Concor

Bisoprolol fumarate

Stable chronic heart failure w/ reduced systolic left ventricular function in addition to ACE inhibitors, & diuretics & optionally cardiac glycosides. 5 mg & 10 mg: HTN & CHD (angina pectoris).

Individualized dosage. HTN or angina pectoris Adult 5 mg once daily. May be increased to 10 mg once daily. Max recommended dose: 20 mg once daily. Severe renal impairment (CrCl <20 mL/min) & severe liver function disorders Not >10 mg. Stable chronic heart failure 1.25 mg once daily for 1 wk; if well tolerated increase to 2.5 mg once daily for a further wk; if well tolerated increase to 3.75 mg once daily for a further wk; if well tolerated increase to 5 mg once daily for the 4 following wk; if well tolerated increase to 7.5 mg once daily for the 4 following wk; if well tolerated increase to 10 mg once daily for the maintenance therapy. Max recommended dose: 10 mg once daily.

May be taken with or without food: Take in the morning. Swallow whole w/ some liqd, do not chew.

Hypersensitivity. Acute heart failure or during episodes of heart failure decompensation requiring IV inotropic therapy, cardiogenic shock, 2nd or 3rd degree AV block, sick sinus syndrome, SA block, symptomatic bradycardia, symptomatic hypotension, severe bronchial asthma or severe peripheral arterial occlusive disease or Raynaud's syndrome, untreated phaeochromocytoma, metabolic acidosis.

Cessation of therapy must not be done abruptly. Regular monitoring during initiation & cessation of treatment. Patients w/ HTN or angina pectoris & accompanying heart failure. IDDM (type 1), restrictive cardiomyopathy, congenital heart disease, haemodynamically significant organic valvular disease, MI w/in 3 mth; bronchospasm (bronchial asthma, obstructive airways diseases), DM w/ large fluctuations in blood glucose values; symptoms of hypoglycaemia can be masked; strict fasting; ongoing desensitisation therapy. May increase both the sensitivity towards allergens and the severity of anaphylactic reactions. 1st degree AV block. Prinzmetal's angina. Peripheral arterial occlusive disease. General anaesth. Patients w/ or w/ a history of psoriasis. Phaeochromocytoma. May mask symptoms of thyreotoxicosis. May impair ability to drive a vehicle or to operate a machinery. Severe renal or hepatic impairment. Not to be used during pregnancy unless clearly necessary. Not recommended during breastfeeding. Childn.

Bradycardia (in patients w/ chronic heart failure). Worsening of heart failure, asthenia (in patients w/ chronic heart failure); dizziness, headache; GI complaints eg, nausea, vomiting, diarrhoea, constipation; feeling of coldness or numbness in the extremities, hypotension; fatigue.

Effect on AV conduction time may be potentiated & -ve inotropic effect increased w/ class-I antiarrhythmic drugs (eg, quinidine, disopyramide; lidocaine, phenytoin; flecainide, propafenone). IV administration of verapamil in patients on β-blocker may lead to profound hypotension & AV block. May increase risk of rebound HTN in abrupt w/drawal of centrally acting BP-lowering medicines (eg, clonidine, methyldopa, moxonodine, rilmenidine) particularly if prior to β-blocker discontinuation. Increased risk of hypotension, & further deterioration of the ventricular pump function in patients w/ heart failure w/ concomitant use of Ca antagonists of the dihydropyridine type (eg, nifedipine, felodipine, amlodipine). Effect on AV conduction time may be potentiated w/ class III antiarrhythmic medicines (eg, amiodarone). Topical β-blockers (eg, eye drops for glaucoma treatment) may add to the systemic effects of Concor. Concomitant use of parasympathomimetic drugs may increase AV conduction time & the risk of bradycardia. Intensification of blood sugar lowering effect w/ insulin & oral antidiabetic drugs. Attenuation of the reflex tachycardia & increased risk of hypotension w/ anaesth agents. Reduction of heart rate, increase of AV conduction time w/ digitalis glycosides. NSAIDs may reduce the hypotensive effect of bisoprolol. May reduce the effect of both bisoprolol & β sympathomimetics (eg, isoprenaline, dobutamine). Combination w/ noradrenaline, adrenaline may unmask the α-adrenoceptor-mediated vasoconstrictor effect. Increased risk of hypotension w/ antihypertensive agents as well as other drugs w/ BP lowering potential (eg, TCAs, barbiturates, phenothiazines). Increased risk of bradycardia w/ mefloquine. Enhanced hypotensive effect of β-blockers but also risk of hypertensive crisis w/ MAOIs (except MAO-B inhibitors).

Beta-Blockers

C07AB07 - bisoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

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