Angina attacks are common conditions. Therefore, it is worth considering an effective medication that is prescribed for the treatment and prevention of this serious disease. According to the instructions, Cordinorm (10 mg and 5 mg) blocks small amounts of cardiac β1-adrenergic receptors, which significantly reduces the formation of cAMP from ATP, stimulated by catecholamines, and inhibits the flow of calcium ions in cells. This medicine is able to reduce the oxygen demand of the middle muscle layer of the heart, exert a negative batho-, chrono-, dromo- and inotropic effect, inhibit conduction and excitability, and slow down AV-conduction.
What helps Kordinorm?
A pharmaceutical drug reduces the intensity of cardiac contractions at rest, as well as during exercise. The drug "Cordinorm" in tablets has hypotensive, antiarrhythmic and antianginal effects. Reduces the activity of the renin-angiotensin system, which is responsible for the normalization of blood pressure. If you increase the dosage of the main active element (bisoprolol), the drug will contribute to the beta2-adrenergic blocking effect. On the first day after taking the pharmacological agent “Cordinorm”, the OPSS (peripheral vascular resistance) slightly increases as a result of the reciprocal increase in the functionality of α-adrenergic receptors and the elimination of stimulation of β2-adrenoreceptors. The total resistance of the vessels in this case returns to the initial level after 1-4 days, and with prolonged therapy with this medication begins to decrease significantly.
According to the instructions, the drug “Cordinorm” (you can see how it looks in the photo) has antihypertensive effectiveness, due to a decrease in the IOC and the functionality of the renin-angiotensin system, and increased activity of peripheral vessels. This is extremely important for those patients who suffer from initial renin hypersecretion. Antiarrhythmic properties of this drug are due to the elimination of arrhythmogenic factors. These include: tachycardia, excessive activity of the sympathetic system, arterial hypertension, increased content of cAMP.
The antianginal effect of the drug “Cordinorm Cor” occurs as a result of a decrease in the need for oxygen to enter the heart muscle due to a reduction in heart rate and a decrease in contractility, normalization of perfusion and lengthening of the diastole of the heart muscle. Unlike beta-adrenergic blockers, which are non-selective, the active element of this medication, prescribed in medium dosages for treatment, does not have such a pronounced effect on organs containing β2-adrenergic receptors, such as the pancreas, smooth muscles, peripheral arteries, the uterus, bronchi and elastic skeletal tissue. Bisoprolol in moderate dosages also does not have a pronounced effect on carbohydrate metabolism, and does not contribute to sodium retention. If this medicine is used in large doses, a blocking effect on both types of β-adrenergic receptors will be observed.
Indications for the prescription of this drug
Cordinorm tablets do not have such a wide list of indications for use, these include:
- Ischemic heart disease (as a preventive measure against angina attacks);
- hypertension
The list of contraindications to the use of this medication
You can not start therapy with a medication without a doctor’s prescription, since it has a lot of limitations. Cordinorm, produced in dosages of 5 mg and 10 mg, is contraindicated in the following pathological conditions:
- shock (including cardiogenic type);
- collapse;
- pulmonary edema;
- chronic heart failure in the stage of decompensation;
- sinoatrial block;
- acute heart failure;
- AV blockade of 2-3 degrees (in the absence of a pacemaker);
- SSSU;
- severe bradycardia (frequency of contractions less than 50 beats per minute);
- cardiomegaly (without signs of heart failure);
- Prinzmetal angina pectoris;
- low blood pressure (with systolic pressure less than 100 mm Hg. Art., in particular with a heart attack);
- bronchial asthma and COPD (as data from the anamnesis);
- late stages of circulatory disorders of the periphery;
- simultaneous use of MAO inhibitors (with the exception of MAO type B);
- Raynaud's disease;
- metabolic acidosis;
- pheochromocytoma (without the combined use of alpha-blockers);
- intolerance to other beta-blockers;
- high sensitivity to the element of this medication;
- age up to 18 years (while the safety and effectiveness of the drug have not been established).
Caution should be used with the Cordinorm medication for patients with hepatic insufficiency and chronic kidney disease, myasthenia gravis, thyrotoxicosis, diabetes mellitus, depression (including a history of), psoriasis, and also in old age.
Dosage regimen and method of administration of the drug
The medicine is taken orally on an empty stomach, without chewing. A single dose should be from 2.5 to 5 mg of Cordinorm according to the instructions. Usually, at the beginning of therapy, the daily dosage is immediately 5 mg. If necessary, the daily dose is allowed to be increased to 10 mg. The minimum dose for adults per day is 20 mg.
Side effects from the use of a medication
Regardless of the dosage with which the patient took the medication - 10 or 5 mg, Cardinorm in some patients can provoke the development of the following side effects:
- CNS: weakness, severe fatigue, dizziness, insomnia, or, conversely, drowsiness, headaches, nightmares, depression, myasthenia gravis, hallucinations, asthenia, tremors.
- Digestive system: nausea, abdominal pain, vomiting, stool disturbance, dry mouth, malfunctioning of the liver, which can manifest as dark urine, yellowness of the skin and sclera, and cholestasis.
- Respiratory system: shortness of breath, nasal congestion.
- Cardiovascular system: discomfort in the chest in the form of strokes and shocks, insufficient contractility of the myocardium, rhythmic disturbances. Some of these symptoms can be observed with strong physical exertion. After taking the drug, cardiac muscle conduction disturbances, sinus bradycardia, the occurrence or complication of already present heart failure (swelling of the legs, shortness of breath) are noted.
- Hematopoietic system: agranulocytosis, leukopenia, thrombocytopenia.
- Reproductive organs: decreased erectile function and weakened libido.
- Organs of vision: dryness and soreness in the eyes, impaired vision, the development of conjunctivitis.
- Allergic reactions: skin itching, rash in the form of urticaria.
- Musculoskeletal system: back pain, spasms of the calf muscles, arthralgia.
Analogs of Cordinorm
If for some reason the drug is not suitable for the patient, the doctor may prescribe other drugs with the same effect. The following drugs are analogues of this medication:
- Aritel
- "Biol";
- Bidop;
- "Coronal";
- "Biprol";
- "Biscard";
- "Concor";
- Tirez;
- "Niperten."
It is worth considering some of the above drugs in more detail.
The drug "Aritel"
It is a combined antihypertensive agent, selective beta1-blocker without internal membrane-stabilizing and sympathomimetic activity. The medicine has antiarrhythmic, antihypertensive and antianginal effects. It blocks β1-adrenergic receptors of the heart, reduces the formation of cyclic adenosine monophosphates from adenosine triphosphates stimulated by catecholamines, reduces the intracellular current of calcium ions, inhibits cardiac conduction processes, blocks β2-adrenergic receptors in high doses.
The total peripheral vascular resistance at the beginning of the use of beta-blockers increases on the first day (as a result of a reciprocal increase in the functionality of alpha-adrenergic receptors and stopping the stimulation of β2-adrenergic receptors).
This analogue of Cordinorm has antihypertensive efficacy due to decreased IOC and the functionality of the renin-angiotensin system, and stimulation of peripheral vessels. This is extremely important for those patients who suffer from initial renin hypersecretion. The antiarrhythmic properties of this drug are due to the elimination of arrhythmogenic causes, for example, tachycardia, excessive activity of the sympathetic system, arterial hypertension, and an increased content of cAMP. The antihypertensive effect occurs due to a decrease in minute blood volume, suppression of peripheral vascular activity.
The hydrochlorothiazide present in the composition of this medication is a thiazide diuretic that helps to reduce the reabsorption of sodium ions in the cortical segments of the Henley loop, without affecting its area passing in the brain layers of the kidneys. It blocks carbonic anhydrase in the proximal sections of the convoluted tubules of the urinary organ, enhances the excretion of bicarbonates, potassium ions and phosphates. Does not affect the basic acid state. It enhances the excretion of magnesium ions, delays calcium ions and reduces the excretion of urate. Diuretic efficacy is observed after 1-2 hours.
Indication for the appointment of the drug "Aritel" can be considered moderate hypertension. The list of contraindications includes:
- advanced and complex forms of asthma;
- cardiogenic shock;
- COPD
- SSSU;
- AV block without a pacemaker;
- bradycardia;
- pheochromocytoma;
- impaired peripheral circulation;
- severe hypotension;
- refractory hypokalemia, hypercalcemia, hyponatremia;
- metabolic acidosis;
- renal failure;
- dehydration;
- use simultaneously with sultopride and flactafenin, combined with MAO inhibitors.
Medication "Concor"
This analogue of Cordinorm is a selective beta1-blocker that has a pronounced antihypertensive, antiarrhythmic and antianginal effect. Its active substance is bisoprolol, which has selective activity against beta1-adrenergic receptors, which also remains outside the therapeutic range.
The drug does not have its own membrane-stabilizing properties and sympathomimetic activity, shows little resemblance to beta2-adrenergic receptors, which are involved in the regulation of metabolism, and beta2-adrenergic receptors of vascular muscles. Therefore, the drug does not affect the resistance of the respiratory tract and the metabolic process with the participation of beta2-adrenergic receptors. In coronary heart disease without signs of heart failure, a single dose of the drug causes a decrease in heart rate and stroke volume, reduces ejection fractions and oxygen demand. This is confirmed by the instructions for use to the analogue of "Cordinorm".
The main indication for prescribing Concor is the treatment of chronic heart failure. The list of contraindications includes:
- cardiogenic shock;
- acute heart failure;
- heart failure at the stage of decompensation;
- sinoatrial blockades;
- AV blockade 2-3 stages without pacemaker;
- bradycardia;
- weak sinus node;
- low blood pressure;
- Raynaud's syndrome;
- bronchial asthma;
- severe obstructive disease;
- metabolic acidosis;
- up to 18 years old;
- lactation, high sensitivity to drugs.
The drug "Tirez"
The Cordinorm analog is a combined antihypertensive agent, selective beta1-blocker without membrane-stabilizing and sympathomimetic activity. The tool has antiarrhythmic, antihypertensive and antianginal effects. It blocks β1-adrenergic receptors of the heart, reduces the formation of cyclic adenosine monophosphates from adenosine triphosphates stimulated by catecholamines, reduces the intracellular current of calcium ions, inhibits cardiac conduction processes, and blocks β2-adrenergic receptors in high doses.
Indications and contraindications for the use of this medication are absolutely identical to those listed for analog drugs.
Reviews
The medicine "Cordinorm" and its analogues are very popular today among medical practitioners and their patients. Despite a fairly wide list of contraindications to such drugs, they are very effective in the treatment of heart diseases and hypertensive phenomena. Patients say that with treatment with such medications their condition has improved significantly. The severity of pathological symptoms decreased, pain in the heart began to disappear gradually, and overall health improved. Adverse reactions, according to patients, when taking "Kordinorma" occur quite often, but they are poorly expressed and the medication is well tolerated. In addition, people indicate that the effect can be observed after a single dose.
Doctors warn patients against self-administration of one of the above medications, since improper dosages and inappropriateness of use can lead to serious negative consequences, up to death. Medicines should be used exclusively according to the indications and recommendations of a specialist.
We reviewed the instructions for use, reviews and analogues of "Kordinorma".