Description
Release form
film-coated tablets.
Packing
50 pcs.
Pharmacological action
Concor – 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 reduces 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 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.
Contraindications
– chronic heart failure at the stage of decompensation
– acute myocardial infarction and post-infarction for 6 months
– severe cardiac arrhythmias
– acute circulatory failure (shock, vascular collapse – less than 90%) mm Hg)
– severe hepatic dysfunction
– gastric ulcer and duodenal ulcer
– hypersensitivity to the drug. should be done only after a careful assessment of the benefit-risk ratio of
– pheochromocytoma (Prescribing Concor Cor to patients with pheochromocytoma is allowed only after taking alpha-blockers)
– in patients with chronic heart failure, Concor Cor should not be used for exacerbation of heart failure or during episodes of decompensation heart failure, which requires iv administration of drugs that affect myocardial contractility in addition to patients with chronic heart failure Accor contraindicated the use of Concor Cor in bradycardia if the pulse is less than 50-60 / min and in case of arterial hypotension if the systolic blood pressure is less than 90-100 mm Hg. Art. should be done only after a careful assessment of the benefit-risk ratio of
– pheochromocytoma (Prescribing Concor Cor to patients with pheochromocytoma is allowed only after taking alpha-blockers)
– in patients with chronic heart failure, Concor Cor should not be used for exacerbation of heart failure or during episodes of decompensation heart failure, which requires iv administration of drugs that affect myocardial contractility in addition to patients with chronic heart failure Accor contraindicated the use of Concor Cor in bradycardia if the pulse is less than 50-60 / min and in case of arterial hypotension if the systolic blood pressure is less than 90-100 mm Hg. Art.
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 in 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, t. K. Symptoms of hypoglycemia can be masked in the treatment of patients who adhere 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 for grade I AV blockade 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 treatment with beta-blockers, in some cases, hair loss, hearing loss or tinnitus, weight gain, mood changes, short-term memory loss, allergic rhinitis.
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 5 mg
other ingredients:
silicon dioxide colloidal,
magnesium stearate,
crospovidone,
microcrystalline cellulose,
corn starch,
calcium hydrogen phosphate,
, drdl
macrogol 400,
iron oxide,
titanium oxide,
methylhydroxypropyl cellulose.
Side effects of
From the side of the central nervous system and peripheral nervous system: possible (especially at the beginning of the course 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 preparations, 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 those contained in cough suppressants, nose drops and eye drops), the effect of bisoprolol may decrease.
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 are masked or mitigated (regular monitoring of plasma glucose levels is necessary).
Overdose
Symptoms: most commonly AV blockade, marked bradycardia, severe BP, bronchospasm, acute heart failure and hypoglycemia. The sensitivity to a single high dose of bisoprolol varies greatly among individual patients and is likely to be high in patients with chronic heart failure.
Treatment: in the event of an overdose, first of all, it is necessary to discontinue the drug and start supportive symptomatic therapy.
At expressed bradycardia – in / in introduction of atropine. If the effect is insufficient, then with caution it is possible to enter a means having a positive chronotropic effect. Occasional staging of an artificial rhythm driver may be required.
With a marked decrease in blood pressure, the introduction of plasma-replacement solutions and vasopressor drugs.
With AV blockade, there is ongoing clinical control, the appointment of beta-adrenomimetics such as epinephrine. If necessary – production of an artificial rhythm driver.
In the exacerbation of the course of chronic heart failure – in / in the introduction of diuretics, drugs with a positive inotropic effect, as well as vasodilators.
In bronchospasm – the appointment of bronchodilators, incl. 2-adrenomimetics and / or aminophylline.
In hypoglycemia – in / in the introduction of dextrose (glucose).
Storage conditions
The product should be stored out of the reach and sight of children.
Shelf life
5 years.
Deystvuyushtee substance
Bisoprolol
Terms and conditions
prescription
dosage form
tablets
Possible product names
CONCOR 0.005 N50 TABLE P / O
Concor 5mg Tab. p / pl / rev X50 (R)
Concor 5mg No. 50
Concor 5mg No. 50 tab
CONCOR 5MG. No. 50 TAB. P / O
Merck KGaA, Russia
