Concor - instructions for use, indications, contraindications, dosage, side effects and analogues

The article was verified by doctors at Euromed Clinic✅

As data accumulated on the possible consequences of COVID-19, scientists noticed that the so-called post-Covid syndrome is often more severe than the viral infection itself.

In addition to damage to the nervous and respiratory systems, kidneys, liver and other organs, doctors note frequent complications after coronavirus on the heart and blood vessels, which can significantly limit a person’s daily and professional life, as well as cause delayed mortality (death).

There is a sufficient number of studies proving that coronavirus causes complications on the human heart and blood vessels, and such complications also affect patients who have not previously suffered from diseases of the cardiovascular system.

Even six months after suffering from COVID-19, doctors detect inflammation of the heart tissue in patients, including those who suffered from the disease asymptomatically.

Contraindications

Concor should not be used for the following diseases:

cardiogenic shock;
acute heart failure;
chronic heart failure (CHF) in the stage of decompensation, which requires the use of inotropic therapy;
sinoatrial block;
atrioventricular (AV) block of II–III degree in patients without a pacemaker;
severe bradycardia with heart rate less than 60 beats per minute;
sick sinus syndrome;
severe arterial hypotension [systolic blood pressure (BP) below 100 mmHg];
Raynaud's syndrome or severe peripheral arterial circulation disorder;
severe form of bronchial asthma;
chronic obstructive pulmonary disease in severe form;
metabolic acidosis;
pheochromocytoma (without simultaneous use of alpha-blockers);
age under 18 years;
breastfeeding period;
hypersensitivity to the components of the drug.

Overdose

An overdose of the drug is accompanied by the following symptoms:

severe bradycardia ;
ventricular extrasystole;
AV block;
arrhythmia;
pronounced decrease in blood pressure;
HNS;
cyanosis (blueness) of the fingers or palms;
difficulty breathing;
dizzy;
bronchospasm;
syncope;
convulsions.

Treatment involves performing a gastric lavage procedure, taking adsorbent medications and prescribing symptomatic therapy:

of atropine or epinephrine into a vein for AV block (in some patients, a temporary pacemaker is installed to solve the problem);
injection of lidocaine for ventricular extrasystole (class IA drugs should not be used);
moving the patient to the Trendelenburg position when blood pressure decreases ;
intravenous administration of plasma-substituting solutions (if there are no signs of incipient pulmonary edema ; if this does not give the expected effect, the patient should be administered epinephrine , dobutamine or dopamine in blood pressure );
prescribing cardiac glycosides , diuretics , as well as glucagon for heart failure ;
intravenous diazepam for seizures;
inhaled administration of β-agonists for bronchospasm.

Doses and method of administration of Concor

Figure 2 - Dosage and method of use of the drug Concor

Concor is taken orally (do not chew or crush) once a day with a glass of water, regardless of meals. But there is a dependence on the time of day. The medicine should be taken exclusively in the first half of the day, that is, you cannot take Concor during the day, evening or at night.

As for the duration of therapy, it is determined by the body’s reaction and the decision of the attending physician.

Arterial hypertension and angina pectoris

The dose of the drug is calculated taking into account the heart rate and general condition of the patient.

To begin with, Concor is prescribed 5 mg, one tablet per day. Then they go up to 10 mg. And in the treatment of hypertension and angina pectoris, the maximum recommended dose is 20 mg per day.

Chronic heart failure without signs of exacerbation

Initially, 1.25 mg once a day. If the patient tolerates the dosage well, then it is gradually increased every two weeks to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg.

If the dosage is poorly tolerated, then it should be reduced. The maximum recommended dose is 10 mg per day.

Reviews of Bisoprolol

Most often, the topic of drug withdrawal is discussed on relevant forums. Reviews about Bisoprolol left by patients and doctors are mainly related to withdrawal syndrome , which occurs against the background of an abrupt cessation of treatment with this drug.

Particular manifestations of it are increased heart rate and attacks of arterial hypertension . Some patients note that during treatment with the drug their vision decreased .

However, since Bisoprolol is prescribed for a long period of time (for some patients even for life), visual impairment and medication intake may be unrelated phenomena.

Taking Bisoprolol may be accompanied by side effects. Some patients practically do not notice them in themselves, while in others, if you believe the reviews, they are quite pronounced.

In connection with all of the above, neither treatment nor discontinuation of the use of this drug should be an independent decision of the patient. In each specific case, the treatment regimen and dosage regimen are determined solely by the doctor who is caring for the patient.

Side effects

Taking Concor may be accompanied by side effects:

From the nervous system: increased fatigue, dizziness, headache, sleep disturbances, depression may be observed (especially at the beginning of therapy), rarely - hallucinations (usually mild and disappear within 1-2 weeks), sometimes - paresthesia.
On the part of the organ of vision: visual disturbances, decreased tear production (must be taken into account when wearing contact lenses), conjunctivitis.
From the cardiovascular system: in some cases - orthostatic hypotension, bradycardia, AV conduction disturbances, decompensation of heart failure with the development of peripheral edema, at the beginning of treatment - deterioration of the condition of patients with intermittent claudication or Raynaud's syndrome.
From the respiratory system: in isolated cases - shortness of breath (in patients prone to bronchospasm).
From the gastrointestinal tract: in some cases - diarrhea, constipation, nausea, abdominal pain, increased activity of liver enzymes in the blood serum (AST, ALT), hepatitis.
From the musculoskeletal system: in some cases - muscle weakness, cramps, arthropathy affecting one or more joints (mono- or polyarthritis).
From the endocrine system: decreased glucose tolerance (with latent diabetes mellitus) and masking of signs of hypoglycemia, in some cases - increased TG levels in the blood, potency disorders.
On the skin: sometimes - itching, skin hyperemia, increased sweating, rash. When treated with beta-adrenergic receptor blockers, hair loss, hearing impairment or tinnitus, weight gain, mood changes, short-term memory loss, allergic rhinitis, and priapism are observed in some cases.

What are statins

Statins are a group of lipid-lowering drugs. They slow down the work of one of the main enzymes involved in the synthesis of cholesterol - HMC-CoA reductase. This leads to a decrease in cholesterol synthesis in the liver.

A decrease in cholesterol synthesis in hepatocytes increases the number of receptors for low-density lipoproteins (LDL-C) and their subsequent uptake from the bloodstream. In addition, there may be some reduction in the formation of LDL due to inhibition of the synthesis in the liver of their precursor, very low density lipoproteins (VLDL). Thus, statins help reduce total cholesterol, LDL cholesterol and VLDL cholesterol in the blood plasma. At the same time, drugs in this group can reduce the level of TG and slightly increase the level of “good cholesterol” (high-density lipoproteins). The effectiveness of lowering blood cholesterol levels depends on the dose of the drug. To obtain the desired level of reduction, fairly high doses are required.

Their numerous additional properties also contribute to the benefit of statins:

improving the functional activity of the endothelium;
stabilization of atheroma (atherosclerotic plaque);
anti-inflammatory, immunomodulatory and antithrombotic effects;
positive effect on bone metabolism.

Concor during pregnancy

Figure 3 - Taking Concor during pregnancy

Expectant mothers should be extremely careful when choosing certain medications. In the case of Concor, you can take it only if the benefit to the mother’s body is greater than the damage. Concor should not be taken during lactation, since the baby receives bisoprolol and auxiliary components through breast milk. If discontinuation of the drug is not possible, then breastfeeding should be discontinued.

Compound

One Bisoprolol tablet contains 0.005 or 0.01 g of bisoprolol fumarate , as well as auxiliary components: magnesium stearate, colloidal silicon dioxide, crospovidone, corn starch (Amylum maydis), microcrystalline cellulose (Cellulose microcrystalline).
For the manufacture of film coating tablets, the following are used: polyvinyl alcohol, titanium dioxide, talc, macrogol, dyes (iron oxide yellow, quinoline yellow, orange yellow).

Interaction with other drugs and alcohol

Figure 4 - Combination of Concor with other medications

The instructions for the drug Concor describe in some detail the compatibility with other drugs, because there is a list of drugs with which the Concor tandem is prohibited. Concor can be used in conjunction with analogues and generics, but such a combination must be discussed with your doctor so that an overdose does not occur and the blood pressure does not drop below normal levels.

Concor and Amlodipine

Amplodipine is an antihypertensive drug used for high blood pressure. The attending physician may prescribe a similar tandem if he believes that Concor will be ineffective. It is worth remembering that patients with heart failure cannot take Amplodipine and Concor together.

Concor and Arifon

Arifon - a diuretic indapamide - in combination with the beta blocker Concor is an effective complex in the treatment of hypertension. Concor lowers blood pressure, and Arifon reduces the volume of circulating blood, thus protecting the patient from signs of heart failure.

But Arifon has a side effect - it flushes potassium from the body, which can cause hypokalemia.

Concor and Lozap

The active substance of the drug Lozap, losartan potassium, is intended for the treatment of arterial hypertension. That is, it does not allow peripheral vessels to spasm and thereby does not allow blood pressure to rise. Concor and Lozap enhance each other's effects. Concor works to reduce cardiac output, while Lozap dilates arterioles and reduces peripheral pressure. As a result, blood pressure returns to normal.

The combination of drugs Concor and Lozap is most effective when the degree of arterial hypertension is quite high, and treatment with one drug is not so effective.

Concor and Enap

The simultaneous use of Concor and Enap or Enalapril, which are based on the same active ingredient - enalapril, should be prescribed with caution, since the drugs can enhance the effect of each other. So, the instructions say: with the simultaneous use of beta-blockers, methyldopa, nitrates, calcium channel blockers, hydralazine, prazosin, the antihypertensive effect may be enhanced. That is, blood pressure that is already lowered with the help of Concor can decrease further.

Enap is good for kidney disease, excess weight and a history of diabetes. Concor is indicated for use in patients with heart rhythm disturbances, tachycardia, and frequent attacks of angina. But if the resting heart rate is 50 - 60 beats/min, and there are conduction blockades, then you should take Enap, since Concor will only worsen these conditions.

The combined use of Concor and Enalapril lowers blood pressure and slows the progression of complications from the heart and kidneys. If you experience constant weakness, dizziness and fatigue during use, you should immediately inform your doctor.

Concor and Prestarium

Like all other ACE inhibitors, Prestarium goes well with the β1-blocker Concor. They are prescribed in tandem for high blood pressure, when the use of one drug is ineffective, reducing the risk of fatal complications for people with heart failure, obesity, diabetes, and chronic kidney disease.

But the decision to prescribe the combination Concor + Prestarium is made by the attending physician.

Prestarium itself is not as effective a medicine as Concor. If the pressure is 180/105 mmHg. Art., then it must be taken in combination with other drugs for hypertension.

Concor and Moxonidine

Concomitant use of Moxonidine with β-blockers such as Concor is not recommended. This can lead to a decrease in myocardial contractility and increased bradycardia

Concor and Lorista

Lorista is a generic version of the drug Lozap. That is, it contains the same active ingredient as the original drug, but it has not passed all stages of clinical trials. Generic status makes medicines cheaper without losing their properties. Lorista contains valsartan, a drug belonging to the group of sartans, which are prescribed for the development of a dry cough due to ACE inhibitors. The combination of Concor and Lorista is inferior in strength to the combination of Concor and any ACE inhibitor, since Lorista does not reduce the risk of complications of coronary artery disease.

Concor and alcohol

Figure 5 - Drinking alcohol with the drug Concor
It is known that when drinking alcohol, blood vessels dilate for a short time, that is, the heartbeat accelerates. True, after a short amount of time the opposite happens - vasospasm. And a sharp rise in blood pressure is not the most pleasant, but also not the most dangerous, thing that can await a patient taking Concor. The instructions directly state that Concor and alcohol are incompatible. The central nervous system is depressed, and the patient’s psychomotor abilities deteriorate. Also, do not forget that the medicine and alcohol will be excreted through one excretory system - the kidneys. This can lead to organ damage, and in some cases functional impairment may develop. Internal bleeding may begin, a hypertensive crisis, pulmonary edema, and vascular collapse may begin. But the worst result of taking Concor and alcohol together is death.

Therefore, doctors strongly recommend that you stop drinking alcohol while taking Concor.

pharmachologic effect

Bisoprolol (INN - Bisoprolol) belongs to the clinical-pharmacological group “ β1-blockers ”. Its action is aimed at relieving the symptoms of myocardial ischemia (antianginal effect), normalizing the disturbed rhythm of contractions of the heart muscle (antiarrhythmic effect), as well as reducing blood pressure (antihypertensive effect).

Analogs

When choosing analogues, it is important to understand that each of them has its own indications for use, side effects, contraindications, active substances, etc. It is important to consult a doctor and not change the drug yourself.

Which is better: Concor, Bisoprolol, Coronal?

All of these drugs contain the same active substance - bisoprolol. They have similar contraindications and indications for use.

Bisoprolol is used to treat arterial hypertension, tachycardic heart rhythm disorders, ischemia, heart failure and various forms of arrhythmia. It is considered antihypertensive and lowers blood pressure. Patients whose blood pressure is 90 mm or lower (hypotension) are prohibited from taking Bisoprolol. It is easier to tolerate by patients and there is less risk of complications when taking it. This applies to diabetes mellitus, respiratory tract diseases, and hypotension.

Coronal is a generic version of Concor, that is, it has the same spectrum of pharmacological action as the original drug, but differs in strength. Coronal also reduces pain and blood pressure, improves blood supply to the heart muscle, and normalizes heart rhythm. But Coronal does not have such a noticeable effect on the patient’s heart rate.

Which is better: Concor, Betalok Zok, Betalok or Egilok?

The active ingredient in the drugs Betalok ZOK, Betalok and Egilok is the same - metoprolol.

The effectiveness of Concor and Betaloc ZOK in reducing blood pressure and stopping attacks of tachycardia is the same. The duration of the therapeutic effect lasts more than a day. But only a cardiologist has the right to prescribe Concor or Betaloc ZOK, having studied the risk factors, medical history and individual sensitivity of the patient to the components of the drug.

Betaloc is a medicine for hypertension, angina and heart failure. Today it is considered obsolete. He was replaced by Betalok ZOK.

Egilok, like Concor, is effective for high blood pressure, but since the active components are different, there are differences. Compared to Concor, Egilok acts very quickly (15-20 minutes after taking the tablet), but this means that the duration of the therapeutic effect is not so long. The drug should be taken two to three times a day during or after meals.

Which is better: Concor, Nebivolol or Nebilet?

The drugs have a positive effect on the heart with high blood pressure, chronic heart failure, ischemia, tachycardia, but Nebilet and its almost complete analogue Nebivolol are based on the active component - nebivolol, which is capable of dilating peripheral vessels and reducing cardiac output. This adds to its effectiveness as an antihypertensive agent.

The active substance nebivolol promotes the production of nitric oxide, which relaxes blood vessels for a longer period. Unlike Concor, it does not contribute to the patient’s weight gain. Since nebivolol dilates blood vessels, it acts faster, but the effect does not last long.

Nebilet and differing from it solely in the degree of purification and, accordingly, in price, Nebivolol is also used for hypertension and coronary heart disease. But it is contraindicated in patients with low blood pressure, cardiogenic shock, severe heart failure, diseases of the respiratory system and liver. Not for use by children, pregnant and lactating women. Treatment should not be started if you have diabetes, thyroid dysfunction, psoriasis or in old age. Concor is safer for the elderly, children and patients with breathing problems.

Concor or Sotahexal

The active ingredient in Sotahexal, sotalol hydrochloride, copes well with arrhythmia and lowers blood pressure. Contraindicated for use in patients with hypotension.

Sotahexal can cause side effects in the form of bronchospasms, disorders of carbohydrate and lipid metabolism.

Concor, compared to Sotahexal, is easier to tolerate and more effective for patients suffering from chronic heart failure. Also, Concor has a lower risk of complications. This applies to diabetes mellitus (Sotahexal increases hypoglycemia), respiratory diseases, and hypotension. But Sotahexal is more often prescribed for arrhythmic disorders.

Indications

Drugs in this group are prescribed only by a doctor and he selects which active ingredient is suitable and its dosage. Usually, for this purpose, the risk of cardiovascular events is determined using a special scale, questionnaire, and tests are taken to determine the lipid spectrum and biochemical blood parameters. Today, statins are prescribed not only after heart attacks and strokes as secondary prevention. Under certain high-risk conditions, a doctor may use statins in the primary prevention of cardiovascular disease.

Serotonergic agents

The relationship between serotonin and alcohol is complex. It is assumed that alcoholics try to use alcohol to normalize low basal levels of serotonin in the brain. Serotonin has been found to be involved in the reinforcing effects of alcohol. In addition, low serotonin levels contribute to impulsive behavior that leads to alcohol consumption. Abnormalities in serotonin metabolism may be accompanied by anxiety and depression, in which case alcohol may be used as a means of self-medication. Serotonergic drugs include the serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Fevarin), citalopram. This class of drugs was developed in the 1980s to treat depressive disorders. The mechanism of action of SSRIs is to block the reuptake of serotonin by presynaptic endings, as a result of which the level of serotonin in the synaptic cleft increases.

Bisoprolol price, where to buy

The price of Bisoprolol depends on which pharmaceutical company produced the drug.

The drug can be bought for 80-310 rubles in Russian pharmacies. Bisoprolol-Prana 5 mg costs about 80-100 rubles. The price of Bisoprolol-Ratiopharm 5 mg in Russia is unknown; at the moment it is not available in pharmacies. Price Bisoprolol-Teva 10 mg No. 30 - 207 rub.

The price of Bisoprolol-Astrapharm in Ukraine starts from 13 UAH.

The price of drug analogues on the Russian pharmaceutical market is from 32 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Bisoprolol-Vertex tablets p.p.o.
5 mg 30 pcs. Vertex AO 101 rub. order
Bisoprolol Alkaloid tab. p/o captivity. 5 mg 30 pcs. Alkaloid AO
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Bisoprolol tablets p.p.o. 2.5 mg 30 pcs. Ozone LLC/Ozone Pharm LLC
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Bisoprolol-Teva tablets p.p.o. 10 mg 30 pcs. Teva LLC
RUB 209 order
Bisoprolol tablets p.p.o. 5 mg 50 pcs. R-Pharm Novoselki LLC
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Pharmacy Dialogue

Bisoprolol Welfarm (tab.p.pl.vol. 10 mg No. 50) Welfarm LLC
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Bisoprolol tablets 5 mg No. 30Pranafarm LLC
83 RUR order
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Bisoprolol (tab.p.pl/vol. 10 mg No. 30)Vertex
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Bisoprolol tablets 10 mg No. 30Pranafarm LLC
96 RUR order

Pharmacy24

Bisoprolol-Teva 10 mg N50 tablets Merkle GmbH, Nimechchina
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Bisoprolol KPKA 10 mg N30 tablets KRKA, d.d., Novo Mesto, Slovenia/TAD Pharma GmbH, Nimeččina
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Bisoprolol-KV 10 mg N30 tablets PAT "Kiev Vitamin Plant", Kiev, Ukraine
22 UAH order
Bisoprolol-Teva 10 mg No. 30 tablets Merkle GmbH, Nimechchina
39 UAH order
Bisoprolol KPKA 5 mg No. 30 tablets KRKA, d.d., Novo Mesto, Slovenia/TAD Pharma GmbH, Nimeččina
20 UAH order

PaniPharmacy

Bisoprolol tablets Bisoprolol-KV tablets 5 mg N30 Ukraine, Kiev Vitamin Plant PJSC
13 UAH order
BISOPROLOL tablets Bisoprolol Sandoz film-coated tablets 5 mg No. 30 Germany, Salutas Pharma
28 UAH order
BISOPROLOL tablets Bisoprolol tablets 5 mg No. 20 Ukraine, Astrapharm LLC
13 UAH order
BISOPROLOL tablets Bisoprolol tablets 5 mg No. 50 Germany, Merckle
59 UAH order
BISOPROLOL tablets Bisoprolol Sandoz film-coated tablets 10 mg No. 90 Germany, Salutas Pharma
76 UAH order

Carbamazepine

It is effective against all symptoms when withdrawing from binge drinking and can be the drug of choice when interrupting mild to moderate binge drinking. The lack of interaction with alcohol allows the drug to be used even if it is present in the blood. It has been established that Carbamazepine affects the neuronal transmission of GABA, glutamate, norepinephrine, acetylcholine and dopamine. Monotherapy with carbamazepine is effective for mild to moderate withdrawal syndrome; for severe withdrawal, benzodiazepines are recommended. The undoubted advantage of carbamazepine is the absence of a euphoric effect and the risk of dependence on the drug.

Proprothene-100

To date, the most studied of the antibody drugs is Proproten-100, which contains potentiated antibodies to the brain-specific protein S-100 (AS-100). The drug Proproten has been studied at all levels of organization of neuronal structures: cellular, intercellular (synaptic), structural, systemic. The most specific of the studied effects can be considered the sensitizing effect of AS-100 on the cell membrane of neurons. The unusual biological effect at the clinical level is manifested by a balanced effect on the mental status of patients. Depending on the initial condition of the patients, the drug has both a sedative and a stimulating effect.