Active substance tablets Concor is a beta1-adrenoblocker of bisoprolol (more precisely, bisoprolol hemifumarate, mixed with bisoprolol fumarate in a 2: 1 ratio).
In addition, the composition of the tablets include excipients that provide this dosage form with the required volume and contribute to the long-term saving of the active substance in the active state (anhydrous calcium hydrogen phosphate, corn starch, etc.).
International Nonproprietary Name (INN)
The drug Concor refers to drugs intended for the treatment of diseases of the cardiovascular system. This is a very numerous group of dissimilar drugs, which, according to the mechanism of pharmacological action, belong to different classes.
At the same time, Concor relates to the so-called beta1-adrenergic blockers (cardioselective adrenoblockers) – drugs that block the effect of stimulating nerve impulses of the central nervous system on the heart muscle.
In addition, beta1-adrenergic blockers block the effect on myocardial cells of stress hormones coming from the bloodstream (such as adrenaline, norepinephrine, etc.).
Concor as a drug from the group of adrenergic blockers: the effect of the drug on the cardiovascular system
Indications for use
As a fairly strong drug, Concor medicine has a fairly long list of contraindications. As well as other medicines, Concor tablets are contraindicated in case of increased individual sensitivity to any of the components of the drug.
It should be noted that all adrenergic blockers have a similar structure, so if a patient has an intolerance of one of them (for example, anaprilin), then it is not recommended to prescribe Concor tablets.
The mechanism of action of the drug involves a significant reduction in cardiac output, so Concor tablets are not prescribed for shock conditions accompanied by a sharp decrease in heart function (cardiogenic shock, collapse), in chronic cardiovascular insufficiency in the decompensation stage, as well as in marked reduction in blood pressure (90 / 60 mm Hg and below).
Since Concor reduces heart rate, inhibits cardiac automatism and adversely affects the conductivity of impulses on the myocardium, tablets are not used at low heart rate (below 50 beats per minute), with sick sinus syndrome, sinus and atrioventricular blockade of the second or third degree ( if there is no pacemaker).
As a beta1-blocker, Concor acts primarily on the corresponding receptors of the heart, but one cannot exclude the development of such a side effect as a blocking effect on the beta2 receptors of the bronchi and peripheral vessels with an increase in the contraction of their muscular elements.
Therefore, this drug is not prescribed for pulmonary diseases that occur with bronchospasm (bronchial asthma, obstructive bronchitis, etc.), as well as peripheral vascular lesions, based on the development of arteriole spasm (Raynaud’s disease, etc.).
Do Concor for Pregnancy and Breast Feeding Pills?
Pregnancy and breastfeeding are contraindications to the appointment of a medicine Concor.
The fact is that adrenergic blockers can cause a reduction in the muscles of the uterus, and can cause miscarriage or premature labor. In addition, the possibility of a negative impact on the fetus cannot be completely excluded, since Concor reduces blood flow in the placenta.
Large-scale clinical studies on the use of this drug in pregnant women have not been conducted for obvious reasons. Concor tablets were used to treat pregnant women only in cases where the benefits of prescribing the drug were many times greater than the risk of developing fetal pathology.
But even with this kind of use, the drug should be stopped for two or three days before the expected birth, and the newborn must be under the constant supervision of a doctor for at least three days.
Release form Concor (description of the appearance of the drug and photos of tablets containing 5 and 10 mg of active substance)
Dosage form of the drug Concor represented lenticular pills, having a characteristic heart shape. In the middle of each tablet there is a strip-groove to facilitate the division into two equal parts.
You should be careful, because there are two dosage forms: tablets containing 5 and 10 mg of active substance. They differ in color: tablets containing 5 mg of the active substance have a lemon shade, and those containing 10 mg are beige.
Both types of tablets are available in blisters of 10 pieces each, blisters are enclosed in cardboard packages of 30-50 tablets (3 or 5 blisters per package).
Country and manufacturer
Where can one buy?
Recipe in Latin
The prescription medication issued by the doctor Concor will be as follows:
Rp .: Tab. Concor 0.01 No. 50
D. S. One tablet once a day.
Translated from the generally accepted Latin abbreviations, this inscription contains an indication for the pharmacy employee: "Take Concor tablets, which contain 10 mg of active ingredient, in an amount of 50 pieces. Give out and label the medicine to take one tablet once a day.".
The price of the drug Concor 5 mg and 10 mg (packs containing 30 and 50 tablets)
The average cost of Concor tablets containing 5 mg of active substance in pharmacies in Moscow is about 200 rubles per pack with 30 tablets, and about 300 rubles per pack with 50 tablets.
Tablets containing 10 mg of the active substance are more expensive (about 300 rubles per pack of 30 tablets and about 500 rubles per pack of 50 tablets).
Medical drug tablets Concor 5 and 10 mg: instructions for use
How much does it work?
Bisoprolol, the active ingredient of Concor, begins to be absorbed immediately after entering the digestive tract, and then, along with other substances from the intestinal lumen, passes through a hepatic filter, where it is partially deactivated.
In general, the bioavailability of the drug is high (about 87%), so that the maximum concentration of the active substance in the blood is reached within 2-3 hours after ingestion, and after three to four hours after using the tablet, you can observe a full-scale picture of the therapeutic effect of Concor (decrease in blood pressure , slowing pulse, reducing the need for heart muscle for oxygen).
Action time tablets Concor
Medical product Concor refers to the adrenergic blockers of prolonged action. The half-life of the active substance from the body is 10-12 hours.
At the same time, approximately 50% of bisoprolol is excreted by the kidneys in pure form, and another 50% is pre-disintegrated in the liver.
Since the liver and kidneys play an important role in the metabolism of bisoprolol, serious diseases of these organs can cause a delay in the active substance of Concor tablets in the body.
However, even with the normal functioning of the liver and kidneys, Concor’s pills-induced lowering of blood pressure remains at a therapeutically significant level for more than 24 hours. For the full recovery of adrenoreceptors it will take two weeks.
How to take heart pills Concor: one, two or three times a day?
Since the active substance of the tablets Concor refers to adrenergic blockers of prolonged action, the drug is taken once a day.
What time to take Concor: in the morning or at night?
Concor tablets should be taken in the morning so that the maximum concentration of the active substance in the blood falls at a time when the body most needs an adrenergic receptor blockade (according to biological rhythms, the adrenergic system is most active during daylight hours).
How to drink pills: before meals or after?
Eating does not affect the body’s assimilation of the active substance of Concor tablets. Therefore, the drug can be taken both before and after meals.
As a rule, in such cases, doctors recommend taking the drug after a meal, since it is more comfortable for most patients to take pills with liquid (they should not be chewed!) On a full stomach.
However, if you prefer to swallow pills before you sit down at the table, or while you are eating, do as you prefer.
The dosage of the drug Concor depends on the type of pathology, the severity of the disease and the general condition of the patient, and can be from 5 to 20 mg / day.
At the same time, as a rule, they start with small doses, gradually increasing the daily dose to the maximum maintenance dose.
How long can I take the drug?
The drug Concor is designed for long-term use. This drug is used for maintenance therapy, that is, for constant blood pressure correction and heart rate.
If you want to stop taking the drug or find an adequate counterpart, you should contact a specialist (general practitioner or cardiologist).
The use of the drug Concor 5 and 10 mg tablets from high blood pressure and as a prophylaxis of strokes (patient reviews and recommendations from cardiologists)
The dose of the drug Concor in those cases when it is used for the treatment of arterial hypertension is selected individually and depends primarily on the level of initial pressure.
So, for example, with mild hypertension for maintenance therapy, as a rule, a dose of 2.5 mg is sufficient. The degree of arterial hypertension is judged by the value of the so-called diastolic pressure (it is recorded as the second indicator immediately after the fraction).
A mild degree of arterial hypertension is a chronic increase in blood pressure, in which the diastolic pressure does not exceed 105 mm Hg. (for example, 160/100 mm Hg).
For the correction of higher blood pressure indicators, maintenance doses of 5-10 mg are used.
In cases where high blood pressure is combined with such manifestations of coronary heart disease, such as angina, you can use the maximum tolerated doses of Concor (up to 20 mg).
In hypertension, if there are no additional indications, the initial dose is half the maintenance, but not more than 5 mg (1.25, 2.5 or 5 mg, depending on the initial pressure level and the general state of the body).
Reviews of patients using Concor tablets to normalize blood pressure indicate that the drug is quite effective, easy to use and well tolerated.
Especially a lot of positive recommendations from elderly patients suffering from a combination of hypertension and angina.
However, there are cases where the corrective action of Concor tablets has proven insufficient. Cardiologists advise such patients to consult a specialist to select an antihypertensive drug from another pharmacological group.
Concor medicine for the heart: use and dosage for chronic heart failure
Concor tablets are one of the basic remedies for treating chronic heart failure in the compensation stage, since they significantly reduce the load on the heart muscle.
However, it should be borne in mind that, by reducing cardiac output, Concor may contribute to the appearance of symptoms of heart failure.
Therefore, treatment in such cases is carried out gradually, starting with small doses, and the maintenance dose is selected individually, focusing on the tolerability of the drug.
As a rule, taking Concor tablets starts with a minimum dose of 1.25 mg (a quarter of a tablet containing 5 mg of active ingredient). With good tolerance, the dose is gradually increased. In this case, follow the following rules:
one. The purpose of the drug is possible only with compensated heart failure. When exacerbation should first achieve stabilization of the process.
2 During the selection of a maintenance dose, regular monitoring of blood pressure, heart rate and absence of symptoms of heart failure is carried out.
3 Increasing the dose is possible only after two weeks of taking a lower dose with good portability.
four. Each time the dose is increased by no more than 1.25 mg.
five. With poor tolerance, you may need to return to a lower dose.
6 The maximum recommended dose of Concor for heart failure is 10 mg.
Side effects of the drug Concor (reviews of patients and the recommendations of cardiologists)
The most common side effects (according to clinical studies)
Common side effects (reviewed patient reviews and doctors forum)
An analysis of reviews posted on the Internet about Concor tablets showed that the prevailing majority of patients tolerate this drug well.
However, there are complaints about the unpleasant symptoms associated with taking Concor. Among the most common side effects are lability of pressure and pulse, general weakness, muscle aches, headache and dizziness, cough.
In addition, there are references to cases where patients were forced to refuse taking Concor tablets because of extremely poor tolerability. Doctors advise to reduce the likelihood of side effects to start with a minimum dose and increase it gradually.
It should be noted that among the patients in need of the Concor preparation there are many people with a labile nervous system (hypertension, vascular dystonia, etc.).
Some of the side effects described in the reviews (such as heart attacks, for example) are most likely not related to taking Concor tablets, but to increased suspiciousness.
In this article, we listed the most common side effects. Meanwhile, the list of possible side effects attached to the instructions for use of the drug is very long.
The fact is that there are registered all the unpleasant symptoms that have appeared in patients while taking Concor tablets, including those that are extremely rare (once in 10,000 doses and less often).
What side effects can be regarded as a contraindication to taking Concor?
If any unpleasant symptoms occur while taking Concor tablets, you should contact your doctor.
The fact is that the side effects of Concor are non-specific and may be signs of a disease. So in some cases, you will need to pass an additional examination.
As for hypersensitivity to the drug, then an individual approach is needed. In some cases, it is sufficient to correct the dose correctly, and in others, the drug should be discontinued.
Often, the unpleasant symptoms that appear at the beginning of taking Concor tablets decrease and completely disappear as the body becomes accustomed to the drug.
Correctly determine the medical tactics: waiting, reducing the dose or changing the drug can only be done by a specialist doctor. This takes into account the nature and severity of side effects, the dynamics of their appearance and the general condition of the body.
In severe cases, a sharp drop in blood pressure (collapse) can occur, coma can develop, and even death can occur.
If there are signs of an overdose, you should immediately consult a doctor. It is shown gastric lavage and the appointment of adsorbing agents (so that the active ingredient of the tablets Concor is not absorbed into the gastric tract).
As antidotes (antidotes) use drugs of the opposite action – atropine and beta-adrenergic mimics (isoprenaline).
In addition, as a rule, sedatives (sedatives) are prescribed, such as diazepam, lorazepam. Cardiac glycosides, cardiotonics (dopamine, epinephrine) and diuretics (diuretics) are used to relieve symptoms of heart failure, and glucagon is used to increase blood glucose levels.
If necessary, conduct resuscitation.
Active ingredient Concor tablets: compatibility and interaction with other drugs
Bisoprolol, the active ingredient in Concor tablets, is incompatible with many other drugs. Therefore, the physician prescribing this drug should be aware of all the medicines that the patient is taking.
In particular, Concor tablets are incompatible with many antiarrhythmic drugs, which are often prescribed to heart patients.
Thus, the combination of bisoprolol with drugs from the group of sodium channel blockers (quinidine, lidocaine, propafenone, novocainamide, diphenin, etc.) can lead to a sharp decrease in heart rate and a drop in blood pressure due to a decrease in cardiac output.
Drugs from the group of calcium channel blockers (verapamil, diltiazem, nifedipine, etc.) also cannot be combined with taking Concor tablets because the unidirectional actions of these drugs are mutually potentiated. Such a combination can lead to a decrease in myocardial contractility and a decrease in heart rate.
Antiarrhythmic drugs from the group of potassium channel blockers (amiodarone) in combination with Concor tablets can cause gross conduction disturbances up to atrioventricular block.
A similar complication can develop in the case of taking Conkor while using cardiac glycosides, which are often prescribed to patients suffering from chronic heart failure.
For the treatment of arterial hypertension, Concor tablets are not recommended in combination with centrally acting antihypertensive drugs (methyldopa, moxonidine, reserpine, guanfacine, etc.), since this combination can provoke a sharp drop in blood pressure and heart rhythm disturbances. In addition, abrupt cancellation of one of the drugs after long-term joint use can cause extremely high "ricochet" jump in blood pressure.
It should be borne in mind that the local use of beta-blockers (for example, in the form of eye drops for glaucoma) can significantly enhance the systemic effect of bisoprolol.
Prescribing bisoprolol in conjunction with drugs from the oppositely directed group (for example, beta-adrenomimetic drugs dobutamine or isoprenaline) will lead to a mutual weakening of the effects of both drugs.
At the same time, the appointment of Concor together with alpha and beta receptor-stimulating adrenomimetics can lead to an increase in peripheral pressure due to the stimulation of alpha-adrenoreceptors.
Great care is needed when prescribing Concor tablets with antidiabetic agents (insulin and tableted hypoglycemic drugs), because bisoprolol potentiates the action of these drugs. In addition, Concor tablets will suppress tachycardia characteristic of lower blood sugar levels, which is fraught with the unexpected development of hypoglycemic coma.
Non-steroidal anti-inflammatory drugs (acetylsalicylic acid, paracetamol, analgin, etc.), glucocorticosteroids (prednisolone, hydrocortisone, dexamethasone, etc.), as well as female sex hormones, estrogens are able to reduce the hypotensive effect of Concor tablets.
The combination of Concor with such a group of antidepressants as MAO inhibitors (phenelzine, nialamide, befol, metralindol, etc.) is strictly contraindicated. You should start using Concor tablets no earlier than two weeks after discontinuation of MAO inhibitors.
In addition, it should be noted that Concor potentiates the inhibitory effect on the central nervous system of neuroleptics, tranquilizers and hypnotic drugs.
It is also necessary to remember that any drugs that directly or indirectly reduce blood pressure (barbiturates, antispasmodics, diuretics, etc.) will increase the hypotensive effect of Concor tablets.
Many medicines from different groups affect the exchange of bisoprolol in the body, thus enhancing or weakening its effect. Thus, the antibiotic rifampicin shortens the half-life of bisoprolol, and sulfasalazin increases the concentration of the active ingredient of Concor tablets in the blood.
The course of treatment drug Concor and nutrition
By itself, Concor does not impose any requirements on the diet, since the bioavailability of the drug and all its transformations in the body, up to excretion, are not related to the mode and quality of nutrition.
However, diseases that are treated with Concor (hypertensive disease, chronic heart failure, atherosclerosis, which led to coronary heart disease and angina) require not only drug therapy.
The generally accepted diet for cores is called Pevzner’s Table No. 10, and involves the maximum restriction of table salt, animal fats, and easily digestible carbohydrates. It is also necessary to reduce the intake of free fluid (including in the form of "liquid" dishes, such as soups, jelly, etc.).
All types of products that may have a tonic effect on the central nervous system, heart and blood vessels, including tea, coffee, cocoa, chocolate, spicy and hot dishes, smoked meats, meat, fish and vegetable decoctions are excluded.
In addition, cholesterol-rich foods and dishes that are prone to flatulence are banned.
Fish and seafood, dishes rich in lipotropic substances (oatmeal), ascorbic acid, B vitamins, nicotinic acid, potassium and magnesium salts are shown.
Compatibility with alcohol
As well as the predominant majority of drugs that reduce blood pressure, Concor tablets are poorly compatible with alcoholic beverages, because alcohol increases the inhibitory effect of the drug on the central nervous system.
In addition, it should be noted that alcohol is categorically contraindicated in pathologies that are indications for the appointment of the drug Concor (hypertension, chronic heart failure, coronary heart disease).
Sports and Tablets Concor
The drug Concor reduces strength and heart rate, so heavy exercise on the background of taking Concor tablets can lead to signs of heart failure (shortness of breath, swelling, etc.).
At the same time, physiotherapy exercises are included in the complex of therapeutic measures for all diseases of the cardiovascular system. At the same time, the type and degree of physical activity is determined by a specialist doctor.
The effect of the drug on the potency
The drug Concor refers to selective beta-blockers. Drugs in this group do not adversely affect the potency.
Many patients are concerned about the fact that the decrease in potency is indicated in the instructions for the drug as one of the possible side effects.
The fact is that, according to international laws, the manufacturer must warn about every registered side effect of the drug.
Decreased potency refers to "very rare" side effects. This means that the probability of developing such a complication is a maximum of 1 chance out of 10,000.
This is incomparably lower than the probability of developing impotence due to the further development of diseases such as hypertension, heart failure or coronary heart disease.
Does the addictive drug cause Concor?
Concor, as well as other drugs from the group of selective beta-blockers, does not cause addiction, even with a very long reception.
It should be noted that under the addiction in pharmacology do not mean the emergence of dependence on the drug, but the need to increase the dose to achieve a therapeutic effect with prolonged use.
Concor tablets can be used for years, and the effectiveness of the minimum maintenance dose depends not on the duration of the course of treatment, but on the condition of the body.
So the need to increase the dose may occur only in connection with the progression of the disease, which necessitated the use of the drug.
Discontinuation Syndrome Concor: symptoms and effects
Have "heavy" cores with a sharp cessation of taking tablets Concor may develop the so-called withdrawal syndrome, which is manifested by the following features:
- tachycardia over 90 beats per minute with no physical exertion
- various cardiac arrhythmias associated with the formation of abnormal pathological sources of rhythm in the cardiac conduction system (extrasystoles, paroxysmal tachycardia attacks)
- a sharp increase in blood pressure until the development of hypertensive crisis
- aggravation of angina
- appearance of signs of heart failure.
It should be noted that the likelihood of withdrawal with abrupt discontinuation of Concor tablets, as well as the severity of its symptoms, does not depend on the duration of the drug intake period, but on the severity of the course of the disease, which necessitated its administration.
Especially dangerous is a sharp interruption of the course in case of pathologies such as:
- coronary heart disease
- high degree of arterial hypertension
- propensity to develop life-threatening tachyarrhythmias (cardiac arrhythmias, accompanied by an increase in heart rate).
How to stop taking a drug like beta-blocker Concor
To avoid the development of withdrawal syndrome, Concor dose is gradually reduced. At the same time, blood pressure and heart rate should be continuously monitored.
There is no single scheme for withdrawal of Concor tablets, since the probability of developing withdrawal syndrome depends on the maintenance dose and the severity of the disease, which served as an indication for prescribing the drug.
As a rule, doctors advise to reduce the maintenance dose of 1.25 mg of the active substance (that is, a quarter of a tablet containing 5 mg of bisoprolol) per week, focusing on the severity of pathological symptoms.