Description
Release form
Coated tablets.
Packing
30 pcs.
Pharmacological action
Concor Cor – selective beta1-blocker. When used in therapeutic doses, it does not have internal sympathomimetic activity and clinically significant membrane-stabilizing properties.
After oral administration, the action develops after 1-3 hours and lasts for 24 hours.
It has a hypotensive effect due to a decrease in cardiac output, inhibition of renin secretion by the kidneys, and effects on the aortic arch and carotid sinus baroreceptors. With prolonged use, Concor Cor reduces the initially increased OPSS.
Has an antianginal effect. Reduces myocardial oxygen demand by lowering heart rate, lowering cardiac output and lowering blood pressure. Increases myocardial oxygen supply by reducing the final diastolic pressure and lengthening the diastole.
In chronic heart failure, Concor Cor suppresses the activated sympatho-adrenal and renin-angiotensin-aldosterone systems, which leads to an improvement in the course of the disease.
Indications
– arterial hypertension
– IHD (angina pectoris)
– chronic heart failure.
Use during pregnancy and lactation
Should not be prescribed Concor during pregnancy and lactation (breastfeeding) due to the lack of clinical experience with the drug in this category of patients.
In exceptional cases of Concor use during pregnancy, treatment should be discontinued 72 hours before the expected date of delivery due to the possibility of bradycardia, hypoglycemia and respiratory depression of the newborn.
If drug withdrawal is not possible, then after delivery, the newborn should be closely monitored. Symptoms of hypoglycemia can be expected within the first 3 days.
Special instructions
Caution should be exercised in the treatment of patients with diabetes with significant fluctuations in blood glucose, as symptoms of hypoglycemia may be masked during treatment of patients, adhering to a strict diet in the treatment of patients with metabolic acidosis of patients with a severe hypersensitivity reaction in the anamnesis during desensitizing therapy with AV blockade of I degree with angiospastic angina (Prinzmetal angina).
In some cases, the use of beta-blockers (including Concor) can cause the development or worsening of psoriasis or lead to the appearance of psoriatic rashes on the skin.
In patients receiving beta-blockers, more severe forms of hypersensitivity reactions may occur.
In the treatment with beta-blockers in some cases, hair loss, hearing loss or tinnitus, weight gain, mood changes, short-term memory loss, allergic rhinitis are observed.
Before surgery, inform the anesthetist about taking Concor.
Pediatric use
Concor should not be prescribed to children due to the lack of clinical experience with the drug in this category of patients.
Influence on the ability to drive vehicles and control mechanisms
The question of the possibility of engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions should be decided only after assessing the patient’s individual reaction to the drug (especially at the beginning of treatment or while drinking alcohol or ethanol-containing drugs).
Composition
1 tab. contains bisoprolol fumarate 2.5 mg
other ingredients:
silicon dioxide colloidal,
magnesium stearate,
crospovidone microcrystalline cellulose,
corn starch,
calcium hydroxide srdkl srdl srdl srdl srdl srd methyl hydroxypropyl cellulose.
Dosage and administration
The following dosage regimen is recommended: the initial dose of Concor Cor is 1.25 mg 1 time / day during the first week. During the second week of administration, 2.5 mg / day is prescribed. In the third week of treatment, the dose is 3.75 mg / day. From the fourth to the eighth week of administration, 5 mg is prescribed (2 tablets of Concor Cor or 1 tablet of Concor containing 5 mg of bisoprolol fumarate or 1/4 tablet of Concor containing 10 mg of bisoprolol fumarate). Then the dose is increased to 7.5 mg (from the eighth to twelfth week).
After the twelfth week of treatment, a maximum dose of 10 mg is prescribed (4 tablets of Concor Cor or 2 tablets of Concor containing 5 mg of bisoprolol fumarate or 1 tablet of Concor containing 10 mg of bisoprolol fumarate). The doctor may adjust the dosage regimen depending on individual tolerance. After starting treatment with Concor Cor at a dose of 1.25 mg, a patient with chronic heart failure should be examined for 4 hours (blood pressure, heart rate, conduction disturbances, worsening symptoms of heart failure). The appearance of side effects may interfere with the appointment of the maximum recommended dose to patients. If necessary, the achieved dose can be gradually reduced. Treatment can be discontinued, if necessary, and then resumed according to the same scheme.
In case of intolerance or worsening symptoms of heart failure during the dose increase process, it is recommended that you first reduce the dose of Concor Cor or stop taking the drug (in case of severe arterial hypotension, worsening symptoms of heart failure, accompanied by acute pulmonary edema, cardiogenic shock, bradycardia or AV block).
Tablets should be taken without chewing with a small amount of liquid.
It is recommended to take Concor Cor in the morning on an empty stomach or during breakfast.
During treatment, regular medical supervision is required. The course of treatment with Concorr Cor is usually long.
The patient should not change the dose or interrupt treatment without the advice of a physician. Prevent sudden termination of treatment with Concor Cor. The course of treatment should end with a gradual dose reduction. This is especially important in the treatment of patients with coronary artery disease, as well as with chronic heart failure (in such cases, the dose should be reduced by 2 times weekly).
In all cases, the duration of treatment with the drug is determined by the doctor.
Side effects of
From the central nervous system and peripheral nervous system: possible (especially at the beginning of treatment) feeling tired, dizziness, headache, sleep disturbance, depression rarely – hallucinations. Typically, these phenomena are mild and pass, usually within 1-2 weeks.
From the side of the organ of vision: rarely – visual impairment, decreased lacrimation (should be taken into account when wearing contact lenses), conjunctivitis.
From the cardiovascular system: in some cases – orthostatic hypotension, bradycardia, impaired AV conduction, decompensation of heart failure with the development of peripheral edema, paresthesia and a feeling of cold in the extremities are possible. At the beginning of treatment, deterioration in patients with intermittent claudication or with Raynaud’s syndrome is possible.
From the respiratory system: rarely – shortness of breath (in patients with a tendency to bronchospasm, including with bronchitis with bronchial obstructive syndrome).
From the digestive system: in some cases – diarrhea, constipation, nausea, abdominal pain, increased activity of liver enzymes in blood plasma (AST, ALT), hepatitis.
From the musculoskeletal system: in some cases – muscle weakness, muscle cramps, arthropathy with damage to one or more joints (mono – or polyarthritis).
From the endocrine system: a decrease in glucose tolerance (with latent diabetes mellitus) and masked signs of hypoglycemia in some cases – an increase in the level of triglycerides in the blood.
From the reproductive system: in some cases – a violation of potency.
Dermatological reactions: itching is rare – redness of the skin, increased sweating, rash.
Drug Interactions
With simultaneous use, Concor may enhance the effect of antihypertensive drugs.
With the simultaneous use of Concor and reserpine, alpha-methyldopa, clonidine, digitalis or guanfacin, a sharp decrease in heart rate is possible.
With the simultaneous use of Concor and clonidine, digitalis preparations, as well as guanfacin, conduction disturbances are also possible.
With the simultaneous use of Concor and sympathomimetics (including contained in cough suppressants, drops in the nose and eye drops) may decrease the effect of bisoprolol.
With the simultaneous use of nifedipine and other calcium channel blockers – derivatives of dihydropyridine can enhance the antihypertensive effect of Concor.
With the simultaneous use of Concor and verapamil or diltiazem and other antiarrhythmic drugs, a sharp decrease in blood pressure, a decrease in heart rate, as well as the development of arrhythmia and / or heart failure are possible (careful monitoring by a doctor is required). Calcium channel blockers and antiarrhythmic drugs should not be administered iv in conjunction with Concor therapy.
With the simultaneous use of Concor and clonidine, the latter can be canceled only if the intake of Concor was completed a few days before, due to the risk of an excessive increase in blood pressure.
With the simultaneous administration of ergotamine derivatives (including ergotamine-containing agents for the treatment of migraine) and Concor, peripheral circulation disorders may intensify.
With concomitant use and rifampicin, a slight decrease in T1 / 2 of bisoprolol is possible (increasing the dose of Concor is usually not required).
With the simultaneous use of Concor and insulin or oral hypoglycemic agents, increased hypoglycemic action is possible.
Symptoms of hypoglycemia mask or moderate (regular monitoring of plasma glucose levels is necessary).
Overdose
Symptoms: bradycardia, arterial hypotension, heart failure, bronchospasm.
Treatment: gastric lavage, activated charcoal intake.
In bradycardia or hypotension, it is possible to administer atropine at a dose of 1.5 to 2 mg, to administer glucagon at a dose of 1-5 mg (up to 10 mg).
Beta2-adrenomimetics (eg salbutamol or phenoterol) are used in bronchospasm.
Storage Conditions
Keep this medicine out of the reach and sight of children.
active substance
bisoprolol
Conditions of dispatch from
pharmacies Prescription
lekarstvennaja form
tablets
Merck KGaA, Russia
