Main > Drugs> Concor

Concor

Application instruction:

Form of release and structure

Indications to use

Contraindications

Route of administration and dosage

Side effects

Special instructions

Medicinal interaction

Terms and storage conditions

The prices in Internet drugstores:

from 170 rub.

In more detail

Конкор в таблетках 10 мг Concor – the selection _{beta1-adrenoblocker}.

Form of release and structure

Dosage form – tablets, film coated: light yellow or light orange color, have the biconvex heart-shaped form and dividing to risk on both sides (on 5 mg or 10 mg in blisters: on 10 pieces, in cardboard packs of 3 or 5 blisters; on 25 pieces, in cardboard packs 2 blisters; on 30 pieces, in a cardboard pack 1 blister; on 5 mg on 30 pieces in the blister, in a cardboard pack 3 blisters).

Active ingredient – a bisoprolola гемифумарат (the bisoprolola fumarates (2:1)):

1 tablet of light yellow color – 5 mg;
1 tablet of light orange color – 10 mg.

Auxiliary components: starch corn, calcium hydrophosphate anhydrous, silicon dioxide colloid anhydrous, кросповидон, cellulose microcrystallic, magnesium stearate.

Structure of a film cover: titanium dioxide (E171), gipromelloz 2910/15, диметикон 100, macrogoal 400, dye ferrous oxide yellow (E172).

In addition as a part of a film cover of light orange color – dye ferrous oxide red (E172).

Indications to use

Chronic heart failure;
Arterial hypertension;
Stable stenocardia at coronary heart disease.

Contraindications

Acute form of heart failure;
Dekompensirovanny chronic heart failure;
Cardiogenic shock;
Atrioventricular (AV) blockade of II and III degrees (in the absence of an electrocardiostimulator);
Sick sinus syndrome;
The expressed bradycardia (heart rate (HR) less than 60 beats per minute);
The expressed lowering of arterial pressure (ABP) (systolic the ABP is lower than 100 mm of a mercury column);
Sinuatrial blockade;
The severe form of bronchial asthma and the chronic obstructive pulmonary disease (COPD) specified in the anamnesis;
Raynaud's disease, heavy disturbances of peripheric arterial circulation;
Metabolic acidosis;
Pheochromocytoma (without combination to alpha adrenoblockers);
Age up to 18 years;
Breastfeeding period;
Hypersensitivity to drug components.

With care patients should appoint Concor with heavy abnormal liver functions, Printsmetal's stenocardia, a diabetes mellitus of 1 type and a diabetes mellitus with essential fluctuations of content of glucose in blood, a hyperthyroidism, AV blockade of the I degree, psoriasis, a heavy renal failure (clearance of creatinine less than 20 ml/min.), inborn heart disease or defect of the valve of heart with the expressed hemodynamic disturbances, a restrictive cardiomyopathy, chronic heart failure against the background of a myocardial infarction within the next 3 months, during the desensibilizing therapy, and also the patient keeping to a rigid diet.

Use of drug during pregnancy is possible if by definition of the doctor the estimated therapeutic effect for mother exceeds potential risk for a fruit (the bisoprolola гемифумарат reduces a blood stream in a placenta).

Route of administration and dosage

Pill is taken inside, without chewing, washing down with enough liquid. It is necessary to accept drug 1 time a day, in the morning, irrespective of meal.

The doctor appoints dosing individually, considering a condition of the patient and clinical indications.

At treatment of stenocardia and arterial hypertension the dose is selected, considering the patient's ChSS. It is necessary to begin with 5 mg a day. In case of need the dose can be brought to 10 mg, the indicator in 20 mg is not recommended to be exceeded.

Treatment of chronic heart failure is carried out according to the standard scheme including a combination therapy which part inhibitors of an angiotensin-converting enzyme (APF) or antagonists of receptors of angiotensin II (are at intolerance of APF inhibitors), diuretics, beta adrenoblockers, cardiac glycosides.

Purpose of Concor is shown only at stable chronic heart failure without aggravation symptoms, and has to take place special phases of titration according to a certain scheme.

The recommended initial dosing at treatment of chronic heart failure – 1,25 mg. Further dose adjustment depends on individual portability of a bisoprolol and is carried out after a certain adaptation to previous.

The dose is increased gradually, 1 time in 2 weeks on 1,25 mg, the maximum dose – 10 mg. Selection of a dose is carried out under observation of the doctor and control of ChSS, the ABP, in case of a state aggravation against the background of the last titration it is necessary to lower a dose to previous.

The temporary aggravation of symptoms of disease, emergence of arterial hypotension or bradycardia is possible from the first days of use of drug, during titration and treatment. In this case it is necessary to carry out simultaneous correction of doses of means of the accompanying therapy and a bisoprolol, and in critical situations to cancel it until stabilization of a condition of the patient. Then it is possible to continue treatment or to begin repeated titration of a dose.

Use of Concor at all indications is long-term.

With easy or moderate severity of abnormal liver functions or kidneys and to patients of advanced age dosing correction, usually, is not required to patients.

At heavy renal failures and a liver the recommended daily dose should not exceed 10 mg, and increase in a dose at this category of patients is carried out with extra care.

Side effects

Against the background of use of Concor there can be following side effects:

From cardiovascular system: very often – bradycardia (at chronic heart failure); often – an aggravation of symptoms of chronic heart failure (at chronic heart failure), feeling of numbness or cold in extremities, strong decrease in the ABP (is more often at patients with chronic heart failure); infrequently – bradycardia (at stenocardia or arterial hypertension), AV conductivity disturbance, orthostatic hypotension, strengthening of symptoms of chronic heart failure (at stenocardia or arterial hypertension);
From the alimentary system: often – vomiting, nausea, diarrhea or a lock; seldom – hepatitis;
From a nervous system: often – dizziness and a headache (is more often in an initiation of treatment of arterial hypertension or stenocardia, has easy temper and passes through 1-2 weeks of therapy); seldom – a loss of consciousness;
From sense bodys: seldom – a hearing disorder, reduction of a slezootdeleniye; very seldom – conjunctivitis;
From mentality: infrequently – sleeplessness, a depression; seldom – terrible dreams, hallucinations;
From reproductive system: seldom – disturbances of a potentiality;
From respiratory system: infrequently – a bronchospasm against the background of bronchial asthma or obstructive respiratory diseases in the anamnesis;
From a musculoskeletal system: infrequently – myotonia, muscular weakness;
From integuments: very seldom – an alopecia; patients with psoriasis have an exacerbation of a disease or emergence of psoriazopodobny rash;
Allergic reactions: seldom – an itch, skin rash, a hyperemia, allergic rhinitis;
From laboratory indicators: seldom – increase in blood of level of concentration of enzymes of a liver (alaninaminotranspherase and aspartate aminotransferase);
Others: often – an adynamy (at chronic heart failure), increased fatigue (is more often in an initiation of treatment of arterial hypertension or stenocardia, has easy temper and passes through 1-2 weeks of therapy); infrequently – an adynamy (at arterial hypertension or stenocardia).

Special instructions

It is impossible to stop sharply therapy, especially sick with coronary heart disease, drug withdrawal has to take place by a gradual dose decline. Correction of dosing is made under observation and according to the recommendation of the doctor.

Purpose of drug is shown to patients with bronchial asthma or HOBL only at a concomitant use of bronchodilators. At increase in resistance of respiratory tracts increase in a dose _{of beta2-adrenomimetik} is recommended to patients with bronchial asthma.

Against the background of Concor increase in sensitivity to allergens and weight of anaphylactic reactions is possible, at the same time treatment by adrenaline (Epinephrinum) can not have sufficient therapeutic effect.

Before planned surgery using the general anesthesia it is necessary to reduce gradually a dose of drug and to cancel its reception in 48 hours prior to operation. The anesthesiologist has to be informed on reception of a bisoprolol.

At a pheochromocytoma use of drug is possible only against the background of alpha adrenoblockers.

Drug can mask hyperthyroidism symptoms.

Though Concor does not exert impact on ability of the patient to control of vehicles and mechanisms, but considering various individual portability of drug and possible disturbance of a state at change of a dose, it is recommended to be careful, especially in an initiation of treatment and in case of simultaneous alcohol intake.

Medicinal interaction

At purpose of Concor the patient has to inform the doctor on all medicines which it accepts. These data will allow the doctor to consider possible interaction of drugs and to make to the patient necessary recommendations of rules and priority of their use.

At treatment of chronic heart failure co-administration of quinidine, lidocaine, Disopyramidum, Phenytoinum, propafenon, flekainid and other antiarrhytmic means of the I class is not recommended.

Undesirable combinations for simultaneous use of Concor:

Diltiazem, verapamil and other blockers of slow calcium channels can cause decrease in sokratitelny ability of a myocardium and disturbance of AV conductivity;
Clonidine, моксонидин, Methyldopum, рилменидин and other hypotensive drugs of the central action can become the reason of decrease in cordial emission and ChSS and to lead to a vazodilatation against the background of reduction of the central sympathetic tone. The probability of ricochet arterial hypertension increases at sharp drug withdrawal up to cancellation of beta adrenoblockers.

It is necessary to observe extra care at treatment of stenocardia and arterial hypertension in combination with lidocaine, quinidine, Disopyramidum, flekainidy, Phenytoinum, propafenony (antiarrhytmic means of the I class), this combination with bisoprololy can reduce sokratitelny ability of a myocardium and AV conductivity.

Drugs with which in a combination purpose of Concor demands extra care:

Felodipin, nifedipine, амлодипин and other derivatives of dihydropyridine – increase risk of arterial hypotension, at chronic heart failure the subsequent deterioration in sokratitelny function of heart is possible;
Non-steroidal anti-inflammatory drugs – reduce hypotensive action of a bisoprolol;
Amiodaronum and other antiarrhytmic drugs III of a class – can aggravate disturbance of AV-of conductivity;
Beta adrenoblockers for topical administration, including eye drops for treatment of glaucoma – raise systemic action of a bisoprolol;
Parasympathomimetics – can increase risk of development of bradycardia and disturbance of AV conductivity;
Peroral hypoglycemic means and insulin – increase the clinical action, hypoglycemia symptoms (tachycardia) can be suppressed or mask;
Drugs for the general anesthesia – increase probability of cardiodepressive action that can lead to arterial hypotension;
Cardiac glycosides – can increase time of carrying out an impulse and lead to development of bradycardia;
Tricyclic antidepressants, fenotiazina, barbiturates and other drugs with anti-hypertensive effect – can increase hypotensive effect of Concor;
Meflokhin – increases probability of development of bradycardia;
Monoamine oxidase inhibitors (MAO) (except MAO B inhibitors) – exponentiate hypotensive effect of drug and are capable to cause development of hypertensive crisis.

The drug combination with izoprenaliny, Dobutaminum and other beta-adrenergic agonists leads to decrease in clinical effect of both medicines.

The concomitant use with bisoprololy the adrenomimetik influencing on alpha and beta adrenoceptors (Norepinephrinum, Epinephrinum), leads to increase in the ABP.