Kordinorm is a selective beta1-blockers without sympathomimetic and membrane stabilizing properties of intrinsic activity.
Structure and Composition
According to instructions issued Kordinorm as white tablets, film-coated, with the amount of active substance 5 and 10 milligrams. The tablets are round and Kordinorm convex shape.
The active substance Kordinorma - bisoprolol fumarate. As auxiliary substances in the tablets Kordinorm also contains microcrystalline cellulose, croscarmellose sodium, mannitol, magnesium stearate, titanium dioxide, hypromellose, macrogol 6000.
Pharmacological action Kordinorma
According to the instructions, Kordinorm blocks in small doses β
-adrenoceptors heart, thereby reducing the formation of cAMP from ATP, which stimulates catecholamine and reduces the current of calcium ions inside cells. Bisoprolol reduces myocardial oxygen demand, adversely BATM, Drome, chrono-and inotropic effects, inhibits excitability and conductivity, slows AV-conduction. Decreases in heart rate during exercise and at rest. Kordinorm has antiarrhythmic, antihypertensive and anti-anginal action. Decreased plasma renin activity.
If you increase the dose of bisoprolol, will be given beta
On the first day after drinking Kordinorma slightly increased PR (total peripheral resistance) due to elimination of the stimulation of β
adrenoceptor and reciprocal increase in the activity of α-adrenergic receptors. Total peripheral vascular resistance returns to its original level after 1-3 days, and during prolonged use decreases.
According to the instructions, Kordinorm has hypotensive effect by reducing the IOC and the activity of the renin-angiotensin system, stimulation of peripheral vessels. It is very important for those sick cat initial hypersecretion of renin.
Antiarrhythmic effect of bisoprolol is due to the elimination of arrhythmogenic factors, such as tachycardia, increased activity of the sympathetic nervous system, increased cAMP, hypertension.
Antianginal Kordinorma occurs due to a decrease in myocardial oxygen demand due to the slowing of the heart rate and decrease contractility, improving perfusion and myocardial diastole lengthening.
In contrast, non-selective beta-blockers, bisoprolol, appointed in mid-dose therapy, not so pronounced effect on containing β
adrenoretseptory organs: pancreas, smooth muscles, arteries periphery, bronchi, uterus and skeletal muscle tissue. Bisoprolol expressed in moderate doses has no effect on carbohydrate metabolism and are not retained in the body of sodium.
If you apply large doses of bisoprolol, will be provided to the blocking effect on both subtypes of β-adrenoceptor.
In the gastrointestinal tract of bisoprolol is absorbed by 80-90%. Simultaneous use of Kordinorma with food on absorption is not wagging. Maximum concentration in the blood within 1-3 hours.
About 35% of bisoprolol is bound to plasma proteins. It has low penetrating ability through the placenta and breast milk.
Half the dose Kordinorma metabolized in the liver to form inactive metabolites, the other half is excreted unaltered.
• CAD (to prevent strokes);
Kordinorm is contraindicated in:
• shock (including cardiogenic);
• pulmonary edema;
• chronic heart failure decompensation;
• acute heart failure;
• sinoatrial block;
• AV-blockade II-III degree (without pacemaker);
• bradycardia (heart rate less than 50 beats per minute);
• cardiomegaly (having no evidence of heart failure);
• Prinzmetal angina;
• hypotension (systolic blood pressure less than 100 mm. Hg. Art., Especially when miokardnom infarction);
• bronchial asthma and COPD in history;
• late stages of peripheral circulatory disorders;
• simultaneous administration of MAO inhibitors (exception - MAO-B);
• Raynaud's disease;
• metabolic atsedoze;
• pheochromocytoma (without co-use of alpha-blockers);
• hypersensitivity to other beta-blockers;
• increased sensitivity to any other component of the formulation;
• children and adolescents up to 18 years (not established the safety and efficacy).
Caution should be used Kordinorm those who have liver failure, chronic renal failure, myasthenia gravis, hyperthyroidism, diabetes, depression (including history), psoriasis, old age.
Dosing and Administration
Tablets Kordinorm ingested on an empty stomach, without chewing, in the morning. A single dose should be between 2 and 5 to 5 milligrams. Usually at the beginning of treatment the daily dose is 5 mg. If necessary, the daily dose increased to 10 mg. The minimum daily dose for adults is 20 milligrams.
Side effects Kordinorma
According to reviews, Kordinorm has the following side effects:
On the part of the central nervous system: a weak state, severe fatigue, dizziness, insomnia or drowsiness, headache, nightmares, depression, hallucinations, myasthenia gravis, fatigue, tremor.
From the digestive tract: nausea, abdominal pain, vomiting, dry mouth, diarrhea or constipation, disorders of the liver, which appear dark urine, yellow skin and sclera, cholestasis.
The respiratory system: nasal congestion, shortness of breath.
Since the cardiovascular system: heart rate, sinus bradycardia, disturbances in conductivity infarction, arrhythmia, pain in the chest, poor myocardial contractility, development or complication of an existing heart failure (shortness of breath, swelling of the ankles and feet).
From the hematopoietic system: leukopenia, agranulocytosis, thrombocytopenia.
Part of the reproductive system: loss of potency and libido weakened.
According to reviews, Kordinorm can cause problems with the eyes, and painful dry eyes, blurred vision, conjunctivitis.
Reviews Kordinorme also say that it can cause allergic reactions such as itching and rashes, hives, and side effects of the musculoskeletal system: back pain, cramps in the calf muscles, arthralgia, muscle weakness.
Analogues are Kordinorma Aritel, Bidop, Biol, Biprol, Bisokard, Coronal, Concor, Niperten and Tiresias. Also a good analogue Kordinorma is bisoprolol.