Cordinorm Cor, tablets 2.5mg 90 pcs

Cronic Heart Failure

Indications

Chronic heart failure

Special instructions

Monitoring of patients taking Cordinorm Cor should include monitoring heart rate and blood pressure (at the beginning of treatment – daily, then once every 3-4 months), electrocardiography (ECG), determination of blood glucose in patients with diabetes (once every 4-5 months). The patient should be taught how to calculate heart rate and instructed about the need for medical consultation if the heart rate is less than 50 beats per minute.

Before starting treatment, it is recommended to conduct studies of external respiratory function in patients with a burdened bronchopulmonary history.

In approximately 20% of patients with angina, beta blockers are not effective. The main causes are severe coronary left ventricular end-diastolic volume, impairing subendocardial blood flow. For “smokers”, the effectiveness of beta-blockers is lower.

In case of thyrotoxicosis, Cordinorm Cor can mask certain clinical signs of thyrotoxicosis (for example, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated because it can increase symptoms.
When using the drug in patients with pheochromacytoma, there is a risk of developing paradoxical hypertension.
In diabetes mellitus, it can mask tachycardia caused by hypoglycemia.

Active ingredient

Bisoprolol

Composition

One tablet contains

active substance – bisoprolol fumarate 2.5 mg

excipients:

lactose monohydrate,

microcrystalline cellulose,

magnesium stearate,

crospovidone

90 pcs

Contraindications

cardiogenic shock
atrioventricular (AV) block II and III degrees
sinoatrial block
sick sinus syndrome
severe sinus bradycardia (heart rate (HR) less than 50 beats per minute)
decompensated heart failure (pulmonary edema, hypoperfusion syndrome or hypotension), ongoing or intermittent inotropic therapy aimed at stimulating beta receptors
angiospastic angina (angina pectoris Prince metal)
symptomatic bradycardia
severe arterial hypotension (systolic blood pressure below 100 mmHg)
bronchial asthma and other obstructive airway diseases
severe forms of peripheral circulatory disorders
simultaneous use of monoamine oxidase inhibitors (MAO)
severe disturbance of peripheral circulation
Raynaud’s syndrome
cardiomegaly (without signs of heart failure)
untreated adrenal tumors (pheochromocytoma)
metabolic acidosis
period of pregnancy and lactation
children and teenagers up to 18 years of age
hypersensitivity to bisoprolol or other components of the drug
galactose intolerance, Lapp lactase deficiency, galactose-glucose malabsorption

Side Effects

Often
– increased fatigue, unmotivated weakness, dizziness, headache
– blurred vision, decreased secretion of tear fluid (should be taken into account when the patient wears contact lenses), conjunctivitis
– orthostatic hypotension, especially in patients with heart failure, bradycardia, impaired atrioventricular (AV) conduction, decompensation of heart failure with the development of peripheral edema; at the beginning of treatment, the condition may worsen in patients with intermittent claudication or Raynaud’s syndrome
– nausea, abdominal pain, diarrhea, constipation, vomiting, dry mouth, changes in laboratory parameters of liver function, increased levels of liver enzymes (ALT, AST), hepatitis
– muscle weakness, muscle cramps, arthropathy with damage to one or more joints (mono- or polyarthritis)
– decreased glucose tolerance (with latent diabetes mellitus) and masked signs of hypoglycemia (in patients receiving insulin), in some cases – increased levels of triglycerides in the blood
– decreased libido and/or potency
– skin itching, development of psoriasis or exacerbation of an existing disease or rash
– paresthesia

Rarely

– anxiety, irritability, sleep disturbance, depression, confusion (especially in elderly patients), hallucinations (usually mild and passing within 1-2 weeks), nightmares, vivid dreams, depressed state
– shortness of breath (bronchospasm when prescribed in high doses or in predisposed patients)
– redness of the skin, increased sweating, rash
– hearing impairment
– allergic rhinitis

Very rarely

– alopecia

Interaction

Allergens used for immunotherapy or allergen extracts for skin testing increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol.

Iodine-containing radiocontrast drugs for intravenous administration increase the risk of anaphylactic reactions. Phenytoin when administered intravenously, drugs for inhalation general anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressive effect and the likelihood of a decrease in blood pressure.

Changes the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, increased blood pressure). Reduces the clearance of lidocaine and xanthines (except diphylline) and increases their concentration in plasma, especially in patients with initially increased clearance of theophylline under the influence of smoking.
The hypotensive effect is weakened by non-steroidal anti-inflammatory drugs (retention of Na+ ions and blockade of prostaglandin synthesis by the kidneys), glucocorticosteroids and estrogens (retention of Na+ ions).

Cardiac glycosides, methyldopa, reserpine and guanfacine, slow calcium channel blockers (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV block, cardiac arrest and heart failure. Nifedipine can lead to a significant decrease in blood pressure. Diuretics, clonidine, sympatholytics, hydralazine and other antihypertensive drugs can lead to an excessive decrease in blood pressure. Prolongs the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.

Tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and hypnotics increase CNS depression. Non-hydrogenated ergot alkaloids increase the risk of developing peripheral circulatory disorders. Ergotamine increases the risk of developing peripheral circulatory disorders; sulfasalazine increases the concentration of bisoprolol in plasma; Rifampin shortens the half-life.

Overdose

Symptoms: arrhythmia, ventricular extrasystole, severe bradycardia, AV block, decreased blood pressure, heart failure, cyanosis of fingernails or palms, difficulty breathing, bronchospasm, dizziness, fainting, convulsions.

Manufacturer

Chanell Medical, Ireland