In the article, we consider the instructions for use and reviews for the Concor medication.
The drug is used to treat coronary heart disease, high blood pressure, heart failure and stable angina in adults, as well as during pregnancy and breastfeeding.
Pharmacological properties
“Concor” is a selective beta-1-blocker, without sympathomimetic activity, it does not have a membrane-stabilizing effect. It has a slight effect on beta-2-adrenergic receptors of the smooth muscles of the bronchial vessels, as well as on beta-2-adrenergic receptors, which are involved in the regulation of metabolic processes. With this in mind, the main active substance of this drug bisoprolol is not able to exert an effect on metabolic processes in which beta-2-adrenergic receptors are involved, as well as on respiratory resistance.
The selective effect of the drug on beta-1-adrenergic receptors also persists beyond the therapeutic range. The active element does not have a significant negative inotropic effect, reduces the functionality of the sympathoadrenal system, blocks beta-1-adrenergic receptors in the heart. When taken once in patients with coronary artery disease without signs of chronic heart failure, bisoprolol lowers heart rate, minimizes stroke volumes of the heart and reduces ejection fractions, and also reduces myocardial oxygen demand. With prolonged therapy, increased OPSS gradually decreases. A decrease in the level of renin activity in the blood is considered as a hypotensive effect of beta-blocker. The maximum effect of the drug is achieved four hours after ingestion. Reviews about "Concor" are available in large numbers, so they will help to give an objective assessment of this drug.
Pharmacokinetics
Even when the medication is prescribed 1 time per day, its therapeutic effectiveness is maintained throughout the day due to the fact that its half-life from the blood is approximately 12 hours. The maximum decrease in blood pressure is achieved approximately 14 days after the course of therapy.
The medication "Concor" is almost completely (> 90%) absorbed from the digestive organs. Eating does not affect the bioavailability of the active substance. Bisoprolol clearance is determined by the balance between the conversion in the liver to metabolites excreted by the kidneys and excretion by the same organs. Reviews on the use of Concor are mostly positive.
Indications for use
A medical device is indicated for the following pathological conditions:
- arterial hypertension;
- regular angina pectoris;
- CHD:
- chronic heart failure.
Release form
This pharmacological agent is available in tablet form. The tablets are coated with a special coating and contain 2.5, 5 or 10 mg of the active element. They are white in color, biconvex, heart-shaped and at risk on both sides. According to reviews, "Concor" 2.5 mg is prescribed most often.
Structure
One tablet contains the main active element - bisoprolol fumarate (2.5 mg) and additional elements: calcium hydrogen phosphate anhydrous, corn starch, magnesium stearate, anhydrous colloidal silicon dioxide, microcrystalline cellulose, crospovidone. The contents of the film membrane include: hypromellose, macrogol 400, dimethicone, titanium oxide.
The tablets of the Concor medication are packaged in blisters, 30 pieces each, in cardboard packs with detailed instructions for use.
Reviews on "Concor" 2.5 mg will be considered below.
Dosage and method of use
This medication is taken orally, once a day. Tablets should be washed with a small amount of water on an empty stomach, before breakfast, either during or immediately after it. They should not be chewed or crushed.
With arterial hypertension and angina pectoris, the dosage is selected strictly individually, taking into account the heart rate and the general condition of the patient. The initial dose for this disease may be 5 mg. Instructions for use and reviews of "Concor" confirm that the product is usually well tolerated.
If necessary, you can start taking 10 mg. The maximum recommended dosage should be no more than 20 mg per day.
In case of chronic heart failure, the standard therapeutic regimen includes the appointment of ACE inhibitors or angiotensin 2 receptor antagonists (in cases of intolerance to the former), cardiac glycosides, diuretics, beta-blockers.
At the beginning of the treatment of chronic heart failure of a chronic nature with the Concor drug, the titration phase is required under medical supervision. A prerequisite for this is stable heart failure in the chronic stages without symptoms of exacerbation.
Individual adaptation may be necessary depending on the tolerability of the prescribed dosage to patients, i.e., the dosage can be increased only if the previous dosage was well tolerated. To ensure the titration process at the beginning of treatment, it is recommended to use bisoprolol in the form of tablets in a dosage of 2.5 according to the instructions.
Reviews about the Concor are of interest to many.
Recommended starting dosages are 1.25 mg once daily. Taking into account tolerance, the dose must be slowly increased - from 2.5 mg to 3.75 mg, then 5 mg, then 7.5 mg, up to 10 mg per day once.
Each increase in dosage should be carried out at intervals of two weeks. During titration, regular monitoring of heart rate, blood pressure and the severity of symptoms of heart failure is necessary. Strengthening the symptoms of this disease is possible already in the first days of the use of the drug. If the patient does not tolerate the recommended maximum dosage of the drug, the possibility of its reduction should be determined. This is indicated in the instructions.
According to Concor reviews, 5 mg is the most optimal dose.
Therapy with a medical agent is, as a rule, very long. Elderly patients do not require dosage adjustment.
Since babies do not have enough clinical studies of the Concor medication, it is not recommended to take this drug to children under 18 years of age.
Currently, there is not so much data regarding the use of the drug in patients with heart failure with type 1 diabetes mellitus. The same can be said about impaired renal or liver function, congenital heart defects or one of the heart valves with hemodynamic changes. In addition, until now, sufficient data regarding patients with restrictive cardiomyopathy, heart failure, and concomitant myocardial infarction have not been obtained.
Side effects
According to reviews of Concor, the following undesirable side reactions may appear during treatment with a medication:
- bradycardia (in patients with heart failure);
- increased symptoms of chronic heart failure;
- a feeling of numbness or cold in the limbs;
- marked decrease in blood pressure (most often in patients with heart failure);
- dizziness;
- orthostatic hypotension;
- cephalgia;
- loss of consciousness;
- sleep disturbance;
- depression;
- reduction of lacrimation, which must be taken into account when wearing lenses;
- hallucinations;
- hearing impairment;
- bronchospasm (most often in patients with bronchial asthma or obstructive airways pathologies);
- conjunctivitis;
- dyspepsia;
- stool disorders;
- muscle weakness;
- cramps
- violation of potency;
- itching, rash, and redness of the skin;
- allergic rhinitis;
- fatigue;
- asthenia.
Contraindications
What else does the instruction manual for Concor tell us? (Reviews and analogues will be considered at the end of the article).
This drug is prohibited for use with the following pathologies:
- heart failure in acute form, as well as in chronic form in the stage of decompensation, which requires drug therapy with a positive inotropic effect;
- cardiogenic shock;
- SSSU;
- AV block of the second and third degree, in the absence of a pacemaker;
- sinoatrial block;
- a strong drop in blood pressure;
- marked reduction in heart rate;
- severe types of bronchial asthma;
- severe disturbance of peripheral circulation ;
- metabolic acidosis;
- pheochromocytoma (without the concomitant use of alpha-blockers);
- age up to 18 years;
- Raynaud's disease;
- high sensitivity to drug substances.
Use during pregnancy and maternal feeding
During pregnancy, the use of the Concor medicine is possible only when the intended effect for the mother outweighs the risk for the unborn child.
Beta-blockers can reduce blood flow in the placenta and can affect the formation of the fetus. Therefore, during treatment with this drug, uterine and placental blood flow should be carefully monitored, as well as monitoring the growth and development of the fetus. In cases of undesirable symptoms, it is recommended to take alternative therapeutic measures.
In addition, it is necessary to examine the baby after childbirth. In the first few days of life, symptoms of hypoglycemia and a decrease in heart rate may occur.
There is no data on the penetration of bisoprolol into breast milk, so the use of the drug is not recommended during lactation.
Special recommendations
Patients are not recommended to abruptly interrupt therapy and change dosages without consulting a doctor, as this can lead to a significant deterioration in heart activity. Antidepressants, antipsychotics, ethanol, sleeping pills and sedatives increase the inhibition of the nervous system.
With caution, this drug is used for diabetes mellitus with fluctuations in blood glucose levels, in patients on a diet, during desensitizing treatment, with angina pectoris, AV blockade of the first degree, mild peripheral circulation disorder, with psoriasis. In bronchial asthma, the simultaneous use of bronchodilating drugs is indicated.
Concor can increase sensitivity to allergens due to weakening of adrenergic regulation under the influence of beta-blockers. When performing general anesthesia, it is necessary to take into account the risk of developing beta-adrenoreceptor blockade.
According to reviews, analogues of "Concor" are no worse.
Analogs
Similar drugs in structural content and in the main active element are:
- Aritel
- Bidop;
- “Aritel Cor”;
- "Biol";
- "Bisogamma";
- "Bisomor";
- "Niperten";
- Bisoprolol-Lugal;
- "Bisoprolol-ratiopharm";
- "Bisoprolol hemifumarate";
- "Concor Cor";
- Cordinorm;
- Corbis
- Tirez.
- Coronal.
Reviews for Concor
Patient reviews about this drug are mostly positive. Patients to whom it was prescribed observed a significant improvement in well-being against the background of frequent jumps in blood pressure and various heart diseases. They noted that their heart rate returned to normal, which also affected the general condition and level of pressure. The only minus of the drug, they believe is that during treatment, negative symptoms often occur, such as dizziness, sleep disturbance, mood changes, as well as problems with the digestive system.
Reviews about "Concor" from experts once again prove that it is a very effective medication, the action of which is aimed at stabilizing cardiac and vascular activity. However, doctors do not recommend self-medication, since the heart is an important organ, and treating such pathologies on their own is extremely dangerous. This is a very serious medication, so it should be prescribed by a specialist.
We reviewed the instructions for use and reviews of the Concor.