: what else is important?

Confirm the effectiveness of hypertension "Bisoprolol" reviews, which are published in large numbers on the World Wide Web. As the manufacturer explains, the positive effect is due to a reduction in the minute volume of blood circulation. In addition, the active ingredient of the drug stimulates peripheral vessels, the renin-angiotensin-aldosterone system is inhibited. Baroreceptors under the influence of "Bisoprolol" become more sensitive. With hypertension, the primary effect can be observed a few days after the start of treatment (but not later than five), and stabilization of the patient's condition is observed after one or two months from the start of treatment.

The effect that eliminates complications on the heart after a sore throat is also confirmed by reviews of "Bisoprolol". As the manufacturer explains, the effectiveness is guaranteed by the fact that, under the influence of the active component, the myocardium receives the necessary amount of oxygen, as the heart rate decreases, the diastole becomes longer, and myocardial perfusion is better. Diastolic pressure rises, the muscle fibers in the ventricles of the heart stretch more efficiently.

"Bisoprolol" for arrhythmia: proven effectiveness

Considering the testimony of "Bisoprolol", one cannot lose sight of the arrhythmia. The effectiveness of taking the medication in patients with this disorder is ensured by suppressing the factors that provoke the corresponding state of the body with the drug. Spontaneous arousal becomes almost impossible.

The drug stands out favorably against the background of non-selectively acting beta-blockers, since the side effects of "Bisoprolol" on other organs are much less at an average therapeutic dose. First of all, this applies to those systems where there are beta2-adrenergic receptors. It also reduces the negative impact on carbon and sodium metabolism (the latter does not accumulate in the body).

Side effects of "Bisoprolol"

Side effects are rare (1 in 100 patients). As follows from the reviews about the drug, patients rarely experience such troubles, on average, the tolerance of the drug is good. At the same time, you need to be prepared for side effects and at the first manifestations of a deterioration in the condition, you should immediately contact your doctor.

In some patients, when using "Bisoprolol", fatigue increases, sleep and vision disturbances are observed, and pain in the eyes appears. Perhaps the development of sinus bradycardia, a decrease in pressure. Relatively often, you can hear complaints about dryness of the oral mucosa and problems with stools. If the drug is used in a very large dose, there is a risk of developing difficulty in breathing. With diabetes, the likelihood of hyperglycemia, hypoglycemia increases (depending on the type of disease). Very rarely, allergic reactions are observed, manifested by urticaria or skin itching, a rash may occur. When using the drug during pregnancy, there is a possibility of a delay in the development of the fetus. In some cases, the so-called withdrawal syndrome was diagnosed, when angina pectoris worsened at the end of the course of treatment. Also, in rare cases, there was a decrease in potency.

Application Specifics

When choosing "Bisoprolol" it is necessary to regularly monitor the patient's condition. It is important to monitor heart rate, pressure. At the beginning of the use of "Bisoprolol", the indicators are checked every day, with good tolerance, the patient's condition can be monitored every 3-4 months. It is recommended to regularly undergo an ECG, with diagnosed diabetes, donate blood for glucose at least once every 4 months. In the treatment of "Bisoprolol" in the elderly, it is recommended to monitor kidney function, the corresponding analysis is given three times a year. If the drug is used to treat CHF at an initial dosage of 1.25 mg, body readings should be taken for the first four hours. The manufacturer recommends monitoring blood pressure, heart rate, taking ECG readings.

For the most effective control of his condition, a patient treated with "Bisoprolol" should be able to calculate the heart rate himself. If the value is less than 50 beats per minute, you should immediately consult your doctor.

What else to pay attention to?

Despite the indications of "Bisoprolol", in some cases, with angina pectoris, the remedy does not have the proper effectiveness. This is due to the specifics of the disease: it is known that all drugs from the group of beta-blockers do not give a result in approximately every fifth patient. As a rule, this is due to coronary atherosclerosis, in which there is a low ischemic threshold. The effectiveness of the drug decreases if a person has been smoking for a long time, as well as with impaired subendocardial blood flow.

Before prescribing Bisoprolol, the doctor checks the functions of external respiration in patients with a burdened bronchopulmonary history. If the patient uses contact lenses, it must be remembered that the use of "Bisoprolol" in some cases provokes a decrease in the release of lacrimal fluid. With an established pheochromocytoma, there is a possibility of a specific form of hypertension if it was not possible to achieve effective alpha-blockade. When choosing in favor of "Bisoprolol" for the treatment of patients with diagnosed thyrotoxicosis, it must be remembered that the drug cannot be abruptly canceled.

Compatibility with other drugs

It is known that the compatibility of "Bisoprolol" and products containing clonidine allows the use of these drugs at the same time, but it is unacceptable to cancel both medications at the same time. First stop taking one drug, and after a few days - the second. When using drugs that reduce the volume of catecholamines, the effectiveness of beta-blockers may increase. It is necessary to inform the doctor about all medicines prescribed by other specialists. The doctor must regularly monitor the patient's condition, otherwise the likelihood of hypotension, bradycardia increases.

The tool can be used for diabetes. The drug does not affect hypoglycemia in most cases, but with the development of tachycardia provoked by this factor, regular intake of "Bisoprolol" can mask the symptoms. The medication in question does not prevent the restoration of blood glucose to normal levels.

Reviews: what do patients say?

On the Internet there are mostly positive reviews about "Bisoprolol". The medication is inexpensive and helps to stabilize the patient's condition even with serious illnesses, if it is used as prescribed by the attending doctor and with regular monitoring of the condition. Mostly negative responses are caused either by self-administration of the drug without the help of a specialist, or intolerance of the body associated with individual characteristics. Also, some patients noted the difficulty of combining the active ingredient "Bisoprolol" with substances present in other drugs. Such an interaction makes it necessary to use the drug only if there is a recommendation from the attending physician who knows which drugs the patient is taking.

At the same time, there are also reviews about "Bisoprolol", which say that the remedy in a particular case was ineffective. As the manufacturer notes, this is possible in every fifth case and is due to other health disorders or individual characteristics. You need to be prepared for such a situation.

Cardiovascular diseases, hypertension, sinus tachycardia and some others require the use of beta-blockers during the treatment course. Despite the fact that there are a large number of drugs belonging to this category, only a few are most popular with doctors. Questions constantly arise about which drug to take: Metoprolol or Bisoprolol, what is better for the patient, how one drug differs from another, and how they are similar. Can they be taken at the same time, use one instead of the other.

Only a doctor can make a decision on prescribing a drug.

Initially, beta-blockers in clinical practice were used in the treatment of angina pectoris and as antiarrhythmic drugs. Subsequently, their effect was proven during secondary prevention after a heart attack, during the period of primary prevention of cardiovascular complications in hypertensive patients.

Numerous studies of the level of norepinephrine in the blood in various situations have confirmed that beta-andrenoblockers eliminate:

• proarrhythmic action;
• hypokalemia and hyperreninemia;
• tachycardia, fibrillatory action;
• progression of myocardial fibrosis and other disorders.

Metoprolol and bisoprolol are considered analogues, as they are derivatives of propranolol and are used for the same indications.

Popular beta blockers

Althoughdrugs are similar, they have an empirically proven important pharmacological difference that affects the choice of the drug in the initial stage.

Differences and features of drugs

To understand the difference between drugs, it is necessary to consider the effect of each of them separately.

It is prescribed for hypertension and diseases of the cardiovascular system, the active substance in it is metoprolol.

The simplest and most accessible of the drugs, which begins to act in 15-20 minutes. However, with regular use or due to the characteristic features of the patient's body, a delay in the onset of action up to 1.5-2 hours is possible.

After taking, the pressure and heart rate decrease, therefore, it is used:

• with arterial hypertension;
• with hyperthyroidism and pathologies of the heart rhythm;
• at a constant excess of pressure 140/100;
• for the relief of attacks during hypertensive crises.

1. Tablets are taken orally with food or after meals. The initial dosage depends on the disease, in the course of the therapeutic course there is a gradual increase in it.
2. The cost of funds varies within the limits available to any segment of the population.

The instruction indicates that the use of the drug, dose adjustment, course duration occur after the appointment of a doctor.

The main use is in the treatment of hypertension, ischemia and heart failure. Recommended for the prevention of angina attacks and in violation of the heart rhythm. The main active ingredient is besoprolol.

When undergoing a therapeutic course, it is prescribed both separately and in combination with cardiac glycosides, ACE inhibitors, diuretics and vasodilators.

Comparison of tablets with analogues indicates a longer half-life of the drug, so it can be taken 1 time / day, orally, regardless of meals, and can be taken on an empty stomach.

Studies have not confirmed positive results when taking the drug in patients with the following pathologies:

• sinus tachycardia;
• ventricular extrasystology;
• supraventricular extrasystology.

Patients with these disorders need medications that differ in their effect on the body.

The decrease in blood pressure occurs after 30-90 minutes. after taking. Regular use gives a good result and a faster response to the medicine, allowing you to reduce pressure in 15-30 minutes.

Due to the large list of contraindications, the drug is prescribed as an adjunct to diuretics and angiotensin-converting enzyme inhibitors. Increasing the dose is possible under the supervision of a physician.

Comparison of drugs and distinctive characteristics

Instructions for use of bisoprolol and metoprolol are similar, but one drug is much cheaper than the second. Often it is this factor that is dominant for patients, and they, without the knowledge of the doctor, replace medicines. You can see the difference by making a comparison.

When compared, it seems that despite the higher cost, Bisoprolol is several orders of magnitude better than Metoprolol. But the study of contraindications explains the caution with which it is prescribed to certain groups of patients.

If the patient has chronic diseases of the urinary system or kidneys, then the use of Bisoprolol will aggravate the situation. It is strictly forbidden to use the drug for women during breastfeeding. Contraindications are pregnancy, arrhythmia and diabetes.

Metoprolol tartrate has a faster effect, so it is more often prescribed to the elderly and patients with unstable blood pressure. However, with heart failure and immediately after a heart attack is not prescribed. In these situations, Metoprolol succinate, a long-acting drug developed on the basis of long-term clinical studies, is used.

In case of impaired liver function caused by heart failure, and if there is a joint administration of drugs that put an additional burden on it, Bisoprolol is preferable.

To determine which drug the patient needs, it is necessary to find out the stability of the drug, the absence of pronounced fluctuations in the blood and the rate of stabilization of the patient's heart rate.

The use of beta-blockers for intravenous use is permitted only under clinical supervision. Their timely appointment helps to reduce mortality in the early postinfarction period and in acute myocardial infarction.

For detailed information about the action and properties of the drugs, we recommend that you familiarize yourself with the video, where the doctor will talk about the features of the drugs.

More:

Instructions for use of Bisoprolol, in what cases is the drug prescribed? To whom is it contraindicated?