Kordinorm

Kordinorm is the selection beta1-adrenoblocker without membrane stabilizing properties and sympathomimetic internal activity.

Structure and form of release

According to the instruction, Kordinorm is issued in the form of white tablets, film coated, with amount of active agent on 5 and 10 milligrams. Tablets Kordinorm have the rounded and convex shape.

Active agent of Kordinorm – a bisoprolol fumarates. As excipients as a part of tablets Kordinorm there are also microcrystallic cellulose, sodium of a kroskarmelloz, Mannitolum, magnesium a stearate, titanium dioxide, a gipromelloza, a macrogoal 6000.

Pharmacological action of Kordinorm

According to the instruction, Kordinorm blocks in small doses _{β1-адренорецепторы} hearts thanks to what reduces formation of tsAMF from ATP which is stimulated by catecholamines, and reduces current of calcium ions in cells. Bisoprolol also reduces oxygen requirement a myocardium, renders negative batmo-, dromo-, hrono-and inotropic action, oppresses excitability and conductivity, slows down AV-conductivity. Reduces ChSS during loadings and at rest. Kordinorm has antiarrhytmic, hypotensive and anti-anginal effect. Reduces activity of a renin of a blood plasma.

If to increase a dose of a bisoprolol, _{beta2-adrenoceptor blocking} effect will be had.

In the first days after Kordinorm's use slightly increases GPRV (general peripheric resistance of vessels) owing to stimulation elimination _{β2-адренорецепторов} and reciprocal increase of activity of α-adrenoceptors.......... The general peripheric resistance of vessels is returned to initial level in 1-3 days, and at the long use decreases.

According to the instruction, Kordinorm possesses hypotensive action due to reduction of the IOC and activity a renin-angiotenzinovoy of system, stimulation of vessels of the periphery. It is very important for those, the cat is sick with initial hypersecretion of a renin.

Antiarrhytmic action of a bisoprolol is caused by elimination of aritmogenny factors, such as tachycardia, a superactivity of a sympathetic nervous system, the increased maintenance of tsAMF, arterial hypertension.

Anti-anginal action of Kordinorm happens due to reduction of oxygen requirement a myocardium thanks to an urezheniye of ChSS and decrease in contractility, improvement of perfusion and lengthening of a diastole of a myocardium.

Unlike non-selective beta adrenoblockers, бисопролол, appointed in average doses for therapy, it is not so expressed influences the bodies containing _{β2-адренорецепторы}: pancreas, smooth muscles, periphery arteries, bronchial tubes, uterus and skeletal muscular tissue. Bisoprolol in average doses it is expressed does not influence also carbohydrate metabolism, does not detain in an organism sodium.

If to apply high doses of a bisoprolol, the blocking effect will be had on both subtypes of β-adrenoceptors..........

Pharmacokinetics

In digestive tract бисопролол it is soaked up for 80-90%. The simultaneous use of Kordinorm with food on absorption does not wag. The maximum concentration in blood is observed in 1-3 hours.

About 35% of a bisoprolol contact proteins of a blood plasma. Has low acute abilities through a placenta and in breast milk.

A half of the accepted Kordinorm's dose is metabolized in a liver and forms inactive metabolites, other half is brought out of an organism in not changed look.

Indications to Kordinorm's use

• An ischemic heart disease (for prevention of attacks of stenocardia);

• arterial hypertension.

Contraindications to Kordinorm's use

Kordinorm is contraindicated at:

• shock (including cardiogenic);

• collapse;

• fluid lungs;

• chronic heart failure in a decompensation stage;

• acute heart failure;

• to sinuatrial blockade;

• To AV blockade of the II-III degree (without pacemaker);

• SSSU;

• the expressed bradycardia (ChSS is less than 50 beats per minute);

• the cardiomegaly (which does not have symptoms of heart failure);

• Printsmetal's stenocardias;

• arterial hypotension (systolic the ABP is less than 100 mm Hg, especially at a miokardny heart attack);

• to bronchial asthma and HOBL in the anamnesis;

• late stages of disturbance of blood circulation of the periphery;

• a concomitant use of MAO inhibitors (an exception – MAO of V type);

• Raynaud's diseases;

• metabolic acidosis;

• to a pheochromocytoma (without joint use of alpha adrenoblockers);

• hypersensitivity to other beta adrenoblockers;

• hypersensitivity to any other component of drug;

• children's and teenage age up to 18 years (safety and efficiency are not established).

Carefully it is necessary to apply Kordinorm that who has a liver failure, a chronic renal failure, a myasthenia, a thyrotoxicosis, a diabetes mellitus, a depression (including in the anamnesis), psoriasis, advanced age.

Route of administration and doses

Pill Kordinorm is taken inside on an empty stomach, without chewing, in the morning. The single dose has to make from 2,5 to 5 milligrams. Usually in an initiation of treatment the day dose makes 5 milligrams. If it is necessary, the daily dose is increased to 10 milligrams. The minimum day dose for adults makes 20 milligrams.

Side effects of Kordinorm

According to responses, Kordinorm has the following side effects:

From the central nervous system: weak state, strong fatigue, dizzinesses, sleeplessness or drowsiness, head pain, nightmares, depressions, hallucinations, myasthenia, adynamy, tremor.

From a digestive tract: nausea, pain in a stomach, vomiting, dryness in a mouth, diarrhea or a lock, disturbances in work of a liver which are shown by dark urine, yellowness of skin and scleras, a cholestasia.

From respiratory system: a bunged-up nose, the complicated breath.

From cardiovascular system: heartbeat, a sinus bradycardia, disturbances in conductivity of a myocardium, arrhythmia, pains in a breast, weak contractility of a myocardium, development or a complication of already available heart failure (short wind, hypostases of anklebones and feet).

From the hemopoietic system: leukopenia, agranulocytosis, thrombocytopenia.

From a reproductive system: a reduced potentiality and the weakened libido.

According to responses, Kordinorm can cause problems with eyes: morbidity and xerophthalmus, vision disorders, conjunctivitis.

Reviews of Kordinorm also say that he can cause allergic reactions in the form of a skin itch and rash, a small tortoiseshell, and also side effects from a musculoskeletal system: dorsodynias, spasms in gastrocnemius muscles, an arthralgia, weakness in muscles.

Kordinorm's analogs

Kordinorm's analogs are Aritel, Bidop, Biol, Biprol, Bisokard, Koronal, Concor, Niperten and Tirez. Also good analog of Kordinorm is Bisoprolol.