Time and again, our team draws the attention of readers to medications that, for one reason or another, have found widespread use in the fight against diseases of the cardiovascular system and help doctors in counteracting such a formidable disease as arterial hypertension.
Increased or decreased blood pressure in the vessels is a direct consequence of disturbances in the functioning of the heart. It is difficult to say for sure what is primary - abnormal pressure provoked by disturbances in the functioning of the main human organ, or disruptions in the functioning of the heart that appeared due to increased blood pressure for other reasons. One thing is certain: hypertension claims thousands of lives every year. Death from causes caused by the patient having this disease is common and often sudden.
To illustrate what has been said, let us turn to statistics: one out of five people inhabiting our wonderful planet is susceptible to hypertension. This is more than one and a half billion people who suffer from headaches every day, often experiencing fear of angina, heart attacks and many other diseases caused by high blood pressure.
Unfortunately, in the list of countries among whose citizens hypertension is most widespread, Russia ranks third, only slightly behind the United States of America and the countries of the European Union. The Russian Academy of Medical Sciences says that sixty-three percent of our country's population is susceptible to hypertension.
Sharp surges in pressure provoke heart attacks and strokes, blockages of blood vessels due to detached blood clots and other catastrophic health consequences, causing mortality in seventy percent of cases from the general statistics of natural mortality of people. Strategically, counteracting hypertension can be divided into three branches. The first is the removal of external manifestations, the so-called symptomatic treatment. The second is unconditional prevention of this disease. The third, and most important, is eliminating the causes of already identified arterial hypertension.
One of the medications that helps in the fight against this truly formidable disease is Coronal. Let’s try, together with you, dear reader, to take a closer look at this medicine.
Pharmacodynamics and pharmacokinetics
The drug has an arrhythmic effect, antianginal , lowers blood pressure by reducing the formation of cyclic AMP from adenosine triphosphate . The intracellular current of calcium ions decreases, the processes of excitation and inhibition are inhibited, heart rate decreases, and myocardial .
Due to the fact that beta2-adrenergic receptors are inhibited, the activity of alpha-adrenergic receptors . In this regard, in the first few days of using Coronal, OPSS , but after a couple of days, it returns to its normal level.
During treatment with the drug, the reninangiotensin system , the sensitivity of baroreceptors returns to normal, and, as a result, the minute volume of blood .
Due to the decrease in the heart's oxygen demand, due to improved myocardial perfusion and prolongation of diastole , the drug has a strong and lasting antianginal effect . The antiarrhythmic effect of the drug is associated with a combination of the factors listed above, as well as the ability to reduce the rate of excitation of sinus and ectopic pacemakers .
Bisoprolol is very well absorbed into the bloodstream, about 90% of the drug enters it. It reaches maximum concentration after 3 hours, about 30% of the active substance binds to blood proteins, and is metabolized mainly in the liver. Excretion is carried out through the kidneys within 10-12 hours.
Analogues and prices
We have already mentioned that both products are quite popular. And this popularity can be explained quite simply: the main active ingredient has a high degree of effectiveness. However, this does not mean that only the above-mentioned medications are made based on this component. There are other medicines that are analogues of Concor and Bisoprolol.
| Biprol. | Bisogamma. | Niperten. |
These are the available analogues. Especially if we are talking about replacing Concor. After all, this product has a very high price. And if, when you go to the pharmacy, you don’t find Bispoprolol there, then you can safely choose one of the analogues mentioned above. The mechanism of their action is almost the same. Only the dosage may differ, as well as the list of side effects. Remember that the cheaper the product, the more side effects it has. Therefore, it may make sense to wait until a new batch of drugs is delivered to the pharmacy, and not just purchase a cheaper analogue that is in stock.
Indications for use of Coronal
Indications for the use of Coronal tablets are arterial hypertension , coronary heart disease and angina pectoris .
Sinus tachycardia is also considered an indication for the use of Coronal ; extrasystole (ventricular and supraventricular); prolapse ; arrhythmia caused by thyrotoxicosis .
Indications for Coronal 5 mg include the prevention of myocardial infarction and minor heart rhythm disturbances.
Overdose
Symptoms
.
In case of overdosage (for example, stagnation of an additional dose of 15 mg instead of 7.5 mg), the development of stage 3 atrioventricular block, bradycardia and confusion were recorded. The most common signs of overdose with beta-blockers are bradycardia, arterial hypotension, cardiac failure, hypoglycemia and bronchospasm. Currently, there are several episodes of overdose in patients with arterial hypertension and/or ischemic heart disease (maximum dose – 2000 mg bisoprolol). Bradycardia and/or arterial hypotension were observed. All patients became comfortable. Due to the wide interindividual variability in sensitivity to a single high dose of besoprolol, patients with heart failure may be more sensitive to the drug. Therefore, treatment should begin with gradual increases in dosage (section “Method of dosage and dosage”).
Likuvannya.
In case of overdose, treat with the drug and carry out supportive and symptomatic therapy. Please note that bisoprolol is highly susceptible to dialysis. If an overdose is suspected, the following steps should be considered before taking appropriate pharmacological action based on the recommendations for other β-blockers.
For bradycardia: intravenous administration of atropine. If the reaction is daily, administer isoprenaline or another drug with caution because it has a positive chronotropic effect. In varicose veins, it may be necessary to administer transvenous fluid to the rhythm.
For arterial hypotension: internal administration of intravenous and vascular drugs. Internal administration of glucagon can be administered.
In case of atrioventricular block II and III stages: careful caution and infusion of isoprenaline or transvenous administration of a pacemaker.
In case of acute chronic heart failure: internal administration of diuretics, inotropic drugs, vasodilators.
For bronchospasm: bronchodilator drugs (for example, isoprenaline), β2-adrenergic agonists and/or aminophylline.
For hypoglycemia: internal administration of glucose.
Contraindications
Prescription and use of the drug is contraindicated in
- allergies to the active substance or other components;
- sick sinus syndrome;
- bronchial asthma;
- cardiogenic or other type of shock ;
- acute heart failure;
- sinoarterial blockade;
- severe bradycardia ;
- a decrease in blood pressure below 100 mm. Hg;
- myocardial infarction;
- AV block , especially second and third degree;
- with Raynaud's disease .
The drug is not prescribed to children or nursing women.
The medicine cannot be combined with MAO inhibitors, floctafenine, or sultopride .
Interactions of the drug Coronal
Coronal should be prescribed with caution concomitantly with MAO inhibitors, since blood pressure increases after stopping the latter. Allergens used for immunotherapy or allergen extracts used for skin testing in combination with beta-blockers can provoke severe systemic allergic reactions. Antiarrhythmic drugs of class I (for example, disopyramide, quinidine, lidocaine, propafenone) and class III (amiodarone, sotalol) should be used with caution. Baclofen is additionally prescribed with caution (possible increase in blood pressure). Coronal may potentiate the effects of other antihypertensive drugs. Concomitant use of reserpine α-methyldopa, clonidine, digitalis or guanfacine may slow intracardiac conduction. Simultaneous administration of sympathomimetic drugs (for example, eye or nasal drops, antitussives) may reduce the therapeutic effectiveness of Coronal. The simultaneous use of drugs of the rifampicin group, which are activators of liver enzymes, can reduce the biological half-life of Coronal, but dose adjustment is not necessary. Combination with calcium channel blockers of the verapamil group, nifedipine or with some antiarrhythmic drugs can lead to bradycardia, conduction disturbances or the development of heart failure, while combination with other vasodilators can cause hypotension. Due to the risk of developing a hypertensive crisis, treatment with Coronal should be discontinued several days before the end of concomitant use of clonidine. The simultaneous use of Coronal and ergotamine derivatives may worsen peripheral circulation. β-adrenergic blockers can potentiate the effect of insulin, oral antidiabetic drugs and mask the symptoms of hypoglycemia (tachycardia). In this regard, it is necessary to regularly monitor blood glucose levels in patients with diabetes. It is possible that the antihypertensive effect may be reduced due to water and sodium retention while taking corticosteroids. Before performing surgery under general anesthesia, the anesthesiologist must be informed that the patient is taking Coronal. Inhalation anesthetics and hydrocarbon derivatives (chloroform, cyclopropanone, halothane, methoxyflurane, etc.) when used simultaneously with β-adrenergic receptor blockers increase the risk of their cardiodepressive effects and the development of hypotensive reactions. Cimetidine may reduce the clearance of beta-adrenergic blockers metabolized in the liver and, accordingly, increase their bioavailability. Xanthines (aminophylline, theophylline) can mutually weaken the therapeutic effect when prescribed with beta-adrenergic receptor blockers.
Side effects of Coronal
The most common side effects:
- dry mouth, diarrhea, nausea, constipation;
- asthenia, drowsiness, depression , headache;
- bradycardia , vasospasm , decreased blood pressure ;
- allergic reactions on the skin, hyperemia ;
- arthralgia , pain and cramps in the calf muscles.
Cases of agranulocytosis , potency disorders , thrombocytopenia , and withdrawal syndrome have been reported.
Side effects of the drug Coronal
From the side of the cardiovascular system - arterial hypotension, including orthostatic, bradycardia, conduction disturbances, paresthesia, and worsening of symptoms in patients with intermittent claudication or Raynaud's syndrome were occasionally noted. From the nervous system side - at the beginning of treatment, increased fatigue, headache, dizziness, sleep disorders, vivid dreams and mental changes (depression, etc.) are possible. On the part of the organ of vision - isolated cases of visual impairment, decreased tear production (which should be taken into account when using contact lenses), conjunctivitis. From the respiratory system - nasal congestion, rhinitis, shortness of breath, bronchospasm were rarely observed. From the gastrointestinal tract - constipation, diarrhea, nausea, abdominal pain; isolated cases of hepatotoxic action of bisoprolol have been described. On the part of muscles and joints - muscle pain, cramps, arthropathy. On the skin side - redness, itching and increased sweating. From the genitourinary system, erectile dysfunction and dysuria were very rarely noted. Metabolism - increased levels of liver enzymes in the blood serum. In patients with a latent form of diabetes mellitus or with a manifest form of this disease, glucose tolerance may decrease and signs of hypoglycemia (tachycardia) may be masked. Cases of increased TG levels in the blood, the appearance of psoriasis, increased severity of its symptoms, or the occurrence of a psoriasis-like rash have been reported. In isolated cases, during treatment with beta-adrenergic receptor blockers, alopecia, hearing impairment and ringing in the ears, weight gain, emotional lability, short-term memory loss, allergic rhinitis, priapism, allergic and nonspecific reactions (pain in muscles, joints, muscle weakness, cramps) were noted. ).
Instructions for use, Coronal tablets (Method and dosage)
The tablets are taken in the morning, 20 minutes before breakfast, whole, without chewing or splitting.
According to the instructions for use of Coronal 5 mg, the starting daily dose is from 2.5 to 5 mg. Then, according to indications, the dosage can be increased to 10 mg. The maximum amount of bisoprolol taken per day is 20 mg.
For patients with severe liver and kidney dysfunction, the daily dosage should not exceed 10 mg.
Form and composition of the drug
The drug "Coronal" is sold in pharmacies in the form of tablets for oral administration. The pills are film-coated and have convexities on both sides. The tablets are packed in boxes with blisters of 10 pieces each.
The active substance in the product is bisoprolol fumarate. In one pill its concentration is 5 mg and 10 mg. The preparation also contains additional elements.
The package may contain 10, 6, 3 or 1 blister of Coronal tablets
Overdose
Symptoms of overdose are: bradycardia, arrhythmia, low blood pressure, acrocyanosis, dizziness, fainting, bronchospasm .
In case of overdose, you should rinse the stomach, take enterosorbents , drugs to eliminate symptoms ( atropine, epinephrine, lidocaine, dopamine, dobutamine, glucagon, diazepam ).
Interaction
Do not take with other beta blockers .
Combine with caution with iodine-containing radiocontrast agents , phenytoin , hydrocarbon derivatives , allergen extracts for skin tests, nifedipine , coumarins , muscle relaxants, tricyclic antidepressants, neuroleptics , sedatives , ethanol , MAO inhibitors .
When Coronal is combined with lidocaine and xanthines , the plasma concentration of the latter increases.
Diabetics should be especially careful, since under the influence of the drug, the effectiveness of insulin may change, and symptoms of hypoglycemia may not appear.
The therapeutic effect of the drug is weakened when combined with non-steroidal anti-inflammatory drugs , corticosteroids , and estrogens .
Biosprolol affects the effectiveness of cardiac clicosides , reserpine , guanfacine , methyldopa , verapamil , diltiazem , amiodarone .
Diuretics, clonidine and hydralazine in combination with medication can greatly lower blood pressure
The combination of Coronal and Sulfasalazine increases the concentration of bisoprolol in the blood plasma, and rimafmpicin reduces the half-life of the drug.
Taking Baclofen, amifostine, floctaphanine, mefloquine, chlorquinine, adrenaline, norepinephrine and Coronal is considered undesirable.
special instructions
During Coronal therapy, it is important to constantly conduct an ECG, monitor heart rate and blood pressure. Patients with diabetes will additionally need to monitor their blood glucose levels, and elderly people will need to monitor their kidney function. Smokers should be aware that this addiction can reduce the effectiveness of Coronal. It is strictly not recommended for patients who have been diagnosed with thyrotoxicosis (excess thyroid hormones) to abruptly stop treatment for hypertension with Coronal. If a depressive state develops, the therapeutic course must be immediately interrupted.
Analogues of Coronal
Level 4 ATC code matches:
Biol
Metocard
Metozok
Nebilet
Nebilong
Betaxolol
Bisogamma
Aritel
Cordinorm
Vasocardin
Corvitol
Bidop
Bisoprolol
Nebivolol
Biprol
Bisoprol
Concor Cor
Lokren
Concor
Niperten
The closest analogues of Coronal are: bicard, bisocard, bisoprolol, bisoprofar, dorez, concor, cordinorm, corbis, bisostad, biprolol .
Other analogues of the drug: azoprol, metocor, atenol, atenolol, atenobene, betak, betalok, breviblock, corvitol, egilok, betacor, vasocardin, corvtol, lokren, metoprolol, metoprolol tartrate, nebivovol, nebikor, nebilong, nebitrend, tenolol .
Coronal price (where to buy)
The price of Coronal for 30 pieces of 5 mg is 121 rubles. The same amount of the drug in a dosage of 10 mg costs approximately 209 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Coronal tablets p.p.o.
10 mg 30 pcs. Zentiva a.s./Saneka Pharmaceuticals a.s. RUB 168 order - Coronal tablets p.p.o. 5 mg 100 pcs. Zentiva a.s./Saneka Pharmaceuticals a.s.
RUB 248 order
- Coronal tablets p.p.o. 5 mg 30 pcs. Zentiva a.s./Saneka Pharmaceuticals a.s.
102 RUR order
- Coronal tablets p.p.o. 5 mg 60 pcs. Zentiva a.s./Saneka Pharmaceuticals a.s.
164 RUR order
- Coronal tablets p.p.o. 10 mg 100 pcs. Zentiva a.s./Saneka Pharmaceuticals a.s.
RUR 397 order
Pharmacy Dialogue
- Coronal (tab.p.pl/vol. 5mg No. 30)Saneca
114 RUR order
- Coronal (tab.p.pl/vol. 10 mg No. 60) Saneca
RUB 282 order
- Coronal (tab.p.pl/vol. 10mg No. 30)Zentiva
RUB 187 order
- Coronal (tab.p.pl/vol. 5mg No. 30)Zentiva
119 RUR order
- Coronal (tab.p.pl/vol. 10mg No. 60)Zentiva
RUB 286 order
show more
Pharmacy24
- Coronal 10 mg No. 60 tablets AT Saneka Pharmaceuticals, Slovak Republic/Zentiva LLC Czech Republic
88 UAH order - Coronal 5 mg No. 60 tablets AT Saneka Pharmaceuticals, Slovak Republic/Zentiva LLC Czech Republic
59 UAH order
- Coronal 5 mg N30 tablets AT Saneka Pharmaceuticals, Slovak Republic/Zentiva LLC Czech Republic
33 UAH order
- Coronal 10 mg N30 tablets AT Saneka Pharmaceuticals, Slovak Republic/Zentiva LLC Czech Republic
59 UAH order
PaniPharmacy
- Coronal tablets Coronal tablets. 10 mg No. 60, Saneca Pharmaceuticals
99 UAH order
- Coronal tablets Coronal tablets. p/o 5 mg No. 30, Saneca Pharmaceuticals
38 UAH order
- Coronal tablets Coronal tablets. 5mg No. 60, Saneca Pharmaceuticals
73 UAH order
- Coronal tablets Coronal tablets. p/o 10 mg No. 30, Saneca Pharmaceuticals
63 UAH order
show more
Comparison of side effects of Biprol and Coronal
Side effects or adverse events are any adverse medical event that occurs in a subject after administration of a drug.
Biprol's side effects are almost the same as Coronal's. They both have few side effects. This implies that the frequency of their occurrence is low, that is, the indicator of how many cases of an undesirable effect of treatment are possible and registered is low. The undesirable effect on the body, the strength of influence and the toxic effect of Biprol are similar to Coronal: how quickly the body recovers after taking it and whether it recovers at all.
