Dianabol side effects for men selective beta 1-blocker without its own sympathomimetic activity, has no membrane stabilizing action. It lowers blood plasma renin activity, reduces myocardial oxygen demand, slows the heart rate (HR) (at rest and during exercise). It has antihypertensive, antianginal and antiarrhythmic action. Blocking in low doses of beta1-adrenergic receptors of the heart, reduces the formation of catecholamines stimulated cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP), decreases intracellular calcium ion current, has a negative chrono-, Drome, BATM and inotropic effects, inhibits the conductivity and excitability. When has exceeded therapeutic doses of beta 2-adrenoceptor blocking activity. The total peripheral vascular resistance at the beginning of the drug in the first 24 hours, is increased (as a result of reciprocal increase in the activity of alpha-adrenoceptor stimulation and removal of beta2-adrenoceptor), which is 1-3 days it returns to the original and with long-term appointment – is reduced. The hypotensive effect associated with a decrease in cardiac output, sympathetic stimulation of peripheral vascular disease, decreased activity of the renin-angiotensin system (is more important for patients with initial hypersecretion of renin), restoration of sensitivity in response to the decrease in blood pressure (BP ) and the effect on the central nervous system (CNS). When hypertension effect occurs within 2-5 days, stable operation is noted after 1-2 months. Antianginal effect is due to a decrease in myocardial oxygen demand as a result of shortening of the heart rate and reduce myocardial contractility, lengthening of diastole, improving myocardial perfusion.By increasing the end-diastolic left ventricular pressure and increase the tension of muscle fibers of the ventricles can be increased oxygen demand, especially in patients with chronic heart failure. When used in high therapeutic doses, unlike non-selective beta-blocker, has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscle, smooth muscle of the peripheral arteries, bronchi and uterus) and carbohydrate metabolism; It does not cause a delay of sodium ions (Na +) in the body; atherogenic action expression is not different from that of propranolol. The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased cAMP levels, hypertension), decrease in the rate of spontaneous excitation of the sinus and ectopic pacemakers and slowing of the atrioventricular (AV) of (mainly antegrade and to a lesser extent, in the retrograde direction through the AV node) and on additional routes.
Absorption – 80-90%, does not affect food intake on absorption. The maximum plasma concentration observed after 1-3 hours, the connection with plasma proteins – 26-33%. Permeability through the blood brain barrier and the placental barrier – is low. 50% of the dose is metabolized in the liver with the formation of active metabolites the half-life -. 10-12 hours Approximately 98% is excreted by the kidneys, of which 50% in an unmodified form, less than 2% through the intestines (in the bile).
: Hypersensitivity to dianabol side effects for men or other beta-blockers; shock (including cardiogenic); collapse; pulmonary edema; congestive heart failure; Chronic heart failure decompensation requiring of inotropic therapy;AV blockade II-III degree, without a pacemaker; sinoatrial block; sick sinus syndrome; bradycardia (heart rate less than 60 beats / min..); cardiomegaly (without heart failure); severe hypotension (systolic blood pressure less than 100 mmHg, especially myocardial infarction); severe bronchial asthma and chronic obstructive pulmonary disease (COPD) history; simultaneous reception of monoamine oxidase inhibitors (MAOIs) (except for MAO-B); late stages of peripheral circulation; Reynaud’s syndrome; pheochromocytoma (without simultaneous use of alpha-blockers): metabolic acidosis; age of 18 years (effectiveness and safety have been established); lactose intolerance, lactase deficiency or glucose-galactose malabsorption (lactose as part of the preparation).
Liver failure; chronic renal failure (creatinine clearance less than 20 mL / min.); myasthenia gravis; hyperthyroidism; diabetes; Prinzmetal angina, AV block of I degree; psoriasis; depression (including history); a history of allergic reactions; adherence to a strict diet; elderly age.
Pregnancy and lactation
Application Bidop drug ® during pregnancy is possible only when the intended benefits of therapy for the mother outweighs the potential risk of side effects in the fetus and / or the child.
There are no data on whether dianabol side effects for men into breast milk. If necessary, use during lactation should stop breastfeeding.
Dosing and Administration
Inside, in the morning on an empty stomach, not liquid, once. The dose should be adjusted individually.
Arterial hypertension and coronary heart disease: prevention of attacks of stable angina usually starting dose is 5 mg 1 time a day.
If necessary, increase the dose to 10 mg 1 time per day. The maximum daily dose of -20 mg per day.
In patients with impaired renal function at creatinine clearance (CC) of less than 20 ml / min. or with severe liver problems, the maximum daily dose -. 10 mg
. Increasing the dose in such patients should be carried out with extreme caution
dose adjustment in elderly patients is not required.
Side effects observed when using the drug, classified into categories depending on their frequency of occurrence: very common > 1/10; often> 1/100, <1/10; uncommon > 1/1000, <1/100; rare > 1/10000, <1/1000; very rare <1/10000, including isolated reports. On the part of the central nervous system : rarely – fatigue, weakness, fatigue, dizziness, headache, sleep disorders, depression, anxiety, confusion, or short-term memory loss, rarely – hallucinations, myasthenia gravis “nightmarish” dream, seizures (including calves), paresthesia in the extremities (in patients with “intermittent” claudication and Raynaud’s syndrome), tremor. On the part of the organ of vision : rarely – visual disturbances, reduced secretion of tear fluid, dry and sore eyes; very rarely – conjunctivitis. On the part of the cardiovascular system : very often – sinus bradycardia, palpitations; often – marked reduction of blood pressure, the manifestation of vasospasm (strengthening of peripheral blood circulation, cooling of the lower limbs, paresthesia, Raynaud’s syndrome); rarely – orthostatic hypotension, conduction disturbances infarction, AV block (up to the development of a complete transverse blockade and heart failure), arrhythmia, weakening of the myocardial contractility, the development of chronic heart failure (swelling of ankles, feet, shortness of breath), chest pain. On the part of the digestive system : often – dryness of the oral mucosa, nausea, vomiting, abdominal pain, constipation or diarrhea; rarely – liver function abnormalities (dark urine, yellow skin or sclera, cholestasis), changes in taste, hepatitis. With the respiratory system: rarely – shortness of breath when administered at high doses (loss of selectivity) and / or in predisposed patients – laryngo and bronchospasm; seldom – nasal congestion. On the part of the endocrine system : hyperglycemia (in patients with insulin-dependent diabetes), hypoglycemia (in patients receiving insulin), hypothyroid state. Allergic reactions :. rare – pruritus, rash, urticaria For the skin : rarely – increased sweating, flushing of the skin; very rare – rash, psoriasiform skin reactions, exacerbation of psoriasis, alopecia. Laboratory findings : rarely – increased activity of “liver” transaminases (increased alanine aminotransferase, aspartate aminotransferase), hyperbilirubinemia, hypertriglyceridemia; in some cases – thrombocytopenia (unusual bleeding and hemorrhage), agranulocytosis, leukopenia. Effect on the fetus : intrauterine growth retardation, hypoglycemia, bradycardia. Other : rarely – arthralgia; rarely – the weakening of the libido, reduced potency; back pain syndrome “cancel” (increasing angina attacks, increased blood pressure).
Overdose symptoms : arrhythmia, ventricular premature beats, bradycardia, AV block, marked reduction in blood pressure, the development of chronic heart failure, cyanosis of nails and hands, shortness of breath, bronchospasm, dizziness, fainting, seizures, hypoglycemia. Treatment : gastric lavage and the appointment of absorbent ; Symptomatic therapy: which developed at AV blockade – intravenous infusion of 1-2 mg of atropine, epinephrine or staging a temporary pacemaker; with ventricular arrhythmia – lidocaine (IA class of drugs does not apply); In marked decrease in blood pressure – the patient must be in the Trendelenburg position; if there are no signs of pulmonary edema – intravenous plasma-solutions, with inefficiency – the introduction of epinephrine, dopamine, dobutamine (to maintain, chronotropic, and inotropic effects and eliminate the pronounced reduction in blood pressure); heart failure – cardiac glycosides, diuretics, glucagon; in convulsions – diazepam intravenously; with bronchospasm–beta2 adrenostimulyatorov inhalation.
Interaction with other drugs allergens used for immunotherapy, or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving dianabol side effects for men.Iodine-containing X-ray contrast agent for intravenous administration increases the risk of anaphylactic reactions. Phenytoin intravenous administration, funds for inhalation anesthesia (derivatives of hydrocarbons) increase the intensity of cardiodepressive action and the likelihood of blood pressure lowering. Modifies the effectiveness of insulin and hypoglycemic agents for oral , masking the symptoms of developing hypoglycemia (tachycardia, increased blood pressure). Reduces the clearance of lidocaine and xanthine (except theophylline) and increases their concentration in the blood plasma, especially in patients with initially increased clearance of theophylline under the influence of smoking. Antihypertensive effect of weakening non-steroidal anti-inflammatory drugs (delay of sodium ions (Na +) and the blockade of prostaglandin synthesis by the kidneys), corticosteroids, and estrogens (delay of ions Na +). Cardiac glycosides, methyldopa, reserpine and guanfacine blockers “slow” calcium channel blockers (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of developing or worsening of bradycardia, AV block, cardiac arrest and heart failure. Nifedipine can lead to a significant reduction in blood pressure. Diuretics, clonidine, sympatholytic , hydralazine and other antihypertensive drugs may lead to an excessive reduction in blood pressure. Extends the action of non-depolarizing muscle relaxants and anticoagulant effect of coumarin . tri- and tetracyclic antidepressants, antipsychotics (neuroleptics), ethanol, sedatives and hypnotics increase central nervous system depression. not recommended simultaneous application with MAO inhibitors (except MAO-B, see. “Contraindications”), due to the significant increase in the hypotensive action, a break in treatment between receiving MAO inhibitors (except MAO-B) and dianabol side effects for men must not be less than 14 days. Negidrirovannye ergot alkaloids increase the risk of peripheral circulatory disorders. Ergotamine increases the risk of peripheral circulatory disorders; rifampin shortens the half-life.
monitoring patients receiving Bidop ® , should include measurement of heart rate and blood pressure (at the beginning of treatment -. Daily, then 1 every 3-4 months) holding an electrocardiogram, determination of blood glucose concentration of diabetic patients (1 in 4 times 5 months.). In elderly patients, it is recommended to monitor renal function (1 time in 4-5 months.). It is necessary to train the patient’s heart rate calculation method and instruct on the need of medical advice in heart rate less than 50 bpm. / Min.
Before treatment recommended study of respiratory function in patients with a history of bronchopulmonary history.
Approximately 20% of patients with angina Beta-blockers are ineffective. The main reasons -. Marked coronary atherosclerosis with a low threshold of ischemia (.. Heart rate less than 100 beats / min) and a higher end-diastolic volume of the left ventricle, which violates the subendocardial blood flow
. At the “smokers” the effectiveness of beta-blockers lower
Patients who use contact lenses, must be taken into account that in the context of treatment may decrease the production of tear fluid.
When used in patients with pheochromocytoma have a risk of paradoxical hypertension (if not previously reached effective alpha adrenoblockade).
When thyrotoxicosis Bidop ® may mask certain clinical signs of hyperthyroidism (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated because the symptoms can increase.
In diabetes may mask tachycardia caused by hypoglycemia. In contrast, nonselective beta-blockers practically no increase insulin-induced hypoglycemia and delay recovery of blood glucose to normal levels.
At the same time taking clonidine its reception can be terminated only a few days after the cancellation Bidop drug ® .
Increased severity of hypersensitivity reactions are possible and the lack of effect of conventional doses of epinephrine (adrenaline) with aggravated allergic history.
In the case of the need for a planned surgical treatment abolition of the drug is carried out for 48 hours before general anesthesia. If the patient has taken the drug before surgery, he should choose the drug for general anesthesia with minimal negative inotropic effect.
Reciprocal activation of the vagus nerve can be eliminated by intravenous administration of atropine (1-2 mg).
Drugs that reduce stocks of catecholamines (including reserpine ), may enhance the effect of beta-blockers, so patients taking such drug combinations should be under constant medical supervision in order to identify pronounced reduction in blood pressure and bradycardia.
patients with bronhospasticheskimi diseases can assign cardioselective blocker in case of intolerance and / or ineffectiveness of other antihypertensive means. Overdosing is dangerous development of bronchospasm.
In the case of elderly patients increasing bradycardia (less than 50 u. / Min.), Pronounced reduction in blood pressure (systolic blood pressure below 100 mm Hg), AV blockade bronchospasm, ventricular arrhythmias, severe violations of the liver and kidney is necessary to reduce the dosage or discontinue treatment. It is recommended to discontinue therapy in the development of depression.
Do not abruptly discontinue the treatment because of the risk of severe arrhythmias and myocardial infarction. Abolition are gradually reducing the dose for 2 weeks or more (reduce dose by 25% in 3-4 days).It is necessary to cancel prior to the study in blood and urine catecholamines and Normetanephrine vanilinmindalnoy acid; titers of antinuclear antibodies.
Effects on ability to drive vehicles and operate machinery
during treatment dizziness, especially early in therapy, and therefore must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions.
Tablets 5 mg, 10 mg.
By 14 tablets in blister PVC / PVDC / Al. At 1.2 or 4 blisters with instruction for use in a cardboard box.