Concor Cor

Concoror corpus (active substance - bisoprolol) is the original German beta-1-blocker, used mainly for the treatment of chronic heart failure.

Concoror cortex is a selective beta-1-adrenoblocker with no intrinsic sympathomimetic activity.

Due to the correctly selected active substance, the drug rapidly reduces the activity of Regin, which is contained in the blood plasma, reduces the amount of oxygen necessary for normal functioning of the myocardium, reduces the number of the contracting heart.

Clinical and pharmacological group

Selective beta-1-adrenoblocker without internal sympathomimetic activity.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Concor Cor 2.5 mg in pharmacies? The average price is at the level of180 rubles.

Form of issue and composition

Concor Cor - tablets covered with a white membrane, biconvex, cordate, with a notch from both ends.

1 tablet contains:

active substance: bisoprolol fumarate - 2.5 mg;
auxiliary components: corn starch (fine powder), calcium hydrophosphate anhydrous, silicon dioxide colloidal anhydrous, crospovidone, magnesium stearate, microcrystalline cellulose;
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composition of the envelope: macrogol 400, hypromellose 2910/15, titanium dioxide (E171), dimethicone 100.

Existing forms of release: 10 tablets in a blister, 3 blisters in a paper bundle; 14 or 30 tablets in a blister, 1 blister in a paper bundle; 25 tablets in a blister, 1 blister in a paper bundle.

Pharmacological effect

Bisoprolol is a cardioselective beta-blocker with no membrane-stabilizing action and sympathomimetic activity. The drug contributes to the emergence of antiarrhythmic effect, the protection of the heart from the influence of adrenaline and other potent hormones. Single use of tablets reduces the heart rate and the need for myocardium in oxygen. The probability of a "cardiac" lethal outcome decreases.

Almost completely (more than 90%) bisoprolol is absorbed through the digestive tract. The bioavailability of the drug does not affect a single meal. Achieves maximum concentration in the blood after 3 hours. The connection with blood proteins is about 35%. Metabolism occurs due to oxidation with the formation of water-soluble metabolites.

Distribution of bisoprolol is wide - 3.5 l per 1 kg. It is excreted through the kidneys. Shelf life is more than 12 hours.

Indications for use

"Kortikor Kor" helps in the treatment of heart failure, the development of which has reached a chronic form.

Contraindications

The following contraindications for the drug:

Sinoatrial blockade.
Bronchial asthma or COPD.
Cardiogenic shock.
Hypersensitivity to bisoprolol or other constituents of the drug.
AV blockade.
Acute and chronic (decompensated) heart failure.
Hypotension arterial.
Syndrome of weakness of the sinus node.
Bradycardia.
Violations of the arterial link of peripheral circulation.
Pheochromocytoma.
Age to 18 years.
Metabolic acidosis.

Caution should be exercised in prescribing Coronecor Concom to patients on desensitizing therapy, with AV block I degree, restrictive cardiomyopathy, congenital heart disease, heart valve disease with severe hemodynamic disorders, CHF with myocardial infarction in the last 3 months, hyperthyroidism, Prinzmetal angina, renal insufficiency with creatinine clearance (CC) less than 20 ml / min, diabetes mellitus type I, diabetes mellitus with significant fluctuations blood glucose levels, psoriasis (including anamnesis), severe liver function disorders, patients on a strict diet.

Use in pregnancy and lactation

During pregnancy, the appointment of Concor Cora is possible only in the exceptional case, when, according to the doctor's conclusion, the expected benefit of therapy for the mother is much higher than the potential risk of fetal side effects.

Dosage and route of administration

The instructions for use indicate that the Concor Cor should be taken without chewing, in the morning during breakfast, squeezed 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 the start of treatment with bisoprolol, the patient should not have signs of exacerbation. Perhaps transient deterioration of heart failure, arterial hypotension or bradycardia during and after the titration period.

Dose titration period

Treatment of chronic heart failure with bisoprolol begins according to the following titration scheme and can be adjusted depending on individual body reactions.

1.25 mg bisoprolol fumarate 1 time per day for 1 week, if well tolerated, increase to
2.5 mg bisoprolol fumarate 1 time per day for the next 1 week, if well tolerated, increase to
3.75 mg 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 once a day for the next 4 weeks, if well tolerated, increase to
10 mg of bisoprolol fumarate once a 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 (arterial pressure, heart rate) and symptoms of progression of heart failure. Symptoms can develop from the first day after the start of treatment.

Modification of treatment

If the maximum recommended dose is poorly tolerated, a gradual dose reduction is possible. If, during the titration period 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 stabilization of the patient's condition, the possibility of re-initiation of bisoprolol treatment should always be considered.

The course of treatment of stable chronic heart failure with bisoprolol is long.

Do not stop treatment suddenly and change the recommended dosage without consulting a doctor, as this can lead to a worsening of the patient's condition. If necessary, treatment with the drug should be completed slowly, gradually reducing the dose.

Patients with impaired hepatic or renal function

There is no data on the pharmacokinetics of bisoprolol in patients with chronic heart failure with impaired hepatic or renal function, therefore, it is necessary to increase the dose with extreme caution.

Children and the elderly

Older patients do not need a dose adjustment.

Clinical data on the efficacy and safety of the drug in children are absent, so bisoprolol is not recommended for use in pediatric practice.

Side effects

Possible such side effects in the treatment of the drug:

From the organ of hearing: rarely - hearing impairment;
From the side of the organ of vision: rarely - a decrease in tearful secretion; very rarely - conjunctivitis;
From the musculoskeletal system: infrequently - muscle cramps, muscle weakness;
From the side of the reproductive system: rarely - a violation of potency;
From the side of the cardiovascular system: very often bradycardia; often - a feeling of numbness or cold in the extremities, pronounced decrease in blood pressure, aggravation of 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 - nightmarish dreams, hallucinations;
From the digestive system: often - nausea, vomiting, constipation, diarrhea; rarely - hepatitis;
Laboratory indicators: rarely - increased levels of triglycerides, liver enzymes in the blood plasma (alanine aminotransferase and aspartate aminotransferase);
On the part of the respiratory system: infrequently - bronchospasm (if indicated in an anamnesis for bronchial asthma or airway obstruction); rarely allergic rhinitis;
dermatological reactions: rarely - hypersensitivity reactions (skin itching, rash, hyperemia); rarely - alopecia; with psoriasis - possibly exacerbation of symptoms of the course of the disease, psoriasis-like rash;
Common violations: often - increased fatigue, asthenia.

Overdose

Symptoms: bronchospasm, AV blockade, bradycardia, hypoglycemia, excessive pressure decrease, acute heart failure.

Overdose therapy: discontinuation of the drug and symptomatic therapy.

special instructions

When using contact lenses, the possible reduction in the presence of tear fluid therapy should be considered.

When prescribing the drug, the doctor must warn the patient that it is possible to change the recommended dose or stop using Concor Cora only after consulting him.

The effect of bisoprolol and its tolerability can be influenced by the simultaneous administration of any other medicines, even non-prescription drugs, so taking other medications without consulting a doctor is not recommended.

Cancellation of the drug should be carried out by gradually reducing the applied dose, as an abrupt termination therapy may lead to a worsening of the heart, especially in patients with ischemic disease.

In patients with bronchial asthma or chronic obstructive pulmonary disease, the use of Concor Cora is possible only when combined with bronchodilating agents. With bronchial asthma, there is a risk of increasing airway resistance, which may require a higher dose of beta2-adrenomimetics.

When appointing a planned surgical intervention with the use of general anesthesia drugs, it is necessary to start the cancellation of the drug in advance, so that its completion is 48 hours before anesthesia begins. An anesthesiologist should be informed that the patient was on Concor Kor treatment.

It should be used with caution in diabetes mellitus with significant fluctuations in blood glucose levels, because the drug can mask symptoms of hypoglycemia, such as tachycardia, excessive sweating, palpitations.

With pheochromocytoma, the purpose of Concor Cora is possible only against the background of the use of alpha-blockers.

Treatment with bisoprolol may mask symptoms of hyperthyroidism.

It should take into account the weakening of adrenergic compensatory regulation against the background of beta-adrenoblockers, the consequence which can be increased sensitivity of the patient to allergens and the development of severe anaphylactic reactions. In this case, treatment with epinephrine (epinephrine) may not have the expected therapeutic effectiveness.

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

Do not drink alcohol-containing drinks during the course of treatment with Concor Kor.
With concomitant use, Concor Cor can increase the effect of antihypertensive agents.
In the case of simultaneous use of Concor Cor and sympathomimetic drugs, it is possible to reduce the effect of bisoprolol.
With the combined use of Concor Cor and guanfacine, alpha-methyldopa, reserpine or clonidine, a sharp decrease in heart rate is possible.
With the concomitant use of Concor Cor and the medicines of digitalis, guanfacin or clonidine, a conduction disorder is possible.

Reviews

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 panic-stricken. There are many medicines, but which is better and more effective? My friend helped me - she had the same problems, but she drank Concor Cor, and he helped her to recover. For 4 months, my mother accepts 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, I used the medicine Concor for many years. I called this medicine Cardiologist with a dose of 1.25motom negoig and gradually I increased: 2.5 then 5mg. I was fine and I drank a few le, then began to reduce the dose and stopped drinking. Many years did without him And now I again have been assigned Concor and I will treat them for hypertension, Ishimia, Heart failure in combination with others. medicines.
Marina. After the second late delivery, I began to "gallop" pressure, and then it became completely high. After consultation in the hospital, they appointed Concor Cor. The price of the drug is acceptable, the tablet is easily divided into parts. I accept almost half a year and I can not get enough of it. The pressure returned to normal. Thank the doctor for the good medicine!