Селективный бета1-адреноблокатор без внутренней симпатомиметической активности, не обладает мембраностабилизирующим действием. Обладает лишь незначительным сродством к β2-адренорецепторам гладкой мускулатуры бронхов и сосудов, а также к β2-адренорецепторам, участвующим в регуляции метаболизма. Следовательно, бисопролол в целом не влияет на сопротивление дыхательных путей и метаболические процессы, в которые вовлечены β2-адренорецепторы.
Избирательное действие препарата на β1-адренорецепторы сохраняется и за пределами терапевтического диапазона.
Бисопролол не обладает выраженным отрицательным инотропным действием. Максимальный эффект препарата достигается через 3–4 ч после приема внутрь. Даже при применении бисопролола 1 раз в сутки его терапевтический эффект сохраняется в течение 24 ч благодаря 10–12-часовому периоду полувыведения из плазмы крови. Как правило, максимальное снижение АД достигается через 2 недели после начала лечения.
Бисопролол снижает активность симпатоадреналовой системы (САС), блокируя β1-адренорецепторы сердца.
При однократном приеме внутрь у пациентов с ИБС без признаков хронической сердечной недостаточности (ХСН) бисопролол урежает ЧСС, уменьшает ударный объем сердца и, как следствие, уменьшает фракцию выброса и потребность миокарда в кислороде. При длительной терапии изначально повышенное ОПСС снижается. Снижение активности ренина в плазме крови рассматривается как один из компонентов гипотензивного действия бета-адреноблокаторов.
Показания к применению
артериальная гипертензия;
ИБС: стабильная стенокардия;
хроническая сердечная недостаточность.
Противопоказания
повышенная чувствительность к бисопрололу и другим бета-адреноблокаторам;
шок (в т.ч. кардиогенный), коллапс;
острая сердечная недостаточность, отек легких;
хроническая сердечная недостаточность в стадии декомпенсации (в т.ч. кардиогенный шок);
AV блокада II–III ст., синоатриальная блокада, синдром слабости синусного узла;
одновременный прием ингибиторов МАО (за исключением ингибиторов МАО-В);
поздние стадии нарушения периферического кровообращения;
болезнь Рейно;
феохромоцитома (без одновременного использования альфа-адреноблокаторов);
метаболический ацидоз;
возраст до 18 лет (эффективность и безопасность не установлены).
Применение при беременности и в период грудного вскармливания
Применение Бидоп при беременности и в период грудного вскармливания возможно в том случае, если польза для матери превышает риск развития побочных эффектов у плода и ребенка.
Способ применения и дозы
Внутрь, утром, натощак, не разжевывая, 2,5–5 мг Бидоп однократно.
При необходимости дозу увеличивают до 10 мг 1 раз в сутки.
Максимальная суточная доза — 20 мг в сутки.
Побочное действие
урежение сердечного ритма
головокружение, нарушения сна, утомляемость
перемежающаяся хромота, нарушения зрения. кожные высыпания.
Лечение: промывание желудка и назначение адсорбирующих лекарственных средств; симптоматическая терапия: при развившейся AV-блокаде – в/в 1-2 мг атропина, эпинефрина или постановка временного кардиостимулятора; при желудочковой экстрасистолии - лидокаин (препараты I A класса не применяются); при снижении АД - пациент должен находиться в положении Тренделенбурга; если нет признаков отека легких, - в/в плазмозамещающие растворы, при неэффективности - введение эпинефрина, допамина, добутамина (для поддержания хронотропного и инотропного действия и устранения выраженного снижения АД); при сердечной недостаточности - сердечные гликозиды, диуретики, глюкагон; при судорогах – в/в диазепам; при бронхоспазме - бета2-адреностимуляторы ингаляционно.
Взаимодействие с другими лекарственными средствами
Аллергены, используемые для иммунотерапии, или экстракты аллергенов для кожных проб повышают риск возникновения тяжелых системных аллергических реакций или анафилаксии у больных, получающих бисопролол.
Йодсодержащие рентгеноконтрастные лекарственные средства для в/в введения повышают риск развития анафилактических реакций. Фенитоин при в/в введении, лекарственные средства для ингаляционной общей анестезии (производные углеводородов) повышают выраженность кардиодепрессивного действия и вероятность снижения АД.
Изменяет эффективность инсулина и пероральных гипогликемических лекарственных средств, маскирует симптомы развивающейся гипогликемии (тахикардию, повышение АД).
Снижает клиренс лидокаина и ксантинов (кроме теофиллина) и повышает их концентрацию в плазме, особенно у больных с исходно повышенным клиренсом теофиллина под влиянием курения.
Гипотензивный эффект ослабляют НПВС (задержка ионов натрия и блокада синтеза простагландина почками), ГКС и эстрогены (задержка ионов натрия).
Сердечные гликозиды, метилдопа, резерпин и гуанфацин, блокаторы медленных кальциевых каналов (верапамил, дилтиазем), амиодарон и другие антиаритмические лекарственные средства повышают риск развития или усугубления брадикардии, AV блокады, остановки сердца и сердечной недостаточности.
Особые указания
Контроль за больными, принимающими Бидоп, должен включать измерение ЧСС и АД (в начале лечения — ежедневно, затем 1 раз в 3–4 мес), проведение ЭКГ, определение глюкозы крови у больных сахарным диабетом (1 раз в 4–5 мес).
У пожилых пациентов рекомендуется следить за функцией почек (1 раз в 4–5 мес).
Форма выпуска
Таблетки
Условия хранения
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Обладает лишь незначительным сродством к β\u003csub\u003e2\u003c/sub\u003e-адренорецепторам гладкой мускулатуры бронхов и сосудов, а также к β\u003csub\u003e2\u003c/sub\u003e-адренорецепторам, участвующим в регуляции метаболизма. Следовательно, бисопролол в целом не влияет на сопротивление дыхательных путей и метаболические процессы, в которые вовлечены β\u003csub\u003e2\u003c/sub\u003e-адренорецепторы."}},{"type":"paragraph","data":{"text":"Избирательное действие препарата на β\u003csub\u003e1\u003c/sub\u003e-адренорецепторы сохраняется и за пределами терапевтического диапазона."}},{"type":"paragraph","data":{"text":"Бисопролол не обладает выраженным отрицательным инотропным действием. Максимальный эффект препарата достигается через 3–4 ч после приема внутрь. Даже при применении бисопролола 1 раз в сутки его терапевтический эффект сохраняется в течение 24 ч благодаря 10–12-часовому периоду полувыведения из плазмы крови. Как правило, максимальное снижение АД достигается через 2 недели после начала лечения."}},{"type":"paragraph","data":{"text":"Бисопролол снижает активность симпатоадреналовой системы (САС), блокируя β\u003csub\u003e1\u003c/sub\u003e-адренорецепторы сердца."}},{"type":"paragraph","data":{"text":"При однократном приеме внутрь у пациентов с ИБС без признаков хронической сердечной недостаточности (ХСН) бисопролол урежает ЧСС, уменьшает ударный объем сердца и, как следствие, уменьшает фракцию выброса и потребность миокарда в кислороде. При длительной терапии изначально повышенное ОПСС снижается. Снижение активности ренина в плазме крови рассматривается как один из компонентов гипотензивного действия бета-адреноблокаторов."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["артериальная гипертензия;","ИБС: стабильная стенокардия;","хроническая сердечная недостаточность."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["повышенная чувствительность к бисопрололу и другим бета-адреноблокаторам;","шок (в т.ч. кардиогенный), коллапс;","острая сердечная недостаточность, отек легких;","хроническая сердечная недостаточность в стадии декомпенсации (в т.ч. кардиогенный шок);","AV блокада II–III ст., синоатриальная блокада, синдром слабости синусного узла;","выраженная брадикардия;","стенокардия Принцметала;","кардиомегалия (без признаков сердечной недостаточности);","артериальная гипотензия (сАД","бронхиальная астма и ХОБЛ в анамнезе;","одновременный прием ингибиторов МАО (за исключением ингибиторов МАО-В);","поздние стадии нарушения периферического кровообращения;","болезнь Рейно;","феохромоцитома (без одновременного использования альфа-адреноблокаторов);","метаболический ацидоз;","возраст до 18 лет (эффективность и безопасность не установлены)."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение Бидоп при беременности и в период грудного вскармливания возможно в том случае, если польза для матери превышает риск развития побочных эффектов у плода и ребенка."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, утром, натощак, не разжевывая, 2,5–5 мг Бидоп однократно."}},{"type":"paragraph","data":{"text":"При необходимости дозу увеличивают до 10 мг 1 раз в сутки."}},{"type":"paragraph","data":{"text":"Максимальная суточная доза — 20 мг в сутки."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"list","data":{"style":"ordered","items":["урежение сердечного ритма","головокружение, нарушения сна, утомляемость","перемежающаяся хромота, нарушения зрения. кожные высыпания."]}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: аритмия, желудочковая экстрасистолия, выраженная брадикардия, AV-блокада, выраженное снижение АД, хроническая сердечная недостаточность, цианоз ногтей пальцев или ладоней, затруднение дыхания, бронхоспазм, головокружение, обморочные состояния, судороги, гипогликемия."}},{"type":"paragraph","data":{"text":"Лечение: промывание желудка и назначение адсорбирующих лекарственных средств; симптоматическая терапия: при развившейся AV-блокаде – в/в 1-2 мг атропина, эпинефрина или постановка временного кардиостимулятора; при желудочковой экстрасистолии - лидокаин (препараты I A класса не применяются); при снижении АД - пациент должен находиться в положении Тренделенбурга; если нет признаков отека легких, - в/в плазмозамещающие растворы, при неэффективности - введение эпинефрина, допамина, добутамина (для поддержания хронотропного и инотропного действия и устранения выраженного снижения АД); при сердечной недостаточности - сердечные гликозиды, диуретики, глюкагон; при судорогах – в/в диазепам; при бронхоспазме - бета\u003csub\u003e2\u003c/sub\u003e-адреностимуляторы ингаляционно."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Аллергены, используемые для иммунотерапии, или экстракты аллергенов для кожных проб повышают риск возникновения тяжелых системных аллергических реакций или анафилаксии у больных, получающих бисопролол."}},{"type":"paragraph","data":{"text":"Йодсодержащие рентгеноконтрастные лекарственные средства для в/в введения повышают риск развития анафилактических реакций. Фенитоин при в/в введении, лекарственные средства для ингаляционной общей анестезии (производные углеводородов) повышают выраженность кардиодепрессивного действия и вероятность снижения АД."}},{"type":"paragraph","data":{"text":"Изменяет эффективность инсулина и пероральных гипогликемических лекарственных средств, маскирует симптомы развивающейся гипогликемии (тахикардию, повышение АД)."}},{"type":"paragraph","data":{"text":"Снижает клиренс лидокаина и ксантинов (кроме теофиллина) и повышает их концентрацию в плазме, особенно у больных с исходно повышенным клиренсом теофиллина под влиянием курения."}},{"type":"paragraph","data":{"text":"Гипотензивный эффект ослабляют НПВС (задержка ионов натрия и блокада синтеза простагландина почками), ГКС и эстрогены (задержка ионов натрия)."}},{"type":"paragraph","data":{"text":"Сердечные гликозиды, метилдопа, резерпин и гуанфацин, блокаторы медленных кальциевых каналов (верапамил, дилтиазем), амиодарон и другие антиаритмические лекарственные средства повышают риск развития или усугубления брадикардии, AV блокады, остановки сердца и сердечной недостаточности."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Контроль за больными, принимающими Бидоп, должен включать измерение ЧСС и АД (в начале лечения — ежедневно, затем 1 раз в 3–4 мес), проведение ЭКГ, определение глюкозы крови у больных сахарным диабетом (1 раз в 4–5 мес)."}},{"type":"paragraph","data":{"text":"У пожилых пациентов рекомендуется следить за функцией почек (1 раз в 4–5 мес)."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом защищенном от света, недоступном для детей месте, при температуре не выше 20 °С."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"Срок годности - 3 года."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.vidal.ru/drugs/company/12\"\u003eГЕДЕОН РИХТЕР ОАО\u003c/a\u003e (Венгрия) "}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Московское представительство ОАО \"Гедеон Рихтер\""}}]}],"source":null},"description_toggle":false,"short_description":"Селективный бета1-адреноблокатор без внутренней симпатомиметической активности, не обладает мембраностабилизирующим действием. 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При однократном приеме внутрь у пациентов с ИБС без признаков хронической сердечной недостаточности (ХСН) бисопролол урежает ЧСС, уменьшает ударный объем сердца и, как следствие, уменьшает фракцию выброса и потребность миокарда в кислороде. При длительной терапии изначально повышенное ОПСС снижается. Снижение активности ренина в плазме крови рассматривается как один из компонентов гипотензивного действия бета-адреноблокаторов.","substance":[{"id":278,"title":"Бисопролол","title_latin":"Bisoprololum","slug":"bisoprolol_278"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Бидоп - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72036/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72036/share_default/"}},"diseases":[],"other_packages":[{"id":93780,"title":"Бидоп","subtitle":{"full":"Таблетки, коробка, 56 шт, 5 мг, для приема внутрь","short":"Таблетки, 56 шт, 5 мг","package":"56 шт, 5 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