Concor and Concor Cor are medications belonging to the group of adrenergic blockers. The drugs in this group are used for treatment, the purpose of which is to eliminate hypertension, angina attacks, ischemia and congestive insufficiency.
Concor and Concor Cor are medications belonging to the group of adrenergic blockers.
The drugs are analogues of each other and have not only similar names, but also chemical composition. For this reason, it is difficult for the patient to determine on his own which is better: Concor or Concor Cor. This question can only be answered by the attending physician treating the patient.
Compound similarities
Both products have the same composition, so they can be considered different forms of the same medication. In both versions of the drug, the active ingredient is bisoprolol fumarate.
In addition to the main component, the tablets of both types of medicine contain the following compounds that play an auxiliary role:
- calcium hydrogen phosphate;
- corn starch;
- colloidal form of silicon dioxide;
- MCC;
- magnesium stearate;
- crospovidone.
The tablet shells of both drugs also have a similar composition, with the exception of a set of dyes that give the drugs their color. Concor tablets have a light orange color due to the content of yellow iron oxide tablets in the shell, which is absent in the Concor Cora shell.
The drugs have antiarrhythmic, hypotensive, and antianginal properties.
The characteristic difference between the drugs Concor and Concor Cor
Dosage forms of the pharmaceutical product are distinguished by the appearance of tablets, which are stylized in shape to resemble a heart. The design of drug packaging is different.
The main difference is the difference in the dosage of the main component: Concor Cora contains 2.5 mg, while Concor is produced in dosages of 5 and 10 mg.
The difference between the drugs is in the form of the package and the number of tablets in it. A drug with a concentration of 2.5 mg of the active ingredient is sold in blisters containing 10 tablets, and the package can have 10, 5 or 3 such blisters. Concor is packaged in packs of 30-50 and 90 tablets.
The high-dose form of Concor is used in the treatment of hypertension and angina pectoris.
Medicines differ in cost: the high-dose form has a higher price compared to the low-dose form of the drug.
A high-dose form of the drug is used in the treatment of hypertension and angina. Bisoprolol in high concentrations can relieve symptoms characteristic of pathologies in the heart without harm to the human body. The dosage of the drug in the treatment of hypertension and coronary artery disease is determined by the attending physician separately for each person.
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A low-dose form of the drug is prescribed for detected heart failure. When treating this pathological phenomenon in the heart, the initial dosage of the drug is 1.25 mg. During further therapy, if necessary, the patient can be switched by the doctor to take medication with a concentration of the active ingredient of 5 or 10 mg.
A large dosage can pose a danger to the patient’s body in the presence of CHF.
Concor Cor has limited indications for use. The drug is recommended for use in elderly people who suffer from heart failure to relieve the negative processes that occur in patients with this disease.
Concor
Concor are tablets containing 5 or 10 mg of bisoprolol.
Each package contains 30 or 50 tablets. The manufacturer of the beta blocker is the Russian company Merck KGAA. The price of tablets is from 197 to 483 rubles.
Concor is prescribed for CHF, high blood pressure and ischemic heart disease, accompanied by angina pectoris.
Contraindications:
- SSSU
- Bronchospasms
- Shock
- Pheochromocytoma
- AV block
- Peripheral circulatory disorders
- Exacerbation of CHF
- Psoriatic rashes
- Heart block.
Concor is drunk in the morning once a day. The minimum dose is 2.5-5 mg. Slowly increase the dosage to 10 or 20 mg.
The use of Concor occasionally provokes visual, vascular, digestive, and immune disorders. Deterioration in the function of the central nervous system, heart, reproductive and respiratory systems is also likely.
Contraindications
Both varieties have similar contraindications for use, which should be taken into account when prescribing the drug for drug therapy.
In accordance with the instructions for use, contraindications to treatment with the drug are:
- acute heart failure;
- decompensated heart failure in chronic form;
- AV blockade 2-3 degrees;
- cardiogenic shock;
- sinoatrial block;
- bradycardia;
- decreased blood pressure;
- presence of bronchial asthma and COPD;
- metabolic acidosis;
- changes in peripheral arterial circulation;
- age less than 18 years;
- allergy to components.
During pregnancy, drug treatment is possible only if it is required to maintain the health of the mother. Bisoprolol has the ability to reduce the speed of blood flow in the placenta, which provokes malnutrition of the fetus, and this can cause problems with its development. During pregnancy and breastfeeding, when using medications, strict monitoring of the condition of the mother and child is necessary.
Instructions for use CONCOR® (CONCOR)
The drug is taken orally 1 time/day. The tablets should be taken with a small amount of liquid in the morning before, during or after breakfast. The tablets should not be chewed or crushed into powder.
Arterial hypertension and angina pectoris
The dose is selected individually, primarily taking into account the heart rate and the patient’s condition.
As a rule, the initial dose is 5 mg of Concor® 1 time / day. If necessary, the dose can be increased to 10 mg 1 time / day. For the treatment of arterial hypertension and angina pectoris, the maximum recommended dose is 20 mg of Concor® 1 time per day.
Chronic heart failure
The standard treatment regimen for chronic heart failure includes the use of ACE inhibitors or angiotensin II receptor antagonists (in case of intolerance to ACE inhibitors), beta-blockers, diuretics and, optionally, cardiac glycosides. At the beginning of treatment of chronic heart failure with Concor® or Concor® Cor, a special titration phase is required under regular medical supervision.
The precondition for treatment with Concor® or Concor® Cor is stable chronic heart failure without signs of exacerbation.
Treatment with Concor® or Concor® Cor begins in accordance with the following titration scheme. Individual adaptation may be required depending on how well the patient tolerates the prescribed dose, i.e. the dose can only be increased if the previous dose was well tolerated.
To ensure an appropriate titration process, it is recommended to use bisoprolol in the dosage form of 2.5 mg tablets at the initial stages of treatment.
The recommended starting dose is 1.25 mg 1 time/day. Depending on individual tolerance, the dose should be gradually increased to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg 1 time / day. Each subsequent dose increase should be carried out at least 2 weeks later. If increasing the dose of the drug is poorly tolerated by the patient, then a dose reduction is possible.
The maximum recommended dose for the treatment of chronic heart failure is 10 mg 1 time / day.
During titration, regular monitoring of blood pressure, heart rate and the severity of symptoms of chronic heart failure is recommended. Worsening of the symptoms of chronic heart failure is possible from the first day of using the drug.
If the patient does not tolerate the maximum recommended dose of the drug, then a gradual dose reduction should be considered.
During the titration phase or after it, a temporary worsening of chronic heart failure, arterial hypotension or bradycardia is possible. In this case, it is recommended, first of all, to adjust the doses of concomitant therapy drugs. It may also be necessary to temporarily reduce the dose of the drug or discontinue it. After stabilization of the patient's condition, the dose should be re-titrated or treatment should be continued.
Duration of treatment for all indications
Treatment with Concor® or Concor® Cor is usually long-term.
Special patient groups
Patients with mild or moderate liver or kidney dysfunction
As a rule, no adjustment of the dosage regimen is required.
In case of severe renal dysfunction (creatinine clearance less than 20 ml/min) and in patients with severe liver diseases
the maximum daily dose is 10 mg. Increasing the dose in such patients should be carried out with extreme caution.
Elderly patients
no dose adjustment is required.
Because there is not enough data on the use of Concor® or Concor® Cor in children; it is not recommended to prescribe the drug to children under 18 years of age
.
To date, there is insufficient data regarding the use of Concor® or Concor® Cor in patients with chronic heart failure in combination with type 1 diabetes mellitus, severe renal and/or liver dysfunction, restrictive cardiomyopathy, congenital heart defects or heart valve disease with severe hemodynamic violations. Also, sufficient data have not yet been obtained regarding patients with chronic heart failure with myocardial infarction within the last 3 months.
How to take Concor and Concor Cor?
According to the instructions, the tablets should be taken orally, the drug should be taken once - in the morning. The intake should be accompanied by washing down the tablet with a small amount of water; The tablets cannot be chewed.
If a patient is diagnosed with arterial hypertension and angina pectoris, the dosage of the drug is determined by the doctor individually, taking into account the clinical course of the pathology and the individual physiology of the patient’s body. The recommended initial dosage of Concor is 5 mg once a day. If necessary, the doctor can increase the dose by 5 mg per day. For drug treatment of hypertension and angina pectoris, the maximum permissible dosage of the drug is no more than 20 mg per day.
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In case of heart failure, the medication regimen involves the appointment of:
- ACE inhibitors or angiotensin blockers.
- Diuretics.
- Beta blockers.
- Cardiac glycosides.
High dosage medication should not be prescribed to patients under 18 years of age.
Treatment of chronic insufficiency using the low-dose version of Concor Cora requires preliminary titration and constant monitoring by a physician.
The duration of the course is determined by the doctor supervising the treatment process.
Treatment of chronic insufficiency using a low-dose version of the drug requires preliminary titration and constant monitoring by a physician. The maximum permissible dosage of the drug for chronic insufficiency is 10 mg per day.
After the initial dose of the medicine, the patient should be observed by a doctor for 4 hours. During this period, the doctor needs to monitor pulse, blood pressure and conductivity indicators.
Drugs should be prescribed with caution when:
- hypoglycemia due to the development of diabetes mellitus;
- pathologies in the thyroid gland;
- Prinzmetal's angina;
- strict diet;
- mild to moderate arterial circulatory disorders;
- AV blockade of the first degree;
- psoriasis.
In addition, caution is necessary when following a strict diet and when carrying out desensitizing treatment.
The regimen for taking Concor Cora and the dose are determined by the doctor in accordance with the characteristics of the patient’s body.
Concor® cor
The patient should not abruptly interrupt treatment or change the recommended dose without first consulting a doctor, as this may lead to a temporary deterioration in heart function. Treatment should not be interrupted suddenly, especially in patients with coronary artery disease. If discontinuation of treatment is necessary, the dose should be reduced gradually.
Monitoring the condition of patients taking Concor Cor should include measuring heart rate and blood pressure (at the beginning of treatment - daily, then once every 3-4 months), conducting an ECG, determining blood glucose in patients with diabetes (once every 4-5 months). months). In elderly patients, it is recommended to monitor renal function (once every 4-5 months).
The patient should be trained in the method of calculating heart rate and instructed about the need for medical consultation if heart rate is <50 beats/min.
Before starting treatment, it is recommended to conduct a study of external respiratory function in patients with a burdened bronchopulmonary history.
In approximately 20% of patients with angina, beta blockers are ineffective. The main reasons: severe coronary atherosclerosis with a low ischemic threshold (heart rate <100 beats/min) and increased end-diastolic volume of the left ventricle, impairing subendocardial blood flow.
Beta blockers are less effective in smokers.
Patients who use contact lenses should take into account that during treatment with the drug, the production of tear fluid may decrease.
When using the drug Concor Cor in patients with pheochromocytoma, there is a risk of developing paradoxical arterial hypertension (if effective alpha-blockade is not previously achieved).
In case of thyrotoxicosis, Concor Cor can mask certain clinical signs of thyrotoxicosis (for example, tachycardia). Abrupt discontinuation of the drug in patients with thyrotoxicosis is contraindicated as it can increase symptoms.
In diabetes mellitus, the use of the drug may lead to masking of tachycardia caused by hypoglycemia. Unlike non-selective beta-blockers, Concor Cor practically does not increase insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentrations to normal levels.
When using clonidine simultaneously, its use can be discontinued only a few days after discontinuation of the drug Concor Cor.
It is possible that the severity of the hypersensitivity reaction may increase and there will be no effect from usual doses of epinephrine against the background of a burdened allergic history.
If planned surgical treatment is necessary, the drug should be discontinued 48 hours before general anesthesia. If the patient took the drug before surgery, he should select a drug for general anesthesia with minimal negative inotropic effects.
Reciprocal activation of the vagus nerve can be eliminated by intravenous atropine (1-2 mg).
Drugs that deplete catecholamine stores (including reserpine) may enhance the effect of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision to detect a significant decrease in blood pressure or bradycardia.
Patients with bronchospastic diseases can be prescribed cardioselective blockers in case of intolerance and/or ineffectiveness of other antihypertensive drugs. If the dose of Concor Cor is exceeded, there is a risk of developing bronchospasm.
If increasing bradycardia (heart rate <50 beats/min), a pronounced decrease in blood pressure (systolic blood pressure <100 mm Hg), or AV blockade is detected in elderly patients, it is necessary to reduce the dose or discontinue treatment.
It is recommended to discontinue therapy with Concor Cor if depression develops.
Treatment should not be abruptly interrupted due to the risk of developing severe arrhythmias and myocardial infarction. The drug is discontinued gradually, reducing the dose over 2 weeks or more (reduce the dose by 25% in 3-4 days).
The drug should be discontinued before testing the content of catecholamines, normetanephrine, vanillinmandelic acid, and antinuclear antibody titers in the blood and urine.
Impact on the ability to drive vehicles and operate machinery
Bisoprolol does not affect the ability to drive a car in a study of patients with coronary artery disease. However, due to individual reactions, the ability to drive a car or work with technically complex mechanisms may be impaired. Particular attention should be paid to this at the beginning of treatment, after changing the dose, and also when consuming alcohol at the same time.
Side effects of Concor and Concor Cora
Common undesirable body reactions may include slow heartbeat, hypotension, nausea, and poor health.
In addition, the following side effects may occur during therapy:
- bradycardia, worsening of chronic heart failure, numbness, severe decrease in blood pressure, orthostatic hypotension;
- dizziness, loss of consciousness, headache, depression, insomnia, nightmares;
- attacks of bronchial asthma;
- cramps, muscle weakness;
- hearing damage, conjunctivitis;
- diarrhea, vomiting;
- increased levels of liver enzymes in the blood;
- decreased potency;
- alopecia;
- itching, rash, redness of the skin, allergic rhinitis.
A product with a minimal amount of active ingredient has a similar list of side effects that occur when using it.
Reviews from doctors
Chamorovsky A. N., cardiologist, work experience 9 years
Concor is a gold standard selective beta blocker that is effective for use in patients with coronary artery disease. Has an effect aimed at reducing the number of heart contractions. Used in patients with heart failure. The drug has an affordable price, which allows it to be used in the treatment of different groups of the population.
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Zafiraki V.K., cardiologist, 18 years of experience
Concor is an original drug, but it is not much more expensive than generics. At the same time, the original drug is the standard of therapeutic effect and safety, and generics can only come close to the original. Well tolerated, side effects typical of beta blockers are rare. Concor is one of the safest in its class.
Sometimes a drug's reputation is damaged if it is used for other purposes. Then there will be no result, and the patient will remain disappointed. Not every pain in the chest, even if on the left, in the region of the heart, is angina. Accordingly, Concor, although it has angina therapy among its indications, will not help if the pain is of a different origin. Only a doctor can figure out what kind of pain it is.
Concor Cor, 30 pcs., 2.5 mg, film-coated tablets
The effectiveness and tolerability of bisoprolol may be affected by the simultaneous use of other drugs. Such interaction can also occur in cases where 2 drugs are taken after a short period of time. The doctor must be informed about taking other drugs, even if they are taken without a doctor’s prescription (i.e. over-the-counter drugs).
Combinations not recommended
Class I antiarrhythmic drugs (for example, quinidine, disopyramide, lidocaine, phenytoin, flecainide, propafenone), when used simultaneously with bisoprolol, can reduce AV conduction and cardiac contractility.
BMCCs such as verapamil and, to a lesser extent, diltiazem, when used simultaneously with bisoprolol, can lead to a decrease in myocardial contractility and impaired AV conduction. In particular, intravenous administration of verapamil to patients taking beta-blockers can lead to severe arterial hypotension and AV block.
Centrally acting antihypertensives (such as clonidine, methyldopa, moxonidine, rilmenidine) can lead to a decrease in heart rate and cardiac output, as well as vasodilation due to a decrease in central sympathetic tone. Abrupt withdrawal, especially before discontinuation of beta-blockers, may increase the risk of developing rebound hypertension.
Combinations requiring special caution
BMCC, dihydropyridine derivatives (for example, nifedipine, felodipine, amlodipine), when used simultaneously with bisoprolol, may increase the risk of developing arterial hypotension. In patients with CHF, the risk of subsequent deterioration in cardiac contractility cannot be excluded.
Class III antiarrhythmic drugs (eg amiodarone) may worsen AV conduction disturbances.
The effect of topical β-blockers (for example, eye drops for the treatment of glaucoma) may enhance the systemic effects of bisoprolol (lowering blood pressure, lowering heart rate).
Parasympathomimetics, when used simultaneously with bisoprolol, may enhance AV conduction disturbances and increase the risk of developing bradycardia.
The hypoglycemic effect of insulin or oral hypoglycemic agents may be enhanced. Signs of hypoglycemia - in particular tachycardia - may be masked or suppressed. Such interactions are more likely when using non-selective beta-blockers.
Agents for general anesthesia may increase the risk of cardiodepressive effects, leading to arterial hypotension (see "Special Instructions").
Cardiac glycosides, when used simultaneously with bisoprolol, can lead to an increase in impulse conduction time and, thus, to the development of bradycardia.
NSAIDs may reduce the hypotensive effect of bisoprolol.
The simultaneous use of Concor® Cor with β-adrenergic agonists (for example, isoprenaline, dobutamine) may lead to a decrease in the effect of both drugs.
The combination of bisoprolol with adrenergic agonists that affect β- and α-adrenergic receptors (for example, norepinephrine, epinephrine) may enhance the vasoconstrictor effects of these drugs that occur with the participation of α-adrenergic receptors, leading to an increase in blood pressure. Such interactions are more likely when using non-selective beta-blockers.
Antihypertensive drugs, as well as other drugs with a possible antihypertensive effect (for example, tricyclic antidepressants, barbiturates, phenothiazines), may enhance the hypotensive effect of bisoprolol.
Mefloquine, when used simultaneously with bisoprolol, may increase the risk of bradycardia.
MAO inhibitors (except MAO B inhibitors) may enhance the hypotensive effect of beta-blockers. Concomitant use may also lead to the development of a hypertensive crisis.
Patient reviews
Vadim, Stavropol
I have heart arrhythmia and have attacks of tachycardia. I can recommend the drug as a fast-acting remedy for arrhythmia; you can forget about attacks of tachycardia.
The advantages of the drug are underestimated. Side effects that arise when taking it: increased fatigue, poor attention, headache, slight dizziness, and most importantly, dry eye syndrome - severe pain in the eyes appears, and it’s simply impossible to work at the computer!
You should be careful with a weak pulse at night, how many times have you woken up from acute lack of air.
Olga B., Krasnodar
Concor is an effective drug for high blood pressure. The advantage of its use is its positive effect on both the heart and blood vessels. The cost of this drug is low. The only inconvenience is that you have to take the pills constantly. If I forget to drink, my blood pressure rises again.
