Concor Plus - 30 Tablets

Arterial hypertension of mild to moderate severity.

Tradename: Concor plus

Concor plus

Compound: Each tablet contains:

1- Bisoprolol fumarate 5 mg

Hydrochlorothiazide 12.5 mg

2- Bisoprolol fumarate 10 mg

Hydrochlorothiazide 25 mg

Auxiliary components: calcium hydrogen phosphate, microcrystalline cellulose, pregelatinized starch, colloidal silicon dioxide, magnesium stearate.

Properties: Bisoprolol is a selective beta1-blocker without intrinsic sympathomimetic and membrane-stabilizing activity. It has antihypertensive, antiarrhythmic and antianginal effects. Blocking in low doses beta1-adrenergic receptors of the heart, reduces the formation of cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP) stimulated by catecholamines, reduces the intracellular flow of calcium ions, has a negative chrono-, dromo-, batmo- and inotropic effect (slows down the heart rate ), inhibits cardiac conduction, reduces excitability and myocardial contractility). When the dose is increased, it blocks beta2-adrenergic receptors.

Hydrochlorothiazide is a thiazide diuretic. Reduces the reabsorption of sodium ions in the cortical segment of the loop of Henley, without affecting its section passing in the medulla of the kidneys. Blocks carbonic anhydrase in the proximal part of the convoluted renal tubules, enhances the excretion of potassium ions, bicarbonates and phosphates by the kidneys. Virtually no effect on the acid-base state. Enhances the excretion of magnesium ions by the kidneys; retains calcium ions in the body and inhibits the excretion of urates. The diuretic effect develops after 1-2 hours, reaches a maximum after 4 hours, the duration of the antihypertensive effect lasts for a day. The diuretic effect decreases with a decrease in the glomerular filtration rate and stops when its value is less than 30 ml / min.

Indications: — arterial hypertension of mild and moderate severity.

Method of administration and dosage: Inside, in the morning (during meals), without chewing with a small amount of liquid 1 time / day.

The dose of the drug is selected individually.

The initial dose of the drug Concor Plus is 1 tab. 5 / 12.5 (containing 5 mg of bisoprolol and 12.5 mg of hydrochlorothiazide) once a day. If the therapeutic effect is insufficient, the dose can be increased to the maximum daily dose of the drug 10/25 — 1 tab. drug Concor plus (containing 10 mg of bisoprolol and 25 mg of hydrochlorothiazide).

Contraindications: — severe forms of bronchial asthma

— chronic obstructive pulmonary disease

— cardiogenic shock

— sick sinus syndrome (including sinus blockade)

— atrioventricular block II and III degree without an artificial pacemaker

— severe bradycardia (heart rate less than 60 beats / min.)

—pheochromocytoma (without the simultaneous use of alpha-1 adrenergic blockers)

— late stages of peripheral circulatory disorders (including Raynaud’s syndrome)

— severe arterial hypotension (systolic blood pressure less than 90 mm Hg. Art.)

— refractory hypokalemia, hyponatremia, hypercalcemia;

— metabolic acidosis

— dehydration

— acute renal failure

— chronic renal failure (creatinine clearance (CC) less than 30 ml / min)

— simultaneous use with floktaphenin, sultopride;

— simultaneous intake of monoamine oxidase (MAO) inhibitors (except for MAO type B inhibitors)

— age up to 18 years (efficacy and safety have not been established)

— severe hepatic impairment (including hepatic precoma and coma)

— gout

— hypersensitivity to bisoprolol, hydrochlorothiazide and other sulfonamide derivatives, as well as to other components of the drug

Precautionary measures: Patients with coronary artery disease require special attention, because abrupt withdrawal can lead to a sudden deterioration in the patient’s condition. During the period of therapy with Concor plus, it is also necessary to monitor the indicators of the acid-base state and the content of electrolytes (potassium, sodium, calcium).

During treatment with Concor plus, patients should consume an adequate amount of liquid and food rich in potassium (for example, bananas, vegetables, nuts), which is necessary to compensate for potassium losses.

The risk of developing hypokalemia can be prevented or reduced by concomitant administration of potassium-sparing diuretics. Before prescribing the drug Concor plus, it is necessary to compensate for the BCC.

In patients with peripheral circulatory disorders, care must be taken when prescribing Concor plus. With thyrotoxicosis, Concor plus (due to the content of bisoprolol in it) can mask clinical signs of the disease (for example, tachycardia).

Patients with pheochromocytoma should not be prescribed Concor Plus until treatment with alpha-blockers is prescribed. In this case, it is necessary to control blood pressure.

Side effects: Often: increased fatigue, dizziness, headache, which are especially frequent

they disappear at the beginning of treatment, are mild and disappear during the first 1-2 weeks of treatment;

Uncommon: sleep disturbance, depression, convulsions

Rarely: «nightmares», hallucinations.

On the part of the cardiovascular system: Uncommon: bradycardia, impaired AV conduction, exacerbation of chronic heart failure, ventricular premature beats, feeling of coldness and numbness of the extremities

Uncommon: orthostatic hypotension

Very rare: chest pain.

From the respiratory system: Uncommon: bronchospasm in patients with bronchial asthma and bronchospasm (in history)

From the digestive system: Often: nausea, vomiting, diarrhea, constipation, dryness of the oral mucosa

Uncommon: loss of appetite, gastrointestinal discomfort, pancreatitis.

From the musculoskeletal system: Uncommon: muscle weakness, cramps in the calf muscles, arthralgia.

From the senses: Rarely: hearing impairment, visual impairment, decreased production of the lacrimal glands (this should be taken into account in patients who use contact lenses).

Storage method: At a temperature not higher than 25 degrees. In a dry place.

Package: The cardboard box contains 1,2 or 3 blisters of 10 tablets, paper instructions.