Concor core (active ingredient - bisoprolol) is the original German beta-1-blocker, used mainly to treat chronic heart failure.
Concor Cor is a selective (selective) beta-1-blocker without internal sympathomimetic activity.
Due to the correctly selected active substance, the drug quickly reduces Regin's activity, which is contained in the blood plasma, reduces the amount of oxygen necessary for the normal functioning of the myocardium, and reduces the number of contractions of the heart.
Selective beta1-adrenergic blocker without internal sympathomimetic activity.
Pharmacy sales terms
It is released on prescription.
How much is Concor Cor 2.5 mg in pharmacies? The average price is at the level of 180 rubles.
Release form and composition
Concor Cor - white coated tablets, biconvex, heart-shaped, with serif at both ends.
1 tablet contains:
- active ingredient: bisoprolol fumarate - 2.5 mg;
- auxiliary components: corn starch (fine powder), anhydrous calcium phosphate, anhydrous silicon colloid dioxide, crospovidone, magnesium stearate, microcrystalline cellulose;
- shell composition: macrogol 400, hypromellose 2910/15, titanium dioxide (E171), dimethicone 100.
Existing forms of release: 10 tablets in a blister, 3 blisters in a paper pack; 14 or 30 tablets in a blister, 1 blister in a paper pack; 25 tablets in a blister, 1 blister in a paper bundle.
Bisoprolol is a cardioselective beta-blocker without membrane stabilizing action and sympathomimetic activity. The drug contributes to the antiarrhythmic effect, protecting the heart from the effects of adrenaline and other potent hormones. A single pill application reduces the heart rate and myocardial oxygen demand. The probability of a "heart" lethal outcome decreases.
Almost completely (more than 90%) bisoprolol is absorbed through the gastrointestinal tract. A single meal is not affected by the bioavailability of the drug. Reaches the maximum blood concentration after 3 hours. Communication with blood proteins is about 35%. Metabolism occurs due to oxidation with the formation of water-soluble metabolites.
The distribution of bisoprolol is wide - 3.5 liters per 1 kg. Excreted through the kidneys. The withdrawal period is more than 12 hours.
Indications for use
“Cortikor Cor” helps in the treatment of heart failure, the development of which has reached a chronic form.
The drug has the following contraindications:
- Sinoatrial blockade.
- Bronchial asthma or COPD.
- Cardiogenic shock.
- Hypersensitivity to bisoprolol or other components of the drug.
- AV blockade.
- Acute and chronic (decompensation) heart failure.
- Arterial hypotension.
- Syndrome of the sinus node weakness.
- Violations of the arterial link of the peripheral circulation.
- Age up to 18 years.
- Metabolic acidosis.
Care should be taken when prescribing Concor Cora to patients undergoing desensitization therapy for AV block I degree, restrictive cardiomyopathy, congenital heart disease, valvular heart disease with severe hemodynamic disturbances, CHF with myocardial infarction during the last 3 months, hyperthyroidism, angina pectoris, heart failure with myocardial infarction during the last 3 months, hyperthyroidism, stenocardia, heart failure with myocardial infarction during the last 3 months, hyperthyroidism, angina , renal failure with creatinine clearance (CC) less than 20 ml / min, type I diabetes, diabetes mellitus with significant fluctuations in the concentration of glucose in the blood, psoriasis (including history), expressed impaired liver function, patients on a strict diet.
Use during pregnancy and lactation
During pregnancy, the appointment of Concor Cor is possible only in an exceptional case, when, according to the doctor, the expected benefit from therapy for the mother is much higher than the potential risk of side effects in the fetus.
Dosage and method of use
The instructions for use indicate that Concor Cor should be taken without chewing, in the morning during breakfast, with a small amount of liquid.
Standard therapy for chronic heart failure: ACE inhibitors or angiotensin II antagonists, β-adrenoreceptor blockers, diuretics, and, if necessary, cardiac glycosides.
Before treatment with bisoprolol, the patient should not have signs of exacerbation. Transient deterioration of heart failure, hypotension, or bradycardia during and after the titration period are possible.
Dose titration period
Treatment of chronic heart failure with bisoprolol begins according to the following titration scheme and can be adjusted depending on the individual reactions of the body.
- 1.25 mg bisoprolol fumarate 1 time per day for 1 week, if well tolerated, increase to
- 2.5 mg of bisoprolol fumarate 1 time per day for the next 1 week, if well tolerated, increase to
- 3.75 mg of bisoprolol fumarate 1 time per day for the next 1 week, if well tolerated, increase to
- 5 mg of bisoprolol fumarate once a day for the next 4 weeks, if well tolerated, increase to
- 7.5 mg of bisoprolol fumarate 1 time per day for the next 4 weeks, if well tolerated, increase to
- 10 mg of bisoprolol fumarate 1 time per day as maintenance therapy.
The maximum recommended dose of bisoprolol fumarate is 10 mg 1 time per day.
During the titration period, careful monitoring of vital signs (blood pressure, heart rate) and symptoms of heart failure progression is necessary. Symptoms may develop from the first day after the start of treatment.
If the maximum recommended dose is poorly tolerated, a gradual dose reduction is possible. If during the period of titration or after it there is a worsening of heart failure, arterial hypotension or bradycardia develops, it is recommended to adjust the dosage of the drug, which may require a temporary reduction in the dose of bisoprolol or suspension of treatment. After the patient's condition has stabilized, the possibility of re-initiating treatment with bisoprolol should always be considered.
The treatment of stable chronic heart failure with bisoprolol is a long one.
Do not stop treatment suddenly and change the recommended dosage without consulting a doctor, as this may worsen the patient's condition. If necessary, treatment with the drug should be completed slowly, gradually reducing the dose.
Patients with impaired liver or kidney function
There is no data on the pharmacokinetics of bisoprolol in patients with chronic heart failure simultaneously with impaired liver or kidney function, therefore, it is necessary to increase the dose with extreme caution.
Children and the elderly
Elderly patients do not require dose adjustment.
Clinical data on the efficacy and safety of the drug in children are not available, so bisoprolol is not recommended for use in pediatric practice.
Possible side effects of drug treatment include:
- From the organ of hearing: rarely - hearing impairment;
- On the part of the organ of vision: rarely - a decrease in tear secretion; very rarely - conjunctivitis;
- From the musculoskeletal system: infrequently - muscle cramps, muscle weakness;
- From the reproductive system: rarely - a violation of potency;
Since the cardiovascular system: very often - bradycardia; often - a feeling of numbness or cooling in the limbs, a pronounced decrease in blood pressure, aggravation of the symptoms of CHF; infrequently - orthostatic hypotension, violation of AV conduction;
- From the side of the central nervous system: often - headache, dizziness; rarely - loss of consciousness;
mental disorders: infrequently - insomnia, depression; rarely, nightmares, hallucinations;
- On the part of the digestive system: often - nausea, vomiting, constipation, diarrhea; rarely, hepatitis;
- Laboratory indicators: rarely - an increase in the concentration of triglycerides, the activity of liver enzymes in the blood plasma (alanine aminotransferase and aspartate aminotransferase);
- On the part of the respiratory system: Infrequently - bronchospasm (with a history of bronchial asthma or airway obstruction); rarely - allergic rhinitis;
- dermatological reactions: rarely - hypersensitivity reactions (pruritus, rash, hyperemia); very rarely - alopecia; in psoriasis, possible exacerbation of symptoms of the disease, psoriasis-like rash;
- General disorders: often - fatigue, asthenia.
Symptoms: bronchospasm, AV-blockade, bradycardia, hypoglycemia, excessive pressure reduction, acute heart failure.
Overdose therapy: discontinuation of the drug and symptomatic therapy.
When using contact lenses should take into account the possible reduction during therapy with tear fluid.
When prescribing the drug, the doctor should warn the patient that it is possible to change the recommended dose or stop the use of Concor Corus only after consulting him.
The effect of bisoprolol and its tolerability may be affected by the simultaneous use of any other drugs, even non-prescription drugs, so it is not recommended to take other drugs without consulting a doctor.
Discontinuation of the drug should be carried out by gradually reducing the applied dose, since an abrupt cessation of therapy can lead to a deterioration in the activity of the heart, especially in patients with ischemic disease.
In patients with bronchial asthma or chronic obstructive pulmonary disease, use of Concor bark is possible only when combined with bronchodilators. In bronchial asthma, there is a risk of increasing the resistance of the respiratory tract, which may require a higher dose of beta2-adrenomimetics.
When prescribing a planned surgical intervention with the use of drugs of general anesthesia, it is necessary to start in advance the abolition of the drug, so that its completion occurs 48 hours before the start of anesthesia. The anesthesiologist must be informed that the patient was on treatment with Concor Cor.
Tablets should be used with caution in diabetes mellitus with significant fluctuations in the level of glucose concentration in the blood, since the drug can mask such symptoms of hypoglycemia as tachycardia, excessive sweating, palpitations.
With pheochromocytoma, the appointment of Concor bark is possible only against the background of taking alpha-blockers.
Bisoprolol treatment may mask the symptoms of hyperthyroidism.
We must take into account the weakening of adrenergic compensatory regulation against the background of the action of beta-blockers, which may result in the patient's increased sensitivity to allergens and the development of severe anaphylactic reactions. In this case, treatment with adrenaline (epinephrine) may not have the expected therapeutic efficacy.
When using the drug, you must consider the interaction with other drugs:
- Do not drink alcoholic beverages during the course of treatment with Concor Cor.
- When used simultaneously, Concor Cor can enhance the effects of antihypertensive drugs.
- In the case of simultaneous use of the drug Concor Cor and sympathomimetics, it is possible to reduce the action of bisoprolol.
- With the combined use of the drug Concor Cor and guanfacine, alpha methyldopa, reserpine or clonidine, a sharp decrease in heart rate is possible.
- With the simultaneous use of the drug Concor Cor and preparations of digitalis, guanfacine or clonidine, conduction disturbance is possible.
We picked up some reviews of people who used the drug Concor Cor:
- Svetlana When my mother (67 years old) was diagnosed with coronary heart disease, I was in a panic. There are many medications, but which one is better and more effective? Rescued a friend - she had the same problems, but she drank Concor Cor, and he helped her bounce back. For 4 months, mother takes this miracle drug (with the permission of the doctor) and jokes that she feels better than in her youth.
- Zoya I am an elderly person who used Concor for many years. I assigned this medicine to a cardiologist with a dose of 1.25 mots and I gradually increased: 2.5 then 5 mg. I was well and I drank a few le, then began to reduce the dose and stopped drinking. For many years I did without him. And now Concorde has again been appointed to me and I will be treating them for hypertension, Ishimyu, Cardiac insufficiency in combination with other medications.
- Marina. After the second late delivery, I began to “bounce” the pressure, and then I became constantly high. After a consultation at the hospital, Concor Cor was appointed. The price of the drug is acceptable, the tablet is easily divided into parts. I accept almost half a year and I can not rejoice. The pressure returned to normal. Thanks to the doctor for good medicine!
The most frequently used analogues of “Concor Bark” include the following medications:
- “Aritel Cor”;
- “Bidop Cor”;
- “Kondinorm Cor”;
Before using analogues consult your doctor.
Storage conditions and shelf life
Store at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life - 3 years.