Concor tablets p / o 10mg, No. 50

Arterial hypertension,

prevention of angina attacks,

chronic heart failure.

ConcorЃ tablets should be taken once a day with a small amount of liquid, in the morning before breakfast, during or after it. The tablets should not be chewed or powdered.

Arterial hypertension and stable angina pectoris

In all cases, the regimen and dose are selected by the doctor for each patient individually, in particular, taking into account the heart rate and the patient's condition. Typically, the initial dose is 5 mg of ConcorЃ once a day.

Typically, the starting dose is 5 mg once a day. If necessary, the dose can be increased to 10 mg once a day. In the treatment of arterial hypertension and stable angina pectoris, the maximum recommended dose is 20 mg once a 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. The beginning of CHF treatment with ConcorЃ requires a special titration phase and regular medical supervision. A precondition for treatment with ConcorЃ is stable CHF without signs of exacerbation.

Treatment with ConcorЃ begins according to the following titration schedule. In this case, individual adaptation may be required depending on how well the patient tolerates the prescribed dose, i.e., the dose can be increased only if the previous dose was well tolerated.

To ensure an appropriate titration process at the initial stages of treatment, it is recommended to use bisoprolol in a 2.5 mg tablet dosage form.

The recommended starting dose is 1.25 mg once a 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 once a day. Each subsequent dose increase should be carried out at least 2 weeks later. If an increase in the dose of the drug is poorly tolerated by the patient, a dose reduction is possible.

The maximum recommended dose for the treatment of chronic heart failure is 10 mg once a day.

During titration, regular monitoring of blood pressure, heart rate and the severity of symptoms of chronic heart failure is recommended. Aggravation 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 the course of CHF, arterial hypotension or bradycardia may occur. In this case, it is recommended, first of all, to adjust the doses of concomitant therapy drugs. You may also need to temporarily reduce the dose of the drug ConcorЃ or cancel it. After stabilization of the patient's condition, titration of the dose should be repeated, or treatment should be continued.

Duration of treatment for all indications

Treatment with ConcorЃ is usually long-term.

Special patient groups

Impaired kidney or liver function

Mild to moderate hepatic or renal impairment usually does not require dose adjustment.

In severe renal impairment (CC less than 20 ml / min) and in patients with severe liver disease, the maximum daily dose is 10 mg. Increasing the dose in such patients should be done with extreme caution.

Elderly patients

No dose adjustment is required.

Children

Because there is not enough data on the use of ConcorЃ in children; it is not recommended to prescribe the drug to children and adolescents under the age of 18.

To date, there is insufficient data on the use of ConcorЃ 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 disturbances. Also, until now, there have been no sufficient data on patients with chronic heart failure with myocardial infarction in the last 3 months.

Active ingredient: bisoprolol fumarate 10 mg

Excipients : calcium hydrogen phosphate anhydrous - 127.5 mg, corn starch (fine powder) - 14 mg, colloidal silicon dioxide anhydrous - 1.5 mg, microcrystalline cellulose - 10 mg, crospovidone - 5.5 mg, magnesium stearate - 1.5 mg.

The composition of the film shell: hypromellose 2910/15 - 2.2 mg, macrogol 400 - 0.53 mg, dimethicone 100 - 0.22 mg, iron dye yellow oxide (E172) - 0.12 mg, iron dye red oxide (E172) - 0.002 mg, titanium dioxide (E171 ) - 0.85 mg.

Hypersensitivity to bisoprolol or any of the excipients;

acute heart failure, chronic heart failure in the stage of decompensation, requiring inotropic therapy;

cardiogenic shock;

AV block II and III degree, without pacemaker;

SSSU;

sinoatrial blockade;

severe bradycardia (heart rate <60 beats / min);

severe arterial hypotension (systolic blood pressure <100 mm Hg);

severe forms of bronchial asthma;

severe peripheral arterial circulation disorders, Raynaud's syndrome;

pheochromocytoma (without the simultaneous use of alpha-blockers);

metabolic acidosis;

age up to 18 years (insufficient data on efficacy and safety).

With caution: desensitizing therapy, Prinzmetal's angina, hyperthyroidism, type I diabetes mellitus and diabetes mellitus with significant fluctuations in blood glucose concentration, degree I AV block, severe renal failure (CC less than 20 ml / min), severe liver dysfunction, psoriasis, restrictive cardiomyopathy, congenital heart defects or heart valve disease with severe hemodynamic disturbances, CHF with myocardial infarction within the last 3 months, severe forms of COPD, strict diet.

Film-coated tablets of light orange color, heart-shaped, biconvex, with a score on both sides.

Composition:

Active ingredient: bisoprolol fumarate 10 mg

Excipients : calcium hydrogen phosphate anhydrous - 127.5 mg, corn starch (fine powder) - 14 mg, colloidal silicon dioxide anhydrous - 1.5 mg, microcrystalline cellulose - 10 mg, crospovidone - 5.5 mg, magnesium stearate - 1.5 mg.

The composition of the film shell: hypromellose 2910/15 - 2.2 mg, macrogol 400 - 0.53 mg, dimethicone 100 - 0.22 mg, iron dye yellow oxide (E172) - 0.12 mg, iron dye red oxide (E172) - 0.002 mg, titanium dioxide (E171 ) - 0.85 mg.

pharmachologic effect

Selective beta1-blocker without intrinsic sympathomimetic activity, does not have membrane stabilizing activity. Reduces the activity of plasma renin, reduces myocardial oxygen demand, reduces heart rate (at rest and during exercise) and cardiac output, while the stroke volume does not significantly decrease. Inhibits AV conduction. It has antianginal and hypotensive effects. In high doses (200 mg or more), it can cause blockade and? 2-adrenergic receptors, mainly in the bronchi and vascular smooth muscles.

The hypotensive effect is associated with a decrease in the minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (it is of greater importance for patients with initial renin hypersecretion), restoration of sensitivity in response to a decrease in blood pressure and an effect on the central nervous system.

The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in heart rate and a decrease in contractility, an increase in diastole, and an improvement in myocardial perfusion.

The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased cAMP content, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers, and a slowdown in AV conduction (mainly in the antegrade and, to a lesser extent, in the retrograde directions) through the AV node) and along additional paths.

Indications of the active substances of the drug

Arterial hypertension,

prevention of angina attacks,

chronic heart failure.

Dosage regimen