Concor: instructions for use, analogues, what are they taking from?

Concor in the instructions for use is presented as a selective drug for 1-adrenergic receptors, developed for the treatment of diseases accompanied by high blood pressure, complicated heart function and increased palpitations.

Composition, release form and packaging

Concor is produced in the form of tablets in a shell resembling a symbol of the heart and having a median recess to facilitate separation. The substance that has an active therapeutic effect is bisoprolol. Inactive components perform an auxiliary function, providing the drug with a stable form, uniformity and preservation.

Tablets containing 5 mg of the therapeutic component are light yellow in color. In beige tablets, the amount of bisoprolol is increased to 10 mg.

Pharmacological action, pharmacodynamics and pharmacokinetics

The medication exhibits valuable therapeutic effects:

• reduces abnormally frequent heartbeats;
• stabilizes the heart rhythm, slowing down the transmission of impulses in the tissues of the myocardium;
• reduces blood pressure, lowering the volume of cardiac output - the amount of blood pumped by the heart per minute (IOC), suppressing the production of the renin enzyme, which regulates blood pressure, by affecting the nerve reflex mechanisms of blood pressure control (baroreceptors of the aortic arch and carotid sinus - carotid sinus) ;
• facilitates the functioning of the myocardium with weak contractions, reducing its oxygen demand due to a decrease in heart rate, cardiac output and pressure in the coronary vessels;
• reduces the frequency and severity of angina attacks associated with acute myocardial ischemia, which occurs due to oxygen starvation of the heart
• with insufficient blood flow or due to spasm of the coronary vessels;
• in case of chronic insufficiency and cardiac ischemia, it suppresses excessive activity of neurohormonal systems, facilitating the course of diseases, significantly reducing mortality and hospitalization of patients;
  with prolonged use, it reduces the total resistance of blood vessels (OPSS) by relaxing their walls and increasing the lumen, positively affecting the manifestations of hypertension and cardiac pathologies.

After taking the pill, approximately 91-92% of the therapeutic substance is absorbed, and the therapeutic effect reaches a maximum after 2-3 hours, lasting up to 24 hours.

A stable antihypertensive effect stabilizes after about 10-14 days of therapy and is manifested in 95% of patients under 60 years of age and more than in 90% of people older than 61-62 years.

Long-term treatment with bisoprolol for patients with heart disease, as well as those who have had a heart attack, is accompanied by a decrease in deaths from 20 to 50%.

Half of the therapeutic substance is removed from the body with urine and 50% is processed in the liver and then also excreted by the kidneys. Therefore, with mild and moderate severity of renal and hepatic diseases in patients receiving Concor, dose reduction is most often not required.

The standard half-life of bisoprolol, 9-12 hours, lengthens with serious impairment of kidney function, liver disease (for example, with cirrhosis, the half-life of the treating substance reaches 20-22 hours). In these cases, the dose must be adjusted to avoid excessive concentration of the active component in the blood.

Concor does not cause mutations, does not suppress the ability to conceive, does not cause congenital malformations in the embryo, malignant processes.

What helps Concor

What is this blocker taken from?

The medication helps in the treatment of the following pathologies:

• frequent and persistent increase in blood pressure;
• damage to the heart muscle due to a violation of its blood supply due to blockage or narrowing of the coronary arteries (IHD - coronary heart disease);
• heart attack (acute ischemia);
• angina pectoris (chronic ischemia);
• chronically occurring and moderately severe insufficiency of heart function without exacerbations for 6-8 weeks;
• heart palpitations on the background of heart disease.

Instructions for use and dosage

Doses and treatment regimen are selected only by a specialist cardiologist, taking into account the underlying disease, heart rate, blood pressure and associated pathologies.

Concor therapy is long-term - from 2 to 6 months or more.

Reception of a medicine at the end of the treatment course is stopped for 2-3 weeks to avoid the painful manifestations of the "withdrawal syndrome."

As a rule, Concor tablets are drunk before or during breakfast - once every 24 hours, with a small amount of water.

The maximum allowable daily adult dose is 20 mg.

Recommended treatment regimens for arterial hypertension

With a slight increase in pressure (lower less than 105 mm Hg) take 2.5 mg. If hypertension is more pronounced, the dose is slowly increased to 5 mg. If the cardiologist considers it necessary, he can increase the amount of bisoprolol to 10 mg per day, but increasing the dose by no more than 2.5 mg per week.

Medication with regular use helps to lower blood pressure by 8-10 units. But it is important to understand that exceeding the dose prescribed by the doctor will not enhance the hypotensive effect, but can cause bradycardia (slowing of the heartbeat), which is dangerous if the patient already has a lowered heart rate.

Treating Chronic Heart Failure

In the initial stage of therapy, a very slow increase in dose is required, since the medicine, reducing the frequency and strength of heart contractions, can lead to a worsening of the condition.

An important condition for initiating bisoprolol therapy is the absence of signs of exacerbation against the background of stable heart failure.

In the first 14-20 days, only 1.25 mg is taken, monitoring the body's response to the drug. In the absence of unpleasant manifestations, the amount of bisoprolol is increased to 2.5 mg. After 2 weeks with normal tolerance, you can start taking 3.75 mg. A further increase in dose (up to 5 mg) is provided after another 14 days.

And in this way, slowly increasing the dose by 1.25 mg every 14 days, it is brought to the maximum and therapeutically significant - 10 mg.

Basic application rules:

• the dose is allowed to be increased only with normal tolerance of the drug;
• when the condition worsens, the dose decreases;
• in the first 2-3 months, blood pressure indicators, heart rate, severity of manifestations of heart failure are monitored.

Important! With a deterioration in respiratory functions, a significant drop in blood pressure (below 90 to 60), an abnormal slowdown in heart rate, immediately reduce the dose of all drugs that the patient receives with Concor, including diuretics, beta-blockers, cardiac glycosides, ACE inhibitors. After normalization of all indicators, it is allowed to gradually return to the previously established dose.

With the development of an attack of angina pectoris, the medicine does not affect the degree of pain. The action of Concor is to prevent attacks (reducing their frequency and severity) and increasing patient tolerance of physical stress.

It is interesting:ACE inhibitors

Special patient groups

Particular care is required in the treatment of patients suffering from:

• severe renal pathologies (CC less than 20 ml / min), liver diseases;
• diabetes mellitus, since signs of hypoglycemia (falling glucose in the blood) can be erased;
• thyrotoxicosis;
• psoriasis
• Prinzmetal angina or AV blockade of the I degree;
• bronchial asthma and a tendency to spasm of the bronchi;
  metabolic acidosis;
• allergic diseases (hypersensitivity may increase, while the introduction of adrenaline will not give a positive reaction);
• pheochromocytoma (possibly a paradoxical increase in pressure).

It is necessary to monitor patients receiving medications that reduce sensitivity to allergens, for young patients aged 14-16 years (safety of use is not defined).

Prior to surgery, an anesthetist needs to be informed of bisoprolol treatment. Usually, 2 days before the operation, the Concor is canceled or the doctor selects another anesthetic with the least negative effect on heart contractions.

The issue of driving, dangerous mechanisms, and activities that require special attention and speed of response is decided after the doctor determines the tolerance of Concor.

During pregnancy and lactation

Concor is not prescribed for nursing mothers and women expecting a baby, since accurate and complete information based on research and clinical experience is not available.

It is known that any adrenergic blockers to one degree or another provoke an increase in uterine tone, which can cause miscarriage or premature labor. It is also impossible to exclude the possibility of a negative effect of bisoprolol on the embryo due to its ability to reduce blood flow activity between the placenta and the vascular system of the fetus.

Bisoprolol passes into breast milk, but its quantity and effect on infants has not been studied. Therefore, an adrenergic blocker is prescribed in isolated cases, if the therapeutic effect of a medication for a nursing and expectant mother far exceeds the probable risks for the embryo and the baby.

If Concor is appointed pregnant, then the medication is canceled 3 days before the planned birth, in order to prevent the baby from respiratory depression and suffocation (neonatal asphyxia), slowing the heartbeat, a sharp drop in blood pressure and glucose.

If it is not possible to cancel the Concor during pregnancy, then the born baby needs constant monitoring by a neonatologist and pediatrician.

Can I drink alcohol while taking Concor

Bisoprolol is incompatible with the use of alcoholic beverages due to the high risk of orthostatic hypotension - a strong decrease in blood pressure and the development of collapse.

Drug interaction

With the simultaneous use of bisoprolol with other medicines, their interaction should be taken into account, often leading to serious consequences.

Important: Concor is forbidden to be taken with MAO inhibitors.

Medications used simultaneously with Concor	Possible effects with concurrent administration
Hypertension medications, verapamil, amplodipine, nifedipine and other calcium antagonists, dihydroergocristine	Risk of hypotension and cardiac impairment
Reserpine, methyldopa, clonidine, cardiac glycosides with digitalis, adonis, guanfacin	A sharp decrease in heart rate, impaired conduction and contractility of the heart
Diltiazem, amiodarone and other antiarrhythmic drugs	A sharp decrease in pressure, heart rate, the development of arrhythmia and heart failure, the development of AV block
Ergotamine derivatives (including migraine treatments)	Strengthening circulatory disorders in peripheral vessels
Insulin and other hypoglycemic agents	Increased hypoglycemic effect and a drop in blood sugar (up to coma)
Xanthines, estrogens, non-steroidal anti-inflammatory drugs, sympathomimetics (including those found in nasal and eye drops, cough suppressants), rifampicin	Decreased Concor efficiency

Contraindications, side effects and overdose

Conditions in which Concor is contraindicated:

• intolerance to bisoprolol, adrenergic blockers;
• bradycardia less than 55-50 beats per minute (pathologically slowed heart rate);
• weakness of the sinus node, atrioventricular or sinoatrial blockade of 2-3 degrees (in the absence of a pacemaker);
• collapse, coma and shock state of any nature;
• severe heart failure, acute heart attack;
  low blood pressure (below 95/65);
• bronchospasm, severe asthma, obstruction of the bronchi, lungs, respiratory failure;
• bleeding
• pregnancy, breastfeeding, children under 14 years old;
• severe impaired blood flow in the peripheral vessels against a spasm of arterioles;
• taking MAO inhibitors;
• severe form of psoriasis;
• pheochromocytoma (admission is allowed only after therapy with alpha-blockers).

The most common side effects, especially at the beginning of treatment: weakness, headache, nausea, dizziness, loose stools or constipation, sleep disturbance. Typically, these manifestations are weak and pass within 7-14 days.

Also may be observed:

• cough, laryngospasm, inflammation of the nasal sinuses (sinusitis, frontal sinusitis);
• itching, runny nose, skin rash, spots;
• numbness, a feeling of cold in the arms and legs;
• cystitis, renal colic.

In 1-2 patients out of a hundred, the following can be noted:

• visual disturbances, dryness and inflammation of the conjunctiva, dry mouth;
• shortness of breath (with a tendency to spasm of the bronchi, obstructive bronchitis, asthma);
• irritability, mental and physical fatigue.

An overdose manifests itself in an increase or occurrence of adverse reactions.

Symptoms

• shortness of breath, spasm of the bronchi;
• pronounced decrease in heart rate, blood pressure;
• interruptions in heart rate;
• cyanosis or yellowing of the skin;
• cold sweat.

You should immediately cancel the medication and conduct emergency treatment. First of all - immediate gastric lavage and the appointment of adsorbents.

Analogues of the drug

Analogs of Concor with a similar therapeutic effect:

• Bisoprolol;
• Bidop;
• Aritel
• Coronal;
• Biol;
• Cordinorm Cor;
• Biprol;
• Hypertension;
• Cordis.

Which is better, bisoprolol or concor

Bisoprolol or concor - which is better to take for maximum effect? The therapeutic effect and effectiveness of these drugs are equivalent, since bisoprolol is the basic therapeutic substance in both drugs. They differ only in small changes in the composition of auxiliary components. The original Concor is much more expensive, and to save money, you can buy generic medicines with bisoprolol from reliable pharmaceutical companies.