Buy Bisoprolol online.
 
Bisoprolol 5mg 30tab.
Manufacturer: Vertex (Russia).
 
Cordinorm 5mg 30tab.
Manufacturer: ACTAVIS GROUP hf. (Iceland).
 
Bisoprolol 5mg 30tab.
Manufacturer: Izvarino Pharma (Russia).
 
Niperten 5mg 30tab.
Manufacturer: Krka, d.d., Novo mesto (Slovenia).
 
Concor 5mg 50tab.
Manufacturer:  MERCK KGaA (Germany) or Takeda Pharmaceutical.
 
Bisogamma 5mg 30tab.
Manufacturer: WOERWAG PHARMA GmbH & Co. KG (Germany).
 
Bisoprolol 2,5mg 30tab.
Manufacturer: Vertex (Russia).
 
 
Selective beta-1-blocker without its own sympathomimetic activity; has antihypertensive, antiarrhythmic and anti-anginal action. Blocking at low doses beta1-adrenoreceptors of the heart, reduces catecholamine-stimulated formation of cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP), reduces the intracellular current of calcium ions (Ca2 +), has a negative chrono-, dromo-, batmo- and inotropic effect (reduces the frequency of cardiac contractions, inhibits conduction and excitability, reduces myocardial contractility).
When the dose is increased, beta2-adrenergic blocking action exerts.
The total peripheral vascular resistance at the beginning of beta-blockers application, in the first 24 hours, increases (as a result of the reciprocal increase in the activity of alpha-adrenergic receptors and elimination of stimulation of beta2-adrenoreceptors), which returns to the initial one after 1-3 days, and decreases with long-term administration.
The antihypertensive effect is associated with a decrease in the minute volume of blood, sympathetic stimulation of the peripheral vessels, a decrease in the activity of the renin-angiotensin-aldosterone system (is of greater importance for patients with initial renin hypersecretion), restoration of the sensitivity of the aortic arch baroreceptors (there is no increase in their activity in response to a decrease in arterial pressure (BP)) and influence on the central nervous system. With arterial hypertension, the effect occurs after 2-5 days, stable effect - after 1-2 months.
The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in the heart rate and a decrease in contractility, diastole lengthening, and improvement in myocardial perfusion. By increasing the end-diastolic pressure in the left ventricle and increasing the stretching of the ventricular fibers, myocardial oxygen demand may increase, especially in patients with chronic heart failure (CHF).
In contrast to nonselective beta-blockers, when administered at moderate therapeutic doses, it has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscles, smooth muscles of peripheral arteries, bronchi and uterus) and on carbohydrate metabolism, does not cause retention of sodium ions (Na +) in the body. When used in large doses has a blocking effect on both subtypes of beta-adrenergic receptors.
Pharmacokinetics. Bisoprolol is almost completely absorbed from the gastrointestinal tract (80-90%). Eating does not affect the absorption of the drug. The maximum concentration in the blood plasma is achieved in 2-3 hours. Linkage to blood plasma proteins is approximately 35%. Permeability through the blood-brain barrier and the placental barrier is low, the secretion with breast milk is low.
Metabolised in the liver. The half-life (T1 / 2) is 9-12 hours, prolonged if the kidney function is impaired (with a creatinine clearance less than
40 ml / min - 3 times), in old age, with liver disease (with cirrhosis increases to 21.7 hours). It is excreted by the kidneys - 50% unchanged, less than 2% through the intestine.
 
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