The drug "Concor Cor": indications for use, reviews, analogues
Cardiovascular diseases occupy today almost the first place in the mortality rate of the world population. And every year these problems are getting younger. If you used to talk about myocardial infarction, then it was about the age of at least 45-50 years, today this disease can hit a 30-year-old.
Modern pharmacy has a mass of medicines to combat "cardiac" problems at different stages of development of these diseases. One of the groups of these drugs are beta-blockers. The principle of action of these drugs is to block beta-adrenergic receptors in the heart. The consequence is a decrease in the heart rate, which leads to a decrease in blood pressure and a general improvement in the human condition.
Beta-blockers have now been developed by a great variety. One of the widely used in the development of cardiac problems is the "Concor Cor."Indications for use, reviews about the drug characterize the drug as sufficiently effective and in demand in patients with cardiac diseases.
The main components and form of the drug
The main component of the drug "Concor Cor" - bisoprolol hemifumarate. A rather large list of substances acts as auxiliary substances: corn starch, microcrystalline cellulose, crospovidone, magnesium stearate, colloidal silicon dioxide, anhydrous calcium hydrogenphosphate.
The drug is offered to consumers in the form of heart-shaped, film coated white tablets( in its composition - macrogol 400, dimethicone 100, hypromelase, titanium dioxide).The risk on both sides is divided into two parts of the tablet "Concor Cor."Packaging of the medicinal product is made in foil blisters, in each of which 10, 14, 25 or 30 can be sealed.
Patients often enough can see the drug "Concor" in pharmacies. Since the names of these two drugs are very similar, pharmacists often have to answer questions about what distinguishes Concor from Concor Cor. So: the difference is only in the volume of the content of the main active ingredient - bisoprolol."Concor" consumers can buy in tablets that have in their composition 5 or 10 mg of active substance, while "Concor Cor" - 2.5 mg.
Consumers need to know that for the purchase of medication blockers in the pharmacy the pharmacist will need to provide a prescription from the doctor.
Concor Cor has a selective beta-1-adrenergic blocking effect. The essence of its impact is in the ability to suppress the transmission of nerve impulses in adrenoreceptors. For this reason, the medication is able to have antihypertensive, antiarrhythmic, anti-anginal effect.
The hypotensive effect of "Concor Cor" reviews of doctors attributed to the fact that bisoprolol reduces the minute volume of blood. In addition, inhibition of the activity of the renin-angiotensin system is carried out in parallel. The greatest clinical effect will be achieved after 5 days from the start of the drug. AD stabilizes by the end of the second month of therapy with the drug Concor Cor.
The drug use indications also guarantee a stable anti-anginal effect by reducing myocardial oxygen demand due to a reduction in the heart rate. Also it must be said that the use of this medication contributes to the lengthening of the diastole period.
The antiarrhythmic effect of Concor Cor is due to the blocking of negative factors, including partial suppression of the sympathetic part of the central nervous system, inhibition of the creation of electrical impulses in the sinus node, inhibition of electrical activity of the myocardium.
Who is receiving the drug and who does not?
What is the evidence for the use of Concor Cor? Customer feedback confirms the high effectiveness of this medication. It is recommended to take to treat heart failure and prevent the development of such conditions in the early stages. To be precise, healthcare workers prescribe this beta-blocker to receive therapy for persistent chronic heart failure with reduced left ventricular systolic function. Usually, "Concor Cor" is prescribed concomitantly with ACE inhibitors, diuretic drugs, cardiac glycosides.
So that no one has a desire to prescribe this medication for themselves, without the doctor's instructions, it is worth to get acquainted with the impressive list of contraindications for taking the "Concor Kor" remedy.
In addition to mandatory for any medication instructions on the prohibition in the presence of intolerance of the components of the drug and the age of patients( up to 18 years of age, there is no information on efficacy and safety), there are many more causes and diseases in which this drug is unacceptable.
"Concor Cor" instructions for use( analogues - modern beta-blockers - have close indications of the inadmissibility of admission) prohibits taking patients with heart failure in acute form and with decompensated chronic insufficiency. Do not prescribe to receive the drug in case of collapse and cardiogenic shock( a condition provoked by a violation of the functions of the heart).You can not take this beta-blocker for large deviations of AV-conduction( II, III degree of AV-blockade) without the presence of an electrocardiostimulator. Also, the reason for refusing admission is the presence of bradycardia( heart rate less than 50 beats / min.), Sinoatrial blockade( impairment of the sinus pulse through the sinatoatrium connection).Contraindicated medication for patients suffering from prinzmetal angina( spasms of blood vessels that feed the heart, with simultaneous rise of the segment S-T) and syndrome of weakness of the sinus node( SSSU).
Concor Cor can not be taken with low systolic blood pressure( below 90 mm Hg), in the presence of severe bronchial asthma, those with a history of chronic obstructive pulmonary disease( COPD).
The use of the Concor Cor preparation is inadmissible in the presence of abnormalities in the peripheral circulation system( mostly in the late stages), with Raynaud's disease, pheochromocytoma( benign or malignant tumor of the APUD system), metabolic acidosis( acid-base shiftbalance in the direction of increasing acidity due to the accumulation of acidic products in tissues, their insufficient binding or destruction).
Treatment regimen and allowable volumes of bisoprolol
According to the instructions, this beta-blocker is taken once a day, preferably in the morning, after a meal. Tablets "Concor Cor"( from which the medication was not applied - whether it is CHD, chronic form of heart failure or hypertension) need not be chewed or crushed, they are swallowed whole and washed down with a small amount of water.
For the treatment of chronic heart failure with the use of the drug "Concor Cor," it is recommended that the dose is titrated first. The essence of the process is as follows: during the 1st week the volume of the beta-blocker taken in terms of bisoprolol is 1.25 mg, at the 2nd week the dosage is doubled( 2.5 mg), the third is 3.75 mg. During the period from the 4th week until the end of the 7th dose, 5 mg of bisoprolol per day is administered;from the 8th week to the 11th - 7.5 mg. Starting with the 12th week, the maximum possible 10 mg is taken. Dosage should( and can) be increased only after making sure that the previous one is transferred normally and does not cause negative sensations.
Here on the surface - the essence of the answer to the question of how the "Concor" differs from "Concor Cor": the second variant( 2.5 mg of bisoprolol) is ideal for initiating therapeutic measures for persistent chronic heart failure states, while the first( 5or 10 mg) is more suitable for maintenance treatment.
If, at some point in the selection of the dose, the symptom of heart failure has appeared, medical experts recommend correcting the dosage taken in parallel diuretics or ACE inhibitors. When the condition improves after a while, it is necessary to continue the titration process "Concor Cor."
Therapy with this medication is of a lengthy nature. The abolition of this beta-blocker should be slow, especially for patients suffering from coronary artery disease.
Exceeding the permissible dose: consequences and treatment
The instruction for the drug is always accompanied by the tablets "Concor Cor."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 high dose has been taken.
The symptoms are as follows: hypertension and bradycardia develop, there is a high probability of bronchospasm and hypoglycemia, possibly the onset of acute heart failure.
The effects of taking a large dose in different people can vary significantly. Probably, those who suffer from heart failure have a high sensitivity to exceeding the recommended dosage. The most correct decision for the patient is to contact the doctor( if it is possible to 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 an emergency, gastric lavage and absorbent intake( activated charcoal or analogues) are usually performed. Further, depending on the situation, treatment with bisoprolol may be discontinued and supportive and symptomatic therapy will be conducted in the hospital for the required period of time.
The instruction for "Concor Cor", indications for use, medical reviews and other sources of information bring to the attention of specialists and consumers that bisoprolol is quite difficult to dialysis.
Negative manifestations of the application of "Concor Cor"
As almost any medicine, Concor Cor can give side effects of different intensity to human systems and organs.
With regard to the cardiovascular system, the most frequent complaints of patients on the occurrence of bradycardia and hypertension( to a greater extent in people suffering from chronic heart failure), angiospasm may develop. To a lesser extent, there is a possibility of disturbance of AV-conduction, cardiac decompensation accompanied by peripheral edema.
The reaction to the CNS medication appears less pronounced and may include increased fatigue, headaches and dizziness, asthenia, sleep and wakeful periods. Very rarely patients complain of cramps, nightmares and hallucinations. In most cases, all these symptoms do not have intense coloring and take place 1-2 weeks after the beginning of therapy with Concor Kor.
Indications for use and a list of contraindications sharpen the attention of patients who have a history of information on COPD and bronchial asthma, that there is a possibility of bronchospasm development. Rarely they say about the appearance of allergic rhinitis.
On the part of the digestive tract, the most likely occurrence of nausea, vomiting, constipation, diarrhea, a feeling of dryness of the mucous membranes in the oral cavity. Less is said about the development of hepatitis and changes in liver enzymes.
In addition to all the above, patients report visual impairment and conjunctivitis( rarely), cramps in the calf muscles and muscle weakness, and potency disorders( very rarely).
Of allergic manifestations, rashes, skin itching and redness of the skin are most often possible.
"Concor Cor" and pregnancy
The reception of the beta-blocker "Concor Cor" during pregnancy is possible only in cases when the expected use of it for the health of the mother exceeds 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 thus can have a negative impact on the fetal development of the baby. If, nevertheless, the medication is prescribed for admission to a pregnant woman, health care providers 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, one must move on to other, alternative methods of treatment.
After birth, the child should be carefully examined. During the first 3 days, the baby's blood glucose level may drop, possibly also the development of bradycardia symptoms( a decrease in heart rate).
Regarding lactating women, there is no information on the isolation of bisoprolol with breast milk or its safety for the child. Therefore, if you need to take the "Concor Cor" during this period, you should decide whether to stop lactation.
For the drug "Concor Cor," analogues( there are a lot of them) are most often found in the main active ingredient - bisoprolol. The medication itself is produced in Germany and Norway. Of the Russian analogues, most often used are drugs such as "Aritel" and "Aritel Kor", "Biprol", "Bisoprolol-Prana".Although the latter is produced in many countries of the world: "Bisoprolol Teva" - Hungary, Israel, "Bisoprolol-Lugal" - Ukraine. Actually, the direct analogue is Concor.
Further from the most frequently used similar means can be named "Bidop" and "Bidop Kor", "Biol", "Bisogamma", "Bisomor", "Cordinorm" and "Cordinorm Kor", "Tiresz", "Niperten".
In general, the list of analogs( synonyms) is wide and varied, but it is unacceptable to decide on what to replace "Concor Cor".The right to choose one or another medication for replacement belongs only to the attending physician.
Interaction with other
medicines The effectiveness and tolerability of beta-blockers can be adversely affected by the simultaneous use of two drugs. As for the preparation "Concor Cor"( indications for use, reviews of medical workers and patients confirm this reaction), intolerance can arise even if close-in medicines have been taken after a short time after each other.
Further, patients taking bisoprolol should be aware that allergens for immunotherapy or even extracts for carrying out skin tests can trigger the development of severe systemic allergic reactions or anaphylaxis. Anaphylactic shock can also lead to the simultaneous use of bisoprolol and iodine-containing contrast agents for intravenous administration.
Diuretics, sympatholytics and other antihypertensive medications used with bisoprolol may cause excessive blood pressure lowering.
Tetracycline antidepressants, antipsychotics, sedatives and hypnotics depress CNS.The effect of insulin or other similar hypoglycemic medicines for oral administration against the background of treatment with Concor Kor medication may be intensified. Symptoms of developing hypoglycemia( tachycardia in particular) can be suppressed or masked.
What should I look for?
People to whom Concor Cor has been prescribed for use should not discontinue treatment or change the recommended dosage, without first consulting a physician. In such cases, the deterioration of the heart. This is especially true for patients with ischemic heart disease. If there is a need to stop treatment with Concor Kor, the manufacturer recommends doing so, gradually reducing the dosage.
In patients who smoke, the effectiveness of beta-blockers is lower than those who do not smoke.
Those who wear contact lenses, it should be borne in mind that beta-blockers can cause a decrease in the production of tear fluid.
If the patient has a need for a planned surgical intervention, the Concor Cor should not be taken completely at least 48 hours before the general anesthesia. If surgical intervention was required in an emergency, and the patient has already taken a beta-blocker, then for the general anesthesia he needs to choose a medicine with a minimum negative inotropic effect.
In conclusion, I would like to say that whatever the "Concor Cor" testimony, the high efficiency of patients and medical workers, the decision to assign to each individual exactly the means of "Concor Cor," and not any otherbeta-blocker, should belong only to the attending physician.