Cardiovascular diseases today occupy almost the first place in mortality worldwide. And every year these problems are getting younger. If earlier they talked about myocardial infarction, then it was about the age of at least 45-50 years, today this disease can affect a 30-year-old.
Modern pharmacy has a mass of drugs to combat “heart” problems at different stages of the development of these diseases. One of the groups of these medicines are beta-blockers. The principle of action of these funds is to block beta-adrenergic receptors in the heart. The consequence is a decrease in heart rate, which leads to a decrease in blood pressure and a general improvement in the condition of a person.
Beta blockers have now been developed by a great many. One of the widely used in the development of cardiac problems is Concor Cor. Indications for use, reviews about the drug characterize the drug as quite effective and in demand among patients with cardiac diseases.
The main components and form of the drug
The main component of the drug “Concor Cor” is bisoprolol hemifumarate. A rather large list of substances acts as auxiliary substances: corn starch, microcrystalline cellulose, crospovidone, magnesium stearate, colloidal silicon dioxide, anhydrous calcium hydrogen phosphate.
The drug is offered to consumers in the form of heart-shaped, film-coated white tablets (it contains macrogol 400, dimethicone 100, hypromelase, titanium dioxide). The risk on both sides is divided into two parts of the Concor Cor tablet. Packaging of the drug is carried out in foil blisters, in each of which 10, 14, 25 or 30 pieces can be sealed.
Patients can often see the drug “Concor” in pharmacies. Since the names of these two drugs are very similar, pharmacists often have to answer questions about how "Concor" differs from "Concor Cor". So: the difference is only in the amount of content of the main active ingredient - bisoprolol. Consor consumers can buy in tablets containing 5 or 10 mg of the active substance, while Concor Cor - 2.5 mg.
Consumers need to know that in order to purchase blocking medicines in a pharmacy, the pharmacist will need to provide a prescription from a doctor.
Pharmacodynamics
Concor Cor has a selective beta-1-blocking effect. The essence of its effect is in the ability to suppress the transmission of nerve impulses in adrenoreceptors. For this reason, the medication is able to have a hypotensive, antiarrhythmic, antianginal effect.
The hypotensive effect of “Concor Kor” is attributed by doctors to the fact that bisoprolol reduces the minute volume of blood. In addition, the activity of the renin-angiotensin system is inhibited in parallel. The greatest clinical effect will be achieved after 5 days from the start of the drug. Blood pressure stabilizes at the end of the second month of therapy with Concor Kor.
Indications for the use of the drug also guarantee stable antianginal effect by reducing the myocardial oxygen demand due to a decrease in heart rate. It must also be said that the use of this medication helps to lengthen the period of diastole.
The antiarrhythmic effect of the “Concor Kor” remedy is due to the blocking of negatively influencing factors, which include partial suppression of the effects of the sympathetic part of the central nervous system, suppression of the processes of creating electrical impulses in the sinus node, and inhibition of the myocardial electrical activity.
To whom is the drug indicated, and to whom - not?
What are the indications for use with Concor Cor? Customer reviews confirm the high effectiveness of this medicine. It is recommended to be taken to treat heart failure and prevent the development of such conditions in the early stages. To be precise, healthcare providers prescribe this beta-blocker for treatment of persistent chronic heart failure with reduced systolic function of the left ventricle. Usually, "Concor Cor" is prescribed in parallel with ACE inhibitors, diuretics, cardiac glycosides.
So that no one would want to prescribe this medication for themselves on their own, without the advice of a doctor, you should familiarize yourself with the impressive list of contraindications for taking the Concor Cor.
In addition to the mandatory indication for any medication to prohibit the presence of intolerance to the components that make up the drug and the age of the patients (up to 18 years old - there is no information about the effectiveness and safety), there are many other reasons and diseases in which it is unacceptable to take this medicine.
"Concor Cor" instructions for use (analogues - modern beta-blockers - have close indications of the inadmissibility of admission) are forbidden for patients with heart failure in acute form and with decompensated chronic failure. Do not prescribe a medication for collapses and cardiogenic shock (a condition provoked by a violation of the functions of the heart). You can not take this beta-blocker with large deviations in AV conductivity (II, III degree of AV block) without the presence of an pacemaker. Also, the reason for refusing admission is the presence of bradycardia (heart rate (heart rate) less than 50 beats / min.), Sinoatrial blockade (impaired passage of the sinus impulse through the sinoatrial connection). The medication is contraindicated in patients suffering from Prinzmetal angina (spasms of the vessels that feed the heart, with the simultaneous elevation of the ST segment) and sinus node weakness syndrome (SSS).
You can not take "Concor Cor" with low systolic blood pressure (below 90 mm Hg. Art.), In the presence of severe asthma, those who have a history of chronic obstructive pulmonary disease (COPD).
Further, the use of the Concor Kor drug is unacceptable if there are deviations from the norm in the peripheral circulatory system (to a greater extent concerns the late stages), with Raynaud's disease, pheochromocytoma (a benign or malignant tumor of the APUD system), and metabolic acidosis (shift of acid-base balance) in the direction of increasing acidity due to the accumulation of acidic products in tissues, their insufficient binding or destruction).
The treatment regimen and acceptable volumes of bisoprolol
According to the instructions, this beta-blocker is taken once a day, preferably in the morning, after eating. Concor Kor tablets (from which the medicine would not be used - whether it is coronary heart disease, a chronic form of heart failure or hypertension) do not need to chew or grind, they are swallowed whole and washed down with a small volume of water.
To conduct therapeutic measures for chronic heart failure using the medicine “Concor Cor”, it is first recommended to titrate the dose. The essence of the process is as follows: during the 1st week, the volume of the taken beta-blocker in terms of bisoprolol is 1.25 mg, at the 2nd week the dosage doubles (2.5 mg), at the 3rd it is 3.75 mg. During the period from the 4th week until the end of the 7th dose is 5 mg bisoprolol per day; from the 8th week to the 11th - 7.5 mg. Starting from the 12th week, the maximum possible 10 mg is taken. The dosage should (and can) be increased only by making sure that the previous one is tolerated normally and does not cause negative feelings.
Here on the surface - the essence of the answer to the question of how "Concor" differs from "Concor Cor": the second option (2.5 mg bisoprolol) is ideal for initiating therapeutic measures for persistent chronic conditions of heart failure, while the first (5 or 10 mg) is more suitable for maintenance treatment.
If at some point in the selection of a dose symptoms of heart failure appear, medical experts recommend adjusting the dosage of diuretics or ACE inhibitors taken in parallel. When after some time the condition improves, the titration of the Concor Kor should be continued.
Therapy using this medication is long-lasting. The withdrawal of this beta-blocker should be carried out slowly, especially for patients suffering from coronary artery disease.
Exceeding the permissible dose: consequences and treatment
Instructions for the drug always accompanies Concor Kor tablets. From what they are taken and what are the contraindications, it was described earlier. Now we will talk about what to do if for some reason an unacceptably large dose was taken.
Symptoms are as follows: arterial hypertension and bradycardia develop, bronchospasm and hypoglycemia are highly likely, the onset of acute heart failure is possible.
The consequences of taking a large dose in different people can vary significantly. It is likely that those who suffer from heart failure are highly sensitive to exceeding the dosage recommended by the doctor. The most correct decision for the patient is to see a doctor (if possible, do it yourself) or call an ambulance. Depending on the extent to which the medication was taken, the doctor will determine the measures that need to be taken to alleviate the patient's condition.
As urgent measures, gastric lavage and absorption of absorbents (activated carbon or its analogues) are usually performed. Further, depending on the situation, treatment with bisoprolol may be discontinued, and supportive and symptomatic therapy will be carried out for a necessary period of time in a hospital setting.
Instructions for Concor Kor, indications for use, medical reviews and other sources of information inform specialists and consumers that bisoprolol is difficult to dialysis.
Negative manifestations of the use of Concor Cor
Like almost any medicine, Concor Kor is able to provide side effects of varying intensity on human systems and organs.
As for the cardiovascular system, the most common complaints of patients about the occurrence of bradycardia and arterial hypertension (mostly in people suffering from chronic heart failure) may develop angiospasm. To a lesser extent, there is a probability of a violation of AV conduction, decompensation of cardiac activity, accompanied by peripheral edema.
The reaction to the medication of the central nervous system is less pronounced and may consist of increased fatigue, headaches and dizziness, asthenia, disturbed periods of sleep and wakefulness. Very rarely, patients complain of cramps, nightmares and hallucinations. In most cases, all these symptoms do not have an intense color and disappear 1-2 weeks after the start of therapy with Concor Kor.
Indications for use and a list of contraindications draw attention of patients who have a history of information about COPD and asthma, which is likely to develop bronchospasm. Rarely speak about the appearance of allergic rhinitis.
From the gastrointestinal tract, nausea, vomiting, constipation, diarrhea, a feeling of dry mucous membranes in the oral cavity are most often possible. Less talk about the development of hepatitis and changes in liver enzymes.
In addition to all of the above, patients report impaired vision and conjunctivitis (rarely), cramps in the calf muscles and muscle weakness, and impaired potency (very rare).
Of the allergic manifestations, rash, skin itching and redness of the skin are most often possible.
Concor Cor and pregnancy
Reception of the beta-blocker Concor Kor during pregnancy is possible only in cases where its expected health benefits for the mother outweigh the possible risk for the developing baby.
Any beta-blockers (and Concor Cor, among them) reduce the intensity of blood flow in the placenta and thereby can have a negative effect on the intrauterine development of the baby. If, nevertheless, the medication is prescribed for use by a pregnant woman, health workers should constantly monitor blood flow in the placenta and uterus, as well as monitor the growth and development of the child. In the event of any negative factors for a woman and a child, it is necessary to switch to other alternative methods of treatment.
After birth, the baby should be carefully examined. During the first 3 days, the baby's blood glucose level may decrease, the development of symptoms of bradycardia (a decrease in heart rate) is also possible.
As for nursing women, there is no information on the allocation of bisoprolol with breast milk or on its safety for the baby. Therefore, if it is necessary to take "Concor Cor" funds during this period, it is necessary to decide on the termination of lactation.
Similar medicines
The medicine “Concor Kor” has analogues (there are a lot of them) most often according to the main active component - bisoprolol. The medication itself is produced in Germany and Norway. Of the Russian analogues, such medicines as Aritel and Aritel Cor, Biprol, Bisoprolol-Prana are most often used. Although the latter is produced in many countries of the world: Bisoprolol Teva - Hungary, Israel, Bisoprolol-Lugal - Ukraine. Actually, the Concor is a direct analogue.
Further, the most frequently used similar products include “Bidop” and “Bidop Kor”, “Biol”, “Bisogamma”, “Bisomor”, “Kordinorm” and “Kordinorm Kor”, “Tirez”, “Niperten”.
In general, the list of analogues (synonyms) is quite wide and varied, but it is unacceptable to decide on how to replace "Concor Cor". The right to choose one or another medicine for replacement belongs only to the attending physician.
Interaction with other drugs
The use of two drugs at the same time can adversely affect the good effectiveness and tolerability of beta-blockers. As for the drug “Concor Kor” (indications for use, reviews of health care providers and patients confirm this reaction) intolerance can occur even if drugs similar in principle to the effect of exposure were taken after a short period of time after each other.
Next, patients taking bisoprolol need to know that allergens for immunotherapy or even extracts for skin tests can trigger the development of severe systemic allergic reactions or anaphylaxis. The simultaneous use of bisoprolol and iodine-containing contrast agents for intravenous administration can also lead to anaphylactic shock.
Diuretics, sympatholytics, and other antihypertensive drugs used in conjunction with bisoprolol can cause an excessive decrease in blood pressure.
Tetracycline antidepressants, antipsychotics, sedatives and sleeping pills depress the central nervous system. The effect of insulin or other hypoglycemic drugs similar to it for oral administration on the background of treatment with Concor Kor medication may increase. Symptoms of developing hypoglycemia (tachycardia in particular) may be suppressed or masked.
What to look for?
It is unacceptable for people to whom “Concor Cor” is prescribed for use to interrupt treatment on their own or change the recommended dosage without first consulting with your doctor. In such cases, a deterioration in the activity of the heart is possible. This is especially true for patients with coronary heart disease. If there is a need to stop treatment with the Concor Kor drug, the manufacturer recommends doing this, gradually reducing the dosage.
Beta-blockers are less effective in smokers than non-smokers.
Contact lens wearers should note that beta-blockers can cause a decrease in tear fluid production.
If the patient needs to undergo a planned surgical intervention, the reception of “Concor Kor” must be stopped completely at least 48 hours before the general anesthesia. If surgical intervention was required on an emergency basis, and the patient has already taken a beta blocker, then for general anesthesia he needs to choose a medication with a minimally negative inotropic effect.
In conclusion, I want to say that no matter what the testimony for Concor Kor medicine, reviews of high efficiency on the part of patients and health workers, the decision to assign Concor Kor to each specific person, and not to any other beta -blocker should only belong to the attending physician.