The drug Concor - instructions for use. Indications for taking Concor for diseases of the heart and blood vessels. Concor: instructions for use How long can you drink Concor 2.5

Concor Cor: instructions for use and reviews

It is a selective β-adrenergic receptor that has a membrane-stabilizing effect and does not have personal sympathomimetic activity.

Of the main effects on the body, the following should be highlighted: stabilization of heart rate, normalization, reduction of blood plasma renin activity and myocardial oxygen demand. Instructions for use of Concor, as well as other characteristics of the drug will be discussed in this article.

The group of the drug Concor is selective β-adrenergic receptors. The instructions for use accompanying the Concor 2.5, 5 and 10 mg tablets indicate indications such as IHD (coronary heart disease) and.

Despite the positive effects on the body, the medicine can still have negative effects on it if used by patients for whom it is contraindicated. The instructions for use accompanying the medicine Concor do not indicate at what pressure to use the tablets.

The instructions for use accompanying the drug Concor indicate the following:

• symptomatic bradycardia;
• metabolic acidosis;
• sick sinus syndrome;
• AV blockade II-III degree;
• Raynaud's disease;
• sinoatrial block;
• severe form of BA (bronchial asthma);
• hypersensitivity to one of the components of the drug;
• heart failure, which is accompanied by decompensation;
• late stages of peripheral circulatory disorders;
• symptomatic;
• late stages of peripheral circulatory disorders.

In addition, there are also conditions for which this medication can be used, but caution must be exercised:

• type 1 diabetes mellitus;
• liver dysfunction;
• congenital heart defects;
• psoriasis;
• diabetes mellitus with fluctuations in blood glucose;
• Prinzmetal's angina;
• severe forms of chronic obstructive pulmonary disease;
• restrictive cardiomyopathy.

The country of origin of Concor is Germany. The recipe for Concor in Latin is as follows: “Rp.: Tab. Concor 0.01 No. 50 D. S.2

Dosage and overdose

The drug Concor must be taken in the morning. It is advisable not to eat anything before use and take the tablet with a sufficient amount of liquid. The dosage of this medicine is determined only by the attending physician, based on the patient’s condition.

The instructions for use accompanying the Concor tablets indicate the following dosages:

• for arterial hypertension and coronary artery disease, it is recommended to start taking the drug with 5 mg, which is equal to one tablet per day. And in the case of mild hypertension, the dosage can not be used in full, but only half the tablet, which is equal to 2.5 mg. In this case, diastolic pressure should not exceed 105 millimeters of mercury;
• if there is a need to increase the dose for any reason, it can be increased to 10 mg per day, and consultation with your doctor is recommended. It is also worth remembering that the maximum permissible amount of this drug cannot exceed 20 mg per day;
• in cases where the maximum permissible dose is poorly tolerated, it is necessary to reduce it. It should be remembered that this is done gradually, and not abruptly;
• If during or after the titration phase the patient experiences an exacerbation of heart failure, arterial hypertension or bradycardia begins to develop, then in this situation it is necessary to adjust the dosage. This may require a temporary reduction in the amount of bisoprolol taken or even stopping treatment for a certain period;
• cannot be done suddenly, especially for patients with coronary heart disease. Such a decision may well affect the patient’s condition and aggravate the situation. Therefore, treatment with this drug must be interrupted gradually, gently reducing the dosage;
• for patients with mild to moderate renal or liver dysfunction, the dosage is usually not adjusted and the standard dose is prescribed. In severe cases, the maximum allowable amount of the drug per day is 10 mg.

Concor 10 mg

Patients with CHF (chronic heart failure) should take Concor with extreme caution, and the volume of medication in this case is selected personally by the doctor exclusively on an individual basis. If you do not follow the doctor's recommendations and exceed the permissible amount of the drug, an overdose may occur.

In case of overdose, the patient may experience the following complications:

• arterial hypotension;
• bradycardia;
• AV block of the third degree;
• dizziness;
• hypoglycemia;
• acute heart failure;
• bronchospasm.

It is known that patients with heart failure are more sensitive to the composition of Concor than others. Therefore, for this category of patients, it is necessary to be careful when prescribing the dosage and increasing it; this process is done gradually.

If bradycardia occurs, an intravenous injection of Atropine is prescribed. If the required response is absent, Isoprenaline or a similar drug with a positive chronotropic effect is carefully administered. In some situations, transvenous insertion of a pacemaker may be required.

In case of an overdose of Concor, further use is usually stopped and symptomatic therapy is carried out.

Interaction

Taking certain drugs with Concor simultaneously may affect the tolerability of bisoprolol and its effectiveness. This can also happen if used after a short period of time.

You should take the drug very carefully in combination with:

• dihydropyridine derivatives;
• beta-blockers for local use;
• parasympathomimetics;
• class III antiarrhythmic drugs;
• means for general anesthesia;
• adrenergic agonists;
• cardiac glycosides;
• MAO inhibitors;
• class I antiarrhythmic drugs (for arterial hypertension and angina pectoris).

The instructions accompanying the Concor blood pressure pills do not recommend combining use with:

• centrally acting antihypertensive drugs;
• class I antiarrhythmic drugs (for the treatment of CHF);
• CCB (verapamil, diltiazem).

During pregnancy

The active substance of Concor has properties that may have an adverse effect on the development of the fetus, newborn, or the course of pregnancy.

If such treatment is absolutely necessary, then preference should be given to selective β1-adrenergic receptor blockers.

During pregnancy, a medicine makes sense to use only if the expected benefit outweighs the potential risk to the fetus. Such therapy should be accompanied by careful monitoring of uteroplacental blood flow. You should also monitor the baby’s growth.

If a drug has a negative effect, it is worth finding an alternative. After birth, the newborn should be monitored, because symptoms of bradycardia and hypoglycemia can appear within 3 days.

The use of β-adrenergic receptors during pregnancy can lead to intrauterine death, premature birth, spontaneous abortion, or cause fetal growth retardation.

Price ;

A change in medication may be necessary if it is intolerable, insufficiently effective, or if a cheaper remedy is needed. Among the large number of analogues, it is impossible to determine which one will help the patient better without practical application.

It blocks β1-adrenergic receptors with high selectivity, shows low selectivity for adrenergic β2-receptors and does not carry out intrinsic sympathomimetic activity.

As a result, cardiac output and peripheral vascular resistance decrease, renin activity decreases, and a decrease in blood pressure is achieved. To successfully control arterial hypertension, it is important to understand how to take Concor correctly: before meals or after and how many times, whether you can drink it at night and how long you can take Concor without a break. You also need to understand how to treat them for concomitant pathologies and how to stop drinking Concor if it is necessary to discontinue it.

How to take Concor with high blood pressure?

For hypertension, the dosage of the drug should be gradually increased under the control of blood pressure levels, the starting dose is 5 mg. Patients with diastolic pressure less than 105 mmHg. Art. treatment begins with 2.5 mg.

If the target blood pressure has not been achieved, then the daily dosage of the drug is gradually increased by 1.25–2.5 mg and gradually increased to 10 mg. The dose can be increased, but you should not take Concor more than 20 mg.

Patients often have questions related to the rational dosage of medications and the correct dosage regimen, especially if it is necessary to simultaneously take Concor with several drugs.

The product is intended for long-term treatment, so for proper treatment you need to clearly understand how many times to take the drug - 1 or 2 times a day, when to drink it: morning or evening, and whether Concor can be taken at night.

The patient needs to understand:

• how to connect treatment with food intake;
• drink Concor before or after meals;
• How long will it take for the medicine to take effect?
• what is the duration of the therapeutic effect?

The instructions for use provide only one indication of how to take it by time of day: it is advised to take the drug on an empty stomach in the morning or with meals; it does not indicate whether Concor can be taken at night. There are no restrictions on the number of doses, as well as warnings about evening doses.

1 or 2 times a day?

The answer to the questions of those who want to do things their own way, deviating from the recommendations, and those wondering whether it is possible to take Concor twice and at night, is simple: it is possible, but not necessary. There are several reasons why you need to follow the instructions:

• duration of action;
• change in the severity of the effect per day;
• the relationship between the amount of medication taken and errors in the dosing regimen.

The number of doses of the drug is determined by the duration of action. The half-life of bisoprolol is 10.5 hours, and it lasts for more than a day, while the residual effect 24 hours after taking the drug is reduced by less than a third compared to the maximum effect during the day. Therefore, there is no need to take Concor several times. In addition, the ability to take the medicine once and its connection with food intake simplifies treatment and increases patients’ adherence to the chosen prescription regimen.

Foreign studies have found that as the frequency of administration increases, the number of people who violate the medication regimen increases. Thus, when prescribing tablets 2 times a day, every third person violates the dosage regimen; when using them three times, almost half of the patients make mistakes, forgetting to take the medicine on time.

Improper implementation of prescriptions leads to a decrease in the effectiveness of treatment and may lengthen the time for selecting the required dose. Simplifying the treatment regimen improves compliance with prescriptions. The optimal option for convenience is when you need to take a single dosage unit of the medicine in the first half of the day, which is time-related with a meal.

Whether Concor can be taken twice a day is determined only by the doctor who makes prescriptions and monitors treatment; he also determines how long Concor can be taken. Patients should not make independent decisions about changing their treatment regimen.

When: morning or evening?

When analyzing the question of how to drink Concor correctly: when to take it (morning or evening), how best to drink it and why, you will have to pay attention to the points of its influence and the peculiarities of the functioning of the body.

The effects of bisoprolol are ensured by its ability to reversibly block β1-adrenergic receptors belonging to the sympathetic division of the autonomic nervous system. Under its influence, the stimulating effect of adrenaline on the heart and blood vessels decreases. Therefore, it matters at what time to take Concor.

The autonomic part of the nervous system is characterized by a daily cyclicity of processes of activation and inhibition, which are reflected in the heart and blood vessels. During the day it is observed:

• increased heart rate;
• increased vascular tone;
• increase in blood pressure.

At night it is the other way around.

During the daytime, the sympathetic part of the autonomic system is activated and the parasympathetic activity is reduced, which is characterized by an increase in heart rate and an increase in blood pressure in those who are awake. In stressful situations and during physical exertion, under the influence of sympathoadrenal stimuli, the load on the heart increases, vasoconstriction occurs, and blood pressure increases even more and the heart rate increases.

During night sleep, the body's energy reserves are restored due to an increase in the influence of parasympathetic autonomic activity and a decrease in the activity of the sympathetic nervous system. Wherein:

• cardiac activity slows down;
• pulse slows down;
• vascular tone decreases and blood pressure decreases.

On average, during the day, blood pressure readings during sleep and wakefulness in one person differ by 15 mmHg. Art.

Average blood pressure by age

Can I take it in the evening (at night)?

Taking Concor in the evening creates the highest concentration of the drug during the period of natural decrease in the effects of the sympathoadrenal system and will not have the desired effect during the period of its increase, which will lead to insufficient control of hypertension with the same drug load on the liver and kidneys as with morning medication.

Creating a high level of adrenergic blocker while activating the parasympathetic autonomic system can increase the risk of unwanted manifestations from the heart and blood vessels, which will not be promptly diagnosed and eliminated during sleep.

For evening use:

• the maximum effect of the drug occurs during the period of lowering blood pressure;
• during the period of maximum blood pressure, the effect is reduced;
• the risk of arrhythmias and other side effects at night increases.

Before or after meals?

You need to understand why the connection between the use of the drug and food is important and how to take Concor correctly - on an empty stomach or after a meal - if you miss a dose of the medicine. The manufacturer recommends drinking the medicine before meals or with the first meal, advising you to drink it with water.

But there are times when the patient cannot eat after taking the medicine or forgets to take it before breakfast.

The ratio of medication to food is determined by:

• degree of absorption of the drug;
• water and fat solubility;
• influence on the stomach and intestines.

For Concor, the first two factors are taken into account.

Bisopolol is characterized by high bioavailability: 90% of the drug enters the blood and the presence of food does not change the degree of its absorption. But at the same time, different products have different times of breakdown and residence in the stomach. Therefore, when taking the medicine with food, the rate of its absorption will slow down due to the fact that the amount of gastric and intestinal contents increases. Slowing down the rate at which the drug enters the bloodstream will increase the time for the maximum effect to occur. When taking the medicine after meals, its absorption is slow, so it is better to take Concor before meals.

How long does it take to work?

Concor must be taken constantly; it creates a long-lasting effect that develops over several hours.

To understand how long it takes for Concor to work, you need to know:

• periods of concentration;
• influence of food;
• the speed of development of the effect at the site of action.

The time to reach the highest concentration is 2.5–3.5 hours, the maximum hypotensive effect occurs 3–4 hours after taking Concor.

Can I take it with low blood pressure?

Concor helps normalize blood pressure in hypertension due to its hypotensive effect, and this is not the only advantage. In chronic heart failure, it is used not to lower blood pressure, but to reduce the load on the heart.

Reducing vasospasm reduces peripheral resistance, while the same volume of blood is pumped with less energy expenditure by the heart and less pressure. The heart muscle itself does not receive blood during the contraction phase, since the heart vessels fill during diastole with a relaxed myocardium. As the contraction frequency slows down, the duration of diastole increases and the heart itself receives more nutrients and oxygen as it slows down.

Heart failure (HF) can also occur with normal and low blood pressure. Since the drug has a clinically significant hypotensive effect, patients with heart failure need to clearly know whether Concor can be taken with low blood pressure.

The degree of blood pressure reduction can be different, the lowest level is designated as. Hypotension is a condition in which the systolic pressure level is equal to or lower than 90 mm Hg. Art. Acute hypotension is a condition accompanied by a sharp decrease in blood pressure by 20% or more compared to baseline values. In acute cases, the use of Concor and other blood pressure lowering agents is contraindicated.

Concor is contraindicated in case of symptomatic arterial hypotension, that is, with a constant level of systolic blood pressure less than 90 mm Hg. Art. or frequent reduction to such values ​​in the presence of clinical manifestations: dizziness, weakness, collapsed states.

In cases where there are no contraindications and there are conditions requiring the use of Concor, it can and should be used when prescribed by the attending physician. Including in patients with low blood pressure.

If you have low blood pressure, you should take Concor:

• in reduced dosages;
• with a slow increase in dose;
• under close medical supervision.

Therefore, it is advisable to carry out such treatment with Concor in medical institutions.

How to take with low blood pressure?

There are several features in how to take Concor with low blood pressure. The drug is prescribed in reduced doses, gradually titrated. The starting dosage is 1.25 mg, every week the dose is increased by the same amount of medication.

This selection of treatment is carried out by an experienced physician who already has experience in choosing a bisoprolol therapy regimen.

Possible dosage regimen:

• 7 days - 1.25 mg;
• 8–14 days - 2.5 mg;
• further - 3.75 mg.

When taking Concor in patients with low blood pressure, careful monitoring of blood pressure and pulse is required.

Special instructions for treatment

Caution should be exercised in patients who have:

• bronchial asthma;
• anaphylaxis;
• diabetes;
• obliterating or endarteritis;
• 1st degree atrioventricular block.

Carrying out anesthesia may require discontinuation of the drug several days before surgery, so you must inform the anesthesiologist about taking Concor.

During treatment, it is necessary to gradually increase the dose, until it becomes necessary to titrate it. You should not abruptly stop taking the medication; discontinuation of Concor should be gradual.

Interaction with other drugs

Most antihypertensive drugs potentiate the hypotensive effect when used together; the strength of the combination can significantly exceed their effect individually and cause severe acute hypotension.

Concor should not be combined with clonidine, as well as with other drugs with central action. The hypotension they cause can cause acute heart failure.

The combined use of Concor with antiarrhythmic drugs enhances their negative effect on the conduction of excitation in the heart muscle and can cause bradycardia and reduce the strength of muscle contractions of the heart. Concor should not be taken if used:

• Lidocaine;
• Verapamil;

The interaction of Concor with other drugs requires increased attention when used with many drugs: other antiarrhythmic drugs, anesthetics, adrenergic blockers for local use, cardiac glycosides.

Non-steroidal anti-inflammatory drugs can weaken the hypotensive effect of bisoprolol, so you should not take Concor with diclofenac, nimesulide or ibuprofen - this may be accompanied by an increase in blood pressure.

You can take Concor while using herbal-based sedatives and antihypertensive drugs.

How long can you be treated with the drug?

The product is intended for long-term treatment. When determining how much Concor can be taken for hypertension, the following is taken into account:

• effectiveness of hypertension control;
• change in heart rate;
• other effects of the drug.

With good tolerance and adequate blood pressure control, Concor can be taken for as long as required, sometimes for life. For heart failure, Concor is prescribed in the form of courses; in these cases, the duration of taking Concor will be several weeks or months.

How to cancel correctly?

Bisoprolol has a cumulative effect and abrupt cessation of taking Concor can cause withdrawal syndrome in the form of exacerbation of the disease and increased pathological manifestations: increased blood pressure, worsening heart failure.

You need to know how to stop drinking Concor correctly, without causing a worsening of the disease. Before canceling Concor, the specialist explains to the patient the importance of gradually withdrawing from the medicine, so that the withdrawal does not coincide with the moment when it simply runs out and the patient decides not to buy it anymore.

Concor is discontinued gradually with a number of precautions:

• its dose is gradually reduced - it can be halved in a week; you can completely stop taking Concor when it is reduced to 2.5 mg per day or a quarter of the main dose;
• in the process of dose reduction and withdrawal, regular monitoring of blood pressure and pulse is necessary;
• For diabetes, glucose levels are monitored.

Is it possible to take it for cardiac arrhythmia?

Some patients need to know whether Concor can be taken for cardiac arrhythmia. Concor can only be taken for certain types. It slows down the passage of nerve impulses in the sympathetic nerves, reducing the heart rate - it is not used in cases of impaired conductivity and automatism.

It is contraindicated in the following arrhythmias:

• atrioventricular blockades of II - III degree;
• sick sinus syndrome;
• sinoatrial block;
• bradycardia with clinical symptoms.

It is used for other types, such as: tachyarrhythmia, extrasystoles, as well as in patients with an installed pacemaker.

Is it possible to treat with Concor if you have insulin resistance?

The drug can be used in people with concomitant diabetes of all types, therefore it is possible to take Concor even with insulin resistance. The following points need to be taken into account:

• bisoprolol increases the hypoglycemic effect of hypoglycemic drugs and insulin;
• it is possible to blur the manifestations of hypoglycemia by slowing down the heart.

When treating patients with diabetes, carefully monitor blood glucose levels.

Useful video

For more information about Concor tablets, watch this video:

Conclusion

1. Reliable pressure control, ease of dosing and a relatively small number of restrictions in use have ensured frequent recommendations to take Concor.
2. The high selectivity of the action of bisoprolol on adrenergic receptors allows it to be taken by patients for whom others are contraindicated.
3. However, there are a number of warnings and features that need to be taken into account and taken by Concor, adhering to the recommendations for its use.

Concor - a cure for cardiovascular diseases

Concor is a drug that lowers blood pressure, restores heart rhythm and dilates the coronary arteries that carry blood to the heart muscle. But, like any effective drug, Concor has many side effects and contraindications.

How does concor work?

Concor (international nonproprietary name - bisoprolol hemifumarate) is a selective long-acting beta1-blocker, which is produced in tablets of 5 and 10 mg by the Austrian pharmaceutical company Nycomed.

Medicines belonging to the group of beta1-adrenergic blockers selectively act on beta1-adrenergic receptors - nerve endings in the heart area that are sensitive to adrenaline. Adrenaline is also called the stress hormone. How to overcome stress? Create an oasis for yourself, since under its influence the body prepares to repel any attack: blood vessels narrow, blood pressure rises, the heart begins to contract frequently, the bronchi expand and let in as much air as possible, the number of respiratory movements increases.

Concor selectively suppresses the effects of adrenaline on beta1-adrenergic receptors, that is, on the heart. This leads to the fact that the heart begins to beat less frequently, the coronary vessels dilate and blood pressure (BP) decreases.

This drug has almost no effect on adrenergic receptors located in other organs. However, sometimes this action still manifests itself in the form of side effects, for example, in the form of narrowing of the bronchi (bronchospasms), but this happens quite rarely, since it is believed that Concor acts selectively on the heart.

When taken orally, Concor is quickly absorbed from the gastrointestinal tract and enters the blood. Its maximum effect is achieved three to four hours after ingestion and lasts throughout the day. Achieving a stable reduction in blood pressure is achieved two weeks after starting the drug.

For what diseases is Concor prescribed and when is it contraindicated?

Concor is prescribed for the following diseases:

• persistently high blood pressure (arterial hypertension);
• coronary heart disease and angina at rest Angina at rest is the invisible enemy of stress;
• dysfunction of the cardiovascular system - chronic heart failure.
• Take Concor once a day, in the morning, regardless of meals, without chewing the tablet and washing it down with a small amount of water. The dose of the drug is selected by the doctor, it is usually individual. Concor is prescribed for a long time as a basic therapy drug and its withdrawal should be gradual.

Concor should not be taken for the following diseases and conditions:

• acute heart failure;
• chronic heart failure in the stage of decompensation (when the heart cannot cope with its function), requiring treatment with drugs with a positive inotropic effect (for example, cardiac glycosides Cardiac glycosides - help a tired heart, which cause the heart to contract more strongly and rarely);
• cardiogenic shock (for example, against the background of myocardial infarction);
• atrioventricular block (atrioventricular, AV block) of II and III degree, if the patient does not have a pacemaker;
• sick sinus node syndrome (SSNS) – the main driver of the heart rhythm;
• sinoatrial block - when the conduction of cardiac impulses from the sinus node to the atrium is disrupted;
• very rare heartbeats (bradycardia) with a heart rate of less than 60 beats per minute;
• low blood pressure;
• severe respiratory diseases, which are accompanied by bronchial obstruction (bronchial asthma, chronic obstructive pulmonary disease);
• significant disturbances of peripheral arterial circulation, for example, with obliterating endarteritis - persistent narrowing of the arteries of the lower extremities;
• pheochromocytoma – hormonal tumor of the adrenal glands;
• severe diseases (for example, kidneys), which are accompanied by severe metabolic disorders (metabolic acidosis);
• children and adolescents under 18 years of age (insufficient data on effectiveness and safety);
• while breastfeeding Breastfeeding is a personal choice;
• hypersensitivity to the components of Concor.

For many diseases, this drug is prescribed with caution, which is why it should only be prescribed by a doctor. During pregnancy, Concor is used only for health reasons and the decision on its use is made by the attending physician.

Side effects

The side effects of Concor are as follows:

• from the cardiovascular system - bradycardia, increased symptoms of chronic heart failure, coldness or numbness of the extremities, a significant decrease in blood pressure, heart blockades;
• from the central nervous system – dizziness, headache, sometimes – loss of consciousness, depression, insomnia, hallucinations;
• from the senses - dry conjunctiva, conjunctivitis, hearing impairment;
• from the respiratory system - bronchospasms;
• from the digestive system - nausea, vomiting, diarrhea or constipation, liver dysfunction;
• from other organs and systems - muscle weakness, convulsive muscle twitching, sexual dysfunction, baldness, exacerbation of psoriasis, lethargy, fatigue, allergic reactions.

Concor is an effective heart remedy that can only be taken as prescribed by a doctor.

The drug Concor belongs to drugs intended for the treatment of diseases of the cardiovascular system. In this article you can read the instructions for use of the drug Concor. I have been taking Concor 2.5 since the 90s and have not observed any side effects.

Analogues of Concor in the presence of existing structural analogues. Therefore, bisoprolol (the active ingredient of Concor) generally does not affect airway resistance and metabolic processes in which beta2-adrenergic receptors are involved. At the beginning of treatment of chronic heart failure with Concor, a special titration phase is required under regular medical supervision.

It may also be necessary to temporarily reduce the dose of Concor or discontinue it. Treatment with Concor is usually long-term. There is no data on the excretion of bisoprolol in breast milk. Taking Concor is not recommended for women during lactation. If it is necessary to discontinue therapy with Concor before surgery, this should be done gradually and completed 48 hours before general anesthesia.

In patients with pheochromocytoma, Concor can be prescribed only while using alpha-blockers. Class 3 antiarrhythmic drugs (for example, amiodarone), when used simultaneously with Concor, may increase AV conduction disturbances. When used simultaneously with Concor, the hypoglycemic effect of insulin or oral hypoglycemic agents may be enhanced.

The simultaneous use of Concor with beta-agonists (for example, isoprenaline, dobutamine) may lead to a decrease in the effect of both drugs. A good modern drug for blood pressure and ischemia. Both medications helped equally, and if there was an adverse reaction to Bisoprolol, then it was also present to Concor. Impaired potency is noted as one of the side effects of the drug Concor.

I have been taking Concor for about 3 years, it perfectly reduces heart rate, especially after meals., 5 ml. per day after lunch. The sleep is normal, but it seems to me that the drug still has some effect on potency. I didn’t use anything other than Concor. If you want to take both drugs together, then they are combined and the instructions do not indicate negative mutual side effects when taken together. I have been taking Concor since 2006 for tachycardia (pulse during an attack is 100-140 beats) prescribed by an arrhythmologist.

At the beginning of January of this year, against the background of concor, attacks of tachycardia with shortness of breath 1-2 times a day began to bother me again. The slightest load and immediately tachycardia (100-120). Angelina, Go to the doctor. At best, the usual dosage of Concor is no longer enough; at worst, a new disease or heart condition has been added, which leads to outbreaks of tachycardia.

I have been taking Concor for more than 5 years (5 mg). I didn't feel any discomfort. You were able to verify this from your own experience when Concor was canceled and the negative reactions returned. I have been taking Concor for 2.5 years. The pressure does not increase. I’ve been taking Concor 2.5 for almost a month and Amlipin 5, half a tablet, my blood pressure drops to 105/70 (it was 150, 160/105 and crisis 210/110), but I also don’t feel very well with low blood pressure: I’m dizzy.

I have been taking Concor for 2 years, my sugar has risen to 12, my potency has completely disappeared. I have been taking Concor 2.5 for 2 years and Noliprel 2.5 in the evening. A severe cough and chest pain appeared. When Noliprel is discontinued, Concor is not enough for a day. F. Andrey, Why did you not like Concor so much in the treatment regimen? In addition to standard situations, when the drug is not suitable and the side effects stated in the instructions are observed, then it is necessary to cancel or change the medicine.

I stopped drinking Concor with caution. Be very careful when taking this drug. Is it possible to at least exclude concor? She has been taking all these medications for 3 months. In connection with the transition to taking Concor-Cor (after anaprilin, which I came off for some reason), I have a question: as I read in the instructions, Concor-Cor can cause heart failure?

Active ingredient of Concor tablets: compatibility and interaction with other drugs

The attending physician ordered me to continue drinking it, moreover, he added 2.5 mg of Concor-Cor at night, Atoris 10 mg, Riboxin with Panangin and Acecardol. Please resolve your doubts - could the drug cause heart failure, and is it worth continuing to take it at the dose that now turns out to be 3.75 mg? Thank you! And the worsening of the symptoms of the disease was probably caused by an insufficient dosage of the drug; this point was corrected by the attending physician by increasing the dose of tablets.

Shortness of breath can be both a consequence of the disease and a consequence of taking the drug. A cough can also be a consequence of illness, and a consequence of the side effects of Concor taken. I have been taking Concor for 1.5 years at a dosage of 2.5 mg in the morning. Recently, the pressure began to jump both higher (150/100) and lower (97/60).

Concor drug withdrawal syndrome: symptoms and consequences

Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Concor in their practice are presented. Use for the treatment of high blood pressure, coronary artery disease, stable angina and heart failure in adults, as well as during pregnancy and lactation. Side effects and consumption of alcohol with the medicine. Concor is a selective beta1-blocker, without its own sympathomimetic activity, and does not have a membrane-stabilizing effect.

The selective effect of the drug on beta1-adrenergic receptors persists beyond the therapeutic range. The maximum effect of the drug is achieved 3-4 hours after oral administration. After oral administration, Concor is almost completely (>90%) absorbed from the gastrointestinal tract. Food intake does not affect bioavailability. The clearance of bisoprolol is determined by the balance between excretion by the kidneys unchanged (about 50%) and metabolism in the liver (about 50%) to metabolites, which are also excreted by the kidneys.

Parasympathomimetics, when used simultaneously with bisoprolol, may increase AV conduction disturbances and increase the risk of bradycardia. Just like other medications, Concor tablets are contraindicated in case of increased individual sensitivity to any of the components of the drug. The anesthesiologist should be warned that the patient is taking the drug Concor.

Read the information about the drug Concor, instructions for use which, unlike the official one, is given in an abbreviated version. The text is provided for informational purposes only and cannot serve as a substitute for medical advice.

Concor is a drug that belongs to the group of selective 1-blockers and effectively helps in the treatment of various diseases, especially coronary heart disease, complex forms of heart failure and arterial hypertension. Before using the drug, you need to know that the medicine has many contraindications, so the drug should only be prescribed by the attending doctor, who knows the individual characteristics of the patient’s body and will select the correct dose and course of treatment.

Concor is available in the form of film-coated tablets of a soft light color.

Composition of the medicine: The active ingredient is bisoprolol hemifumarate (bisoprolol fumarate (2: 1)) 5 mg and 10 mg.

Additional substances: calcium hydrogen phosphate, anhydrous, corn starch, colloidal silicon dioxide, microcrystalline cellulose, crospovidone, magnesium stearate.

Composition of the product shell: hypromellose, macrogol, dimethicone, iron dye yellow oxide (E172), titanium dioxide (E171).

Concor - instructions for use in various dosage forms

The drug Concor has an anti-ischemic effect, reduces the level of oxygen that is necessary for the myocardium. This effect can be achieved by lowering blood pressure. In addition, the drug helps reduce cardiac output and reduce heart rate. And the supply of oxygen to the heart and muscle layer occurs due to the lengthening of diastole. In addition, end-diastolic pressure decreases.

The drug Concor is distinguished by its hypotensive properties due to its ability to inhibit the secretion of renin by the kidneys, reduce cardiac output and influence the baroreceptors of the aortic arch. In addition, the drug also has an effect on the carotid sinus. Long-term use of Concor leads to a decrease in increased peripheral vascular resistance. In some cases, the use of Concor affects glucose metabolism and the smooth muscles of the bronchi and arteries.

In those patients who suffer from a complex form of heart failure, Concor helps suppress the sympathoadrenal renin-angiotensin-aldosterone system. In the case of a single dose, the effect of the medicine lasts throughout the day.

Concor: instructions for use in tablet form

Scheme for using Concor for treatment

According to the instructions, Concor is taken orally once a day, without chewing and with plenty of water.

For arterial hypertension and angina pectoris, the dose is selected individually for each patient, taking into account the patient’s health condition and concomitant pathologies. The initial dose is 5 mg once a day. If necessary, the dose can be doubled. For arterial hypertension and angina pectoris, the daily dose should not exceed 20 mg.

In acute forms of heart failure, the usual Concor treatment regimen must also be supplemented with ACE inhibitors or angiotensin blockers, diuretics, beta-blockers and cardiac glycosides. The maximum dose in this case should not exceed 10 mg.

Indications, contraindications, side effects of the drug Concor

Indications for use of the product

• Arterial hypertension;
• Coronary heart disease as a prophylaxis for angina pectoris;
• Chronic heart failure.

Contraindications for the use of the drug Concor

• AV block II and III degrees;
• SSSU;
• pronounced sinoatrial block;
• tendency to bronchospasms;
• late stages of peripheral circulatory disorders;
• simultaneous use of MAO inhibitors, with the exception of type B inhibitors;
• when a history indicates that the patient or his relatives have psoriasis (the use of beta-blockers, including Concor, should be made only after a thorough assessment of the benefit-risk ratio;
• pheochromocytoma (prescription of the drug to patients with pheochromocytoma is permitted only after taking alpha-blockers).

Side effects when used

When taking the medicine, the patient may worsen chronic heart failure and bradycardia. Also, taking the drug may be accompanied by low blood pressure, AV conduction disorders, headaches, insomnia, loss of consciousness, nightmares, hearing loss, hallucinations, dizziness, depression, decreased tear production, and conjunctivitis.

As was observed when taking the drug by patients with bronchial asthma and obstructive pathologies of the upper respiratory tract, Concor can cause spasms in the bronchi.

How long can you take Concor?

A course of taking the drug Concor is prescribed only by a doctor who knows about all the patient’s concomitant pathologies.

Concor: instructions for use for children

To date, there is very little data on the use of the drug in children; for this reason, it is not recommended to use Concor in the treatment of patients under 18 years of age.

Use of Concor during pregnancy

During pregnancy, Concor is allowed to be taken only in cases where the benefit to the mother outweighs the risk of side effects in the fetus. Studies have shown that adrenergic blockers reduce blood flow in the placenta and thus can affect the development of the fetus. if the drug has been prescribed, then the attending physician must constantly monitor the blood flow in the placenta and uterus. Monitor the development of the fetus and if suddenly there is even the slightest threat to the health of the mother or fetus, you must urgently replace the drug with another one.

If a pregnant woman did use Concor while carrying a child, then after the birth of the baby she needs to be examined and monitored for the first few days after birth, as symptoms of bradycardia and hypoglycemia may occur. There is no data on whether the active substance penetrates into milk. Therefore, it is not advisable to take the drug while breastfeeding, but if you cannot do without the medication, then breastfeeding should be stopped during Concor therapy.

Interaction of Concor with other drugs

When using the drug and other drugs simultaneously, it must be taken into account that adverse reactions are possible:

• When taking medication and antihypertensive drugs, the effect of the latter is significantly enhanced.
• When used with alpha-methyldopa, reserpine, guanfacine, clonidine and digitalis preparations, the heart rate may sharply decrease.
• When prescribed with sympathomimetics, the effectiveness of bisoprolol may be reduced.
• When using Concor and Nifedipine, the antihypertensive effect of the former may increase.
• When taken with diltiazem or verapamil, it may happen that the heart rate decreases, blood pressure decreases, and arrhythmia or heart failure develops.
• When prescribing a drug with clonidine, the second one can be completely abandoned a few days after starting to take the medication, since blood pressure can jump up significantly.
• The use of Concor with ergotamine causes severe peripheral circulatory disorders.
• When using the drug with rifampicin, in rare cases, a decrease in the effectiveness of bisoprolol may occur, but it is not necessary to increase the dose.
• The use of Concor with insulin increases the hypoglycemic effect, and the manifestations of hypoglycemia are mitigated.

One of the best and most effective analogues of Concor is Coronal. It also copes very well with high blood pressure, but it has many contraindications, which are written in the instructions and every patient should be aware of them before starting therapy with it.

Another good and effective analogue of Concor is Egilok. This drug is considered a synonymous drug, since it has a completely different active ingredient, but it is still considered the best analogue, which is suitable for patients who have contraindications for taking Concor.

In addition to these drugs, there are many others that will also help if suddenly there are any reasons that would become a reason to cancel Concor, among them are: Nebilet (analog), Betalok (analogue), Carvedilol (analog) and others.

Additional information about the drug Concor:

Cardiac treatment is based on various drugs, without which there is no way to support the patient. One of the important medications is Concor.

Both elderly and middle-aged people suffer from high blood pressure. The choice of the right medicine to alleviate the patient’s condition depends on the therapeutic effect of the drug, its harmful and undesirable effects.

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Concor is aimed at lowering blood pressure, reducing elevated heart rate and normalizing heart rhythm. The main component of the drug is bisoprolol hemifumarate. The product is supplemented with other elements such as calcium hydrogen phosphate, starch, crospovidone, microcrystalline cellulose, magnesium stearate.

Concor reduces the necessary need for oxygen supply to the heart myocardium. Long-term use of the drug prevents angina attacks and becomes a prophylactic against developing myocardial infarction.

The tablets begin their therapeutic effect 1-3 hours after taking them. The digestive system accepts Concor well, which quickly dissolves and is absorbed into the bloodstream, and there is no dependence on the time of food intake.

The drug is excreted from the body through the kidneys and liver. After taking the medicine, the highest concentration of Concor is observed 3 hours later. The drug result lasts for 24 hours.

The main medicinal properties of Concor include:

Of all beta blockers, Concor is the most powerful and effective therapeutic agent, providing a long-lasting effect. The greatest therapeutic effect appears to be when taking small and medium doses of the drug.

The drug is available in tablet form of 2.5 mg, 5 mg and 10 mg, covered with a thin film. The package contains 30 or 50 tablets.

The price of the drug depends on the dosage of the tablets. In Moscow pharmacies you can buy medicine for 210 rubles. for a package of 30 tablets or up to 550 rubles. per pack of 50 tablets.

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Concor is prescribed when it is detected:

Concor is prescribed for use no more than a single dose during the day in the morning before breakfast, washed down with a small amount of water, without chewing the tablets.

The average application scheme is as follows:

Treatment with Concor takes a long time, with gradual cessation of use. The average daily dose does not exceed 2.5-5 mg, if necessary and in agreement with the attending physician, it is possible to increase to 20 mg. The course is prescribed for each patient, according to his individual characteristics.

Abruptly stopping Concor tablets can cause devastating, serious exacerbations. Cancellation or replacement of a drug should only be carried out as prescribed by the attending cardiologist.

An overdose affects the state of the heart rhythm, its disturbances, impulse conduction, a sharp decrease in pressure, bronchospasms, fainting, and convulsions.

If blood pressure drops to 100 mmHg. Art. the pulse becomes less than 50 beats per minute, this will require gradual withdrawal of the medication.

In addition to its therapeutic effects, the drug can cause undesirable effects, including:

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Overdose leads to bradycardia, arterial hypotension, bronchospasm, and heart failure.

The drug is not prescribed if the patient has:

Concor, like many medications, is incompatible with alcohol. Its use is also contraindicated for people driving.

The danger of taking the drug for illness lies in the unpredictability of the course of diabetic phenomena and the tendency to develop a hypoglycemic state. Concor is classified as a beta blocker that can speed up the effect of insulin entering the body and other hypoglycemic medications.

Concor reduces tachycardia, and the decrease in glucose levels often goes unnoticed by the sick person. Therefore, taking Concor for diabetes mellitus should be carried out after consultation with a cardiologist and observation by an endocrinologist.

High blood pressure often accompanies an increased heart rate, rapid beating of the main human organ and a malfunction in the conduction system of the heart. Due to very high blood pressure, doctors can prescribe auxiliary medications such as Prestarium and Concor, or Capoten and Concor.

Capoten combines well with various medications used in the treatment of cardiovascular diseases and there are no special contraindications to its use. Therefore, Concor and Capoten tablets are prescribed unlimitedly in medical practice.

Both remedies multiply the actions of each other, promoting the normal functional activity of the heart muscle and the entire circulatory system.

Age: not specified

Chronic diseases: not specified

Hello, I have been taking Concor 1t (2.5) per day for more than a year as a remedy for blood pressure. Recently I decided to reduce my dose to 1/2 tablet per day. And as soon as I did this, from the first day I began to feel aching and tingling pain in my heart. When I started taking the whole tablet, the pain went away. It seems to me that I am addicted to this drug. Could this be possible? If so, how to refuse them? This terrible addiction is scary.

Tags: hypertension, arterial hypertension, concor reviews, concor reviews from cardiologists, concor reviews from doctors

How to take anaprilin The pressure is normal, but sometimes it jumps sharply to 180-190.

Prestarium Please tell us about the drug PRESTARIUM. Specifically I'm interested in.

Cancellation of the drug Please tell me how to properly stop taking the drug CONCOR (I am taking it.

Concor or Prestarium Doctor. I am 37 years old and have had hypertension since I was 25, my weight is normal, slightly increased.

Concor for low blood pressure I am 28 weeks pregnant, with physical activity.

Amlodipine for angina reviews Doctor. I have a question. I have angina pectoris.

The difference between Enap and Enap N With ARVI and overload, my blood pressure rose to 160.

High blood pressure medications Dr. The doctor prescribed Presertan for the treatment of hypertension.

Modern treatment regimen for hypertension Hypertensive since 30 years old, I have been taking medications for fasting, 46 years old.

Lower blood pressure rises in the evening Thank you: it is useful to read your wise advice.

Taking Cordinorm, pulse 50. I am 38 years old, taking Cordinorm as prescribed by a doctor, 1.5.

Weakness when taking Valsacor Doctor! I take Valsacor 40 mg in the morning and 40 mg in the evening.

Blood pressure and high pulse I am an experienced hypertensive patient. I took Concor for about 15 years.

Don't forget to rate the doctors' answers, help us improve them by asking additional questions on the subject of this question .
Also, don’t forget to thank your doctors.

Hello! I would like to clarify that if you have been diagnosed with hypertension (or arterial hypertension), then you will have to take medications for life, no matter how scary it may sound. Because while the drug is in the body, the pressure is maintained, as soon as it is removed from the body, blood pressure surges begin. However, if you have low blood pressure, normal body weight and exercise, it is possible to achieve target blood pressure levels on a diet.
Now about the concor. Indeed, addiction to it can develop, but the pain in the heart area that you describe is not associated with Concor, because this drug does not relieve any pain on its own. Perhaps this is just a coincidence, or when you tried to reduce the dose, your blood pressure increased and pain appeared against this background. In addition, you are taking a small dosage, and its reduction is very unlikely to have such an effect on your body. It is theoretically possible to stop taking Concor, but you must first consult with your doctor.
P.S. Be healthy!

Svetlana Smirnova 2016-01-06 13:05

My blood pressure suddenly increased, my heart palpitations and tachycardia—this happened in September. They gave me pills, everything returned to normal, but I began to be afraid of these symptoms. I recently started taking Concor, took 15 tablets, and had an ultrasound of my heart, and my condition is good. Now we have identified the cause of the pressure - it's chronic. Pancreatitis (although the ultrasound is also good), and hormonal changes due to menopause, I haven’t tested hormones yet - it’s the holidays. How can I get off Concor correctly (I reduced the dose by a quarter), because it causes an exacerbation of pancreatitis, I noticed this.

Oksana 2014-09-03 10:34

Hello. I have been taking Concor for 4 months. Against this background, the pressure is usually 135-140 over 85, but sometimes it is 100 over 60 and on some days it rises to 180 over 115. The question is, what to do in such cases, increase the dose of Concor or drink something else to lower the pressure? I am 45 years old, I take Concor 2.5, twice a day.

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Drawing conclusions

Heart attacks and strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blockages in the arteries of the heart or brain.

What’s especially scary is the fact that a lot of people don’t even suspect that they have hypertension. And they miss the opportunity to fix something, simply dooming themselves to death.

Symptoms of hypertension:

• Headache
• Increased heart rate
• Black dots before the eyes (floaters)
• Apathy, irritability, drowsiness
• Blurred vision
• Sweating
• Chronic fatigue
• Facial swelling
• Numbness and chills in fingers
• Pressure surges

Even one of these symptoms should give you pause. And if there are two of them, then have no doubt - you have hypertension.

How to treat hypertension when there are a large number of medications that cost a lot of money?

Most medications will do no good, and some may even be harmful! At the moment, the only medicine that is officially recommended by the Ministry of Health for the treatment of hypertension is.

Until February 26th. The Institute of Cardiology together with the Ministry of Health is conducting a program " without hypertension". Within which the drug is available FOR FREE, to all residents of the city and region!

In this article you can read the instructions for use of the drug Concor. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Concor in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Concor in the presence of existing structural analogues. Use for the treatment of high blood pressure, coronary artery disease, stable angina and heart failure in adults, as well as during pregnancy and lactation. Side effects and consumption of alcohol with the medicine.

Concor- a selective beta1-blocker, without its own sympathomimetic activity, does not have a membrane-stabilizing effect.

It has only slight affinity for beta2-adrenergic receptors of the smooth muscles of the bronchi and blood vessels, as well as for beta2-adrenergic receptors involved in the regulation of metabolism. Therefore, bisoprolol (the active ingredient of Concor) generally does not affect airway resistance and metabolic processes in which beta2-adrenergic receptors are involved.

The selective effect of the drug on beta1-adrenergic receptors persists beyond the therapeutic range.

Bisoprolol does not have a pronounced negative inotropic effect.

Bisoprolol reduces the activity of the sympathoadrenal system by blocking beta1-adrenergic receptors of the heart.

When administered once orally in patients with coronary artery disease without signs of chronic heart failure, bisoprolol reduces heart rate, reduces the stroke volume of the heart and, as a result, reduces the ejection fraction and myocardial oxygen demand. With long-term therapy, the initially elevated TPR decreases. A decrease in renin activity in blood plasma is considered as one of the components of the hypotensive effect of beta-blockers.

The maximum effect of the drug is achieved 3-4 hours after oral administration. Even when bisoprolol is prescribed once a day, its therapeutic effect persists for 24 hours due to the fact that its T1/2 from blood plasma is 10-12 hours. As a rule, the maximum reduction in blood pressure is achieved 2 weeks after the start of treatment.

Pharmacokinetics

After oral administration, Concor is almost completely (>90%) absorbed from the gastrointestinal tract. Food intake does not affect bioavailability. The clearance of bisoprolol is determined by the balance between excretion by the kidneys unchanged (about 50%) and metabolism in the liver (about 50%) to metabolites, which are also excreted by the kidneys.

Indications

• arterial hypertension;
• IHD: stable angina;
• chronic heart failure.

Release forms

Film-coated tablets 5 mg and 10 mg.

Film-coated tablets 2.5 mg (Concor Cor).

Instructions for use and dosage

The drug is taken orally 1 time per day. The tablets should be taken with a small amount of liquid in the morning before, during or after breakfast. The tablets should not be chewed or crushed into powder.

Arterial hypertension and angina pectoris

The dose is selected individually, primarily taking into account the heart rate and the patient’s condition.

As a rule, the initial dose is 5 mg 1 time per day. If necessary, the dose can be increased to 10 mg 1 time per day. In the treatment of arterial hypertension and angina pectoris, the maximum recommended dose is 20 mg 1 time per day.

Chronic heart failure

The standard treatment regimen for chronic heart failure includes the use of ACE inhibitors or angiotensin 2 receptor antagonists (in case of intolerance to ACE inhibitors), beta-blockers, diuretics and, optionally, cardiac glycosides. At the beginning of treatment of chronic heart failure with Concor, a special titration phase is required under regular medical supervision.

The precondition for treatment with Concor is stable chronic heart failure without signs of exacerbation.

Treatment with Concor begins in accordance with the following titration scheme. Individual adaptation may be required depending on how well the patient tolerates the prescribed dose, i.e. the dose can only be increased if the previous dose was well tolerated.

To ensure an appropriate titration process, it is recommended to use bisoprolol in the dosage form of 2.5 mg tablets at the initial stages of treatment.

The recommended starting dose is 1.25 mg 1 time per day. Depending on individual tolerance, the dose should be gradually increased to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg 1 time per day. Each subsequent dose increase should be carried out at least 2 weeks later. If increasing the dose of the drug is poorly tolerated by the patient, then a dose reduction is possible.

During titration, regular monitoring of blood pressure, heart rate and the severity of symptoms of chronic heart failure is recommended. Worsening of the symptoms of chronic heart failure is possible from the first day of using the drug.

If the patient does not tolerate the maximum recommended dose of the drug, then a gradual dose reduction should be considered.

During the titration phase or after it, a temporary worsening of chronic heart failure, arterial hypotension or bradycardia is possible. In this case, it is recommended, first of all, to adjust the doses of concomitant therapy drugs. It may also be necessary to temporarily reduce the dose of Concor or discontinue it. After stabilization of the patient's condition, the dose should be re-titrated or treatment should be continued.

Duration of treatment for all indications

Treatment with Concor is usually long-term.

Elderly patients do not require dose adjustment.

Because There is not enough data on the use of the drug Concor in children; it is not recommended to prescribe the drug to children under 18 years of age.

To date, there is insufficient data regarding the use of Concor in patients with chronic heart failure in combination with type 1 diabetes mellitus, severe renal and/or liver dysfunction, restrictive cardiomyopathy, congenital heart defects or heart valve disease with severe hemodynamic impairment. Also, sufficient data have not yet been obtained regarding patients with chronic heart failure with myocardial infarction within the last 3 months.

Side effect

• bradycardia (in patients with chronic heart failure);
• worsening symptoms of chronic heart failure (in patients with chronic heart failure);
• feeling of coldness or numbness in the limbs;
• pronounced decrease in blood pressure (especially in patients with chronic heart failure);
• orthostatic hypotension;
• dizziness;
• headache;
• loss of consciousness;
• depression;
• insomnia;
• hallucinations;
• decreased tear production (should be taken into account when wearing contact lenses);
• hearing impairment;
• conjunctivitis;
• bronchospasm in patients with a history of bronchial asthma or obstructive airway diseases;
• nausea, vomiting;
• diarrhea, constipation;
• muscle weakness;
• muscle cramps;
• potency disorders;
• skin itching;
• rash;
• hyperemia of the skin;
• allergic rhinitis;
• asthenia (in patients with chronic heart failure);
• increased fatigue.

Contraindications

• acute heart failure;
• chronic heart failure in the stage of decompensation, requiring therapy with drugs with a positive inotropic effect;
• cardiogenic shock;
• 2nd and 3rd degree AV block, without pacemaker;
• SSSU;
• sinoatrial block;
• severe bradycardia (HR< 60 уд./мин.);
• pronounced decrease in blood pressure (systolic blood pressure<100 ммрт.ст.);
• history of severe forms of bronchial asthma and COPD;
• severe disturbances of peripheral arterial circulation, Raynaud's disease;
• pheochromocytoma (without simultaneous use of alpha-blockers);
• metabolic acidosis;
• age under 18 years (insufficient data on effectiveness and safety);
• hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

The use of Concor during pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

Beta blockers reduce blood flow to the placenta and may affect fetal development. Blood flow in the placenta and uterus should be carefully monitored, as well as the growth and development of the unborn child should be monitored, and in the event of undesirable manifestations in relation to pregnancy or the fetus, alternative therapeutic measures should be taken. The newborn should be carefully examined after birth. In the first 3 days of life, symptoms of bradycardia and hypoglycemia may occur.

There is no data on the excretion of bisoprolol in breast milk. Taking Concor is not recommended for women during lactation. If it is necessary to use the drug during lactation, breastfeeding should be discontinued.

special instructions

The patient should not abruptly interrupt treatment or change the recommended dose without first consulting a doctor, as this may lead to a temporary deterioration in heart function. Treatment should not be interrupted suddenly, especially in patients with coronary artery disease. If discontinuation of treatment is necessary, the dose should be reduced gradually.

Tri- and tetracyclic antidepressants, antipsychotics (neuroleptics), ethanol (alcohol), sedatives and hypnotics increase the depression of the central nervous system.

At the initial stage of treatment with Concor, patients require constant medical supervision.

The drug should be used with caution in diabetes mellitus with significant fluctuations in blood glucose concentrations (symptoms of severe hypoglycemia, such as tachycardia, palpitations or increased sweating may be masked), in patients on a strict diet, during desensitization therapy, 1st degree AV blockade , Prinzmetal's angina, mild to moderate peripheral arterial circulation disorders (increased symptoms may occur at the beginning of therapy), psoriasis (including a history).

Respiratory system: for bronchial asthma or COPD, simultaneous use of bronchodilators is indicated. In patients with bronchial asthma, there may be an increase in airway resistance, which requires a higher dose of beta2-agonists.

Allergic reactions: beta-blockers, including Concor, may increase sensitivity to allergens and the severity of anaphylactic reactions due to the weakening of adrenergic compensatory regulation under the influence of beta-blockers. Therapy with epinephrine (adrenaline) does not always give the expected therapeutic effect.

When performing general anesthesia, the risk of beta-adrenergic receptor blockade should be taken into account. If it is necessary to discontinue therapy with Concor before surgery, this should be done gradually and completed 48 hours before general anesthesia. The anesthesiologist should be warned that the patient is taking the drug Concor.

In patients with pheochromocytoma, Concor can be prescribed only while using alpha-blockers.

When treated with Concor, the symptoms of hyperthyroidism may be masked.

Impact on the ability to drive vehicles and operate machinery

Concor does not affect the ability to drive vehicles, according to the results of a study in patients with coronary artery disease. However, due to individual reactions, the ability to drive a car or work with technically complex mechanisms may be impaired. Particular attention should be paid to this at the beginning of treatment, after changing the dose, and also when consuming alcohol at the same time.

Drug interactions

The effectiveness and tolerability of bisoprolol may be affected by the simultaneous use of other drugs. This interaction can also occur when two drugs are taken within a short period of time. The doctor must be informed about the use of other medications, even if used without a prescription.

Treatment of chronic heart failure

Class 1 antiarrhythmic drugs (for example, quinidine, disopyramide, lidocaine, phenytoin, flecainide, propafenone), when used simultaneously with bisoprolol, can reduce AV conduction and cardiac contractility.

Blockers of slow calcium channels such as verapamil and, to a lesser extent, diltiazem, when used simultaneously with bisoprolol, can lead to a decrease in myocardial contractility and impaired AV conduction. In particular, intravenous administration of verapamil to patients taking beta-blockers can lead to severe arterial hypotension and AV blockade. Centrally acting antihypertensives (such as clonidine, methyldopa, moxonidine, rilmenidine) can lead to a decrease in heart rate and cardiac output, as well as vasodilation due to a decrease in central sympathetic tone. Abrupt withdrawal, especially before discontinuation of beta-blockers, may increase the risk of developing rebound hypertension.

Combinations requiring special caution

Treatment of arterial hypertension and angina pectoris

Class 1 antiarrhythmic drugs (for example, quinidine, disopyramide, lidocaine, phenytoin, flecainide, propafenone), when used simultaneously with bisoprolol, can reduce AV conduction and myocardial contractility.

All indications for use of the drug Concor

Blockers of slow calcium channels, dihydropyridine derivatives (for example, nifedipine, felodipine, amlodipine), when used simultaneously with bisoprolol, may increase the risk of developing arterial hypotension. In patients with chronic heart failure, the risk of subsequent deterioration of cardiac contractile function cannot be excluded.

Class 3 antiarrhythmic drugs (for example, amiodarone), when used simultaneously with Concor, may increase AV conduction disturbances.

The effect of topical beta-blockers (for example, eye drops for the treatment of glaucoma) may enhance the systemic effects of bisoprolol (lowering blood pressure, reducing heart rate).

Parasympathomimetics, when used simultaneously with bisoprolol, may increase AV conduction disturbances and increase the risk of bradycardia.

When used simultaneously with Concor, the hypoglycemic effect of insulin or oral hypoglycemic agents may be enhanced. Symptoms of hypoglycemia, in particular tachycardia, may be masked or suppressed. Such an interaction is more likely when using non-selective beta-blockers.

General anesthesia agents can increase the risk of cardiodepressive effects, leading to arterial hypotension.

Cardiac glycosides, when used simultaneously with bisoprolol, can lead to an increase in impulse conduction time, and thus to the development of bradycardia.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the hypotensive effect of Concor.

The simultaneous use of Concor with beta-agonists (for example, isoprenaline, dobutamine) may lead to a decrease in the effect of both drugs.

The combination of bisoprolol with adrenergic agonists that affect alpha and beta adrenergic receptors (for example, norepinephrine, epinephrine) may enhance the vasoconstrictor effects of these drugs due to their action on alpha adrenergic receptors, leading to an increase in blood pressure. Such an interaction is more likely when using non-selective beta-blockers.

Antihypertensive drugs, as well as other drugs with a possible antihypertensive effect (for example, tricyclic antidepressants, barbiturates, phenothiazines) can enhance the hypotensive effect of bisoprolol.

Mefloquine, when used simultaneously with bisoprolol, can increase the risk of bradycardia.

MAO inhibitors (except MAO B inhibitors) may enhance the hypotensive effect of beta-blockers. Concomitant use may also lead to the development of a hypertensive crisis.

Analogues of the drug Concor

Structural analogues of the active substance:

• Aritel;
• Aritel Core;
• Bidop;
• Biol;
• Biprol;
• Bisogamma;
• Bisocard;
• Bisomore;
• Bisoprolol;
• Bisoprolol-Lugal;
• Bisoprolol-Prana;
• Bisoprolol-ratiopharm;
• Bisoprolol-Teva;
• Bisoprolol hemifumarate;
• Bisoprolol fumarate;
• Concor Cor;
• Corbis;
• Cordinorm;
• Coronal;
• Niperten;
• Tirez.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.