Prohibited during pregnancy
Prohibited during breastfeeding
Prohibited for children
Has restrictions for older people
Has limitations for liver problems
Has limitations for kidney problems
Every person diagnosed with arterial hypertension is forced to take pills to quickly relieve high blood pressure symptoms in order to improve their well-being.
Concor is one of the most common medications used for these purposes, but it is not suitable for all people with the diagnosis mentioned above. For example, in the case of some patients the desired therapeutic effect is not observed or serious side effects occur. Therefore, it is important to know which generics and analogues can be used as an alternative to the original drug.
General information about Concor
The active component of the drug is bisoprolol, which has antiarrhythmic, antihypertensive, and anti-ischemic effects on the body.
This medicinal product belongs to the group of beta blockers, which can act on the nerve endings of the heart, which in turn are extremely sensitive to adrenaline. Adrenaline itself is a stress hormone produced, which is primarily released by the body when it senses danger. This condition is accompanied by dilated pupils, higher than normal blood pressure due to vascular stenosis, as well as rapid contraction of the heart muscle.
At the same time, Concor is able to suppress the effect of adrenaline, bringing the body back to normal and calming its systems.
Among the indications for use of the drug:
- chronic cardiac ischemia;
- angina pectoris;
- congestive heart failure;
- hypertension of primary and secondary type.
Features of using Concor
The original drug must be taken every day in the morning, before breakfast or during meals, remembering to drink small amounts of water. The dose should always be selected exclusively by the doctor and individually for each patient.
Therapy begins with the lowest dose, which is gradually increased to the optimal level.
Abrupt cessation of therapy is strictly contraindicated, as this may sharply worsen the condition. For this reason, drug withdrawal should be accompanied by a gradual reduction in the dose of the drug in order to provide adaptive opportunities for the body.
Is a substitute always worse than a brand name drug?
The only requirement for generic drugs is bioequivalence. The financial costs of producing analogues are always less than for a sample, which explains their lower cost, but the production technology, excipients and shell composition may differ significantly from those of a branded product. Large pharmaceutical companies mostly adhere to accepted production standards and produce high-quality generics, which cannot be unambiguously said about unbranded products. Therefore, replacing the original drug is possible, but not in every case.
Generics Concor
By generics we mean those substitutes for Concor that have a similar composition. Their main advantage is a much lower cost when compared with the original product. Lower prices can be achieved due to the fact that manufacturers do not need to spend money on developing a formula and subsequent testing of the resulting medicine.
Among the well-known generics are:
- Niperten. The medicine is produced in Russia in dosages similar to Concor - 2.5, 5 and 10 mg. The tablets have some differences in shape.
- Bisoprolol. The most popular domestic generic, sold at a very low price.
- Coronal. Slovak product, available in dosages of 5 and 10 mg.
- Biprol. A cheap, domestically produced drug, available in dosages of 2.5, 5 and 10 mg.
- Bidop/Bidop Cor. Not a very popular Irish product, available in three different dosages. It has a fairly attractive price tag.
- Cordinorm. Icelandic remedy in the form of film-coated tablets with a dosage of 5 and 10 mg.
- Aritel/Aritel Cor. Excellent products produced in the Moscow region and sold at an affordable price. Dosages correspond to Concor and Concor Cor.
- Bisogamma. A German-made product sold at a fairly affordable price.
- Biol. A Slovenian-made generic, produced in tablets of 5 and 10 mg.
- Bicard-LF. There are also Belarusian generics of the drug in question on the market. Available in tablet form (30 pieces in one package).
All the drugs mentioned above have similar contraindications for use. In particular, use is not recommended in the following cases:
- deficiency of blood supply due to acute myocardial dysfunction, cardiogenic shock, impaired conduction of the heart muscle, severe hypotension, bradycardia;
- obstructive pulmonary disease of chronic form, bronchial asthma in complex forms, serious disruptions in the process of peripheral circulation;
- minor age.
During pregnancy and during the lactation period, use should be carried out with extreme caution.
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.
Concor's analogues
With the permission of the doctor, the original drug can be replaced not with generics, but with similar drugs. This group of therapeutic agents includes products that contain substances belonging to the group of beta-blockers as active ingredients.
There are both cheaper analogues of Concor on the market, as well as modern analogues of Concor without side effects. In particular, the following foreign and Russian analogues of Concor can be noted:
- Products with the active substance atenolol (Atenolol, Tenormin, Betacard-50, Prinorm). Apply 1-2 times during the day before meals. It is not uncommon for therapy to be accompanied by various adverse reactions, especially allergies.
- Products with the active ingredient metoprolol (Bataloc, Vazocordin, Metoprolol, etc.). These latest generation analogues of Concor act the earliest - 20 minutes after entering the body. At the same time, the active substance is eliminated faster, and therefore the frequency of administration is higher - 2-3 times during the day. It should be taken during or immediately after a meal, since it makes it easier for the medicine to be absorbed. An exception is Betaloc, which is characterized by a prolonged action and should be taken no more than once a day.
- Lokren. The active ingredient is betaxolol. The drug is used primarily for the treatment of hypertension and for the prevention of angina pectoris as part of a complex treatment. Taken only once during the day.
- Nebilet. It has a mild effect, and therefore blood pressure decreases very smoothly. A pronounced effect can be observed after about two weeks. The product is characterized by additional beneficial qualities - it dilates blood vessels and at the same time provides them with protection from atherosclerosis, and also inhibits the process of blood clot formation. Can be used once.
What to replace concor with
Angela
August 12, 2021
Hello! Please help me figure it out! I am 38 years old, female, overweight. Two years ago there was a hypertensive crisis, after which hypertension was diagnosed. The drugs Concor 2.5 mg and Telsartan 40 mg were prescribed. I took Concor constantly, but Telsartan only from time to time when there was an increase in blood pressure. Sometimes there were minor dizzinesses, but I didn’t pay much attention, associating them with VSD. In May, I began to experience severe dizziness, it became especially bad when I went to bed, I felt faint, my blood pressure immediately jumped to 160/100, there was ringing in the ears, my hands went numb at night. I practically couldn’t sleep. The neurologist diagnosed: Vertebral artery syndrome against the background of cervical dorsopathy, exacerbation. MRI of the g/m and shop - no focal changes in the g/m were detected, straightening of the cervical lordosis, protrusion of C5-C7, ultrasound of the DG of the vessels of the neck and head: normal variant. Prescribed treatment: Tagista 16 mg 3 times a day, Mexidol forte 250 mg 2 once a day, trittico 150 mg. I didn’t drink Trittico for fear of addiction and bad reviews; I drank everything else for 2 months. I can’t say that I felt good, Mexidol greatly reduced the pressure during the day to 90/50, and at night sometimes the pressure could jump to 160/110, but the pulse was normal, even lower than usual, and I gradually stopped taking Concor so that it would not reduce the pressure is even greater. After finishing the course of medications, the dizziness became a little less, but sometimes it got worse when lying down. My head felt like it was cottony, heavy, a feeling of squeezing in the back of my head, my ears were stuffed up - all this remained with me. Panic attacks were sometimes added to everything at night. Sleep is very bad. Sometimes I take a Phenibut tablet before bed to help me get some sleep. I don’t drink on a regular basis, for fear of addiction. I didn’t take Concor for almost two months and very occasionally telsartan, when there was an increase in pressure. A week ago, the pressure from the already usual 110/70 rose to 140/100 and the pulse also began to rise from 70 to 100 beats. I started taking Concor again when my pulse was really rising and after taking it I noticed that my dizziness began to get worse. Telsartan reduces the pressure to 130/90 for four hours, and then it rises again. What is noteworthy is that the pressure used to rise at night, but now in the morning. Sleep has practically disappeared. Yesterday morning I took indapamide 1.5 mg and an hour later the pressure jumped to 160 /110, and the pulse was up to 150, I took Concor again and a captopril tablet under the tongue. I lowered the pressure to 90/70, the pulse, of course, also dropped to 70 beats. I felt terrible all day, but in the evening I felt a little better. Even though I haven’t gotten used to this state lately, it’s still hard. At night, the pressure was 130/90, the pulse was 90, and there was a constant pounding of the heart in the ears. It felt like the heart was beating heavily. Please tell me what can replace Concor? Could it be making my dizziness worse? There is 25 mg metoprolol in the medicine cabinet, can I take it? And is it worth replacing telsartan? I had an ECG done in May, there were no abnormalities. Two years ago I did an ultrasound of the heart, everything was also normal.
The question is closed
dizziness
concor
vertebral artery syndrome
