Concor film-coated tab

Manufacturer

Merck

Distributor

Zuellig Pharma

Contents

Bisoprolol fumarate

MIMS Class

Beta-Blockers

Indications

Concor 5 Hypertension, CHD (angina pectoris). Concor 2.5 & Concor 5 Treatment of stable chronic moderate-to-severe heart failure w/ reduced systolic ventricular function in addition to ACE inhibitors & diuretics, & optionally cardiac glycosides.

Dosage

Hypertension/ angina pectoris 1-2 tab (5 mg) once daily. 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 following 4 wk, if well-tolerated increase to 7.5 mg once daily for the following 4 wk, if well-tolerated increase to 10 mg once daily for maintenance therapy.

Contraindication

Chronic heart failure patients w/ acute heart failure or during episodes of heart failure decompensation requiring IV inotropes; cardiogenic shock, 2nd or 3rd degree AV block w/o pacemaker, sick sinus syndrome, SA block, baseline bradycardia (< 60 beat/min), hypotension, severe bronchial asthma or severe COPD, late stages of peripheral arterial occlusive disease & Raynaud's syndrome; untreated phaeochromocytoma, metabolic acidosis. Pregnancy, lactation; childn.

Precautions

Bronchospasm, poorly controlled diabetes mellitus, 1st degree AV block, Prinzmetal's angina, peripheral arterial occlusive disease, strict fasting, psoriasis, thyrotoxicosis. Concomitant inhalation anaesth, desensitisation therapy. IDDM, renal & hepatic impairment, restrictive cardiomyopathy, congenital heart disease, haemodynamically significant organic valvular disease, w/in 3 mth of MI. Elderly (> 80 yr).

Adverse Reactions

At start of treatment but generally recede w/in 1-2 wk treatment: Rare: GI disturbances, skin reactions, decreased BP, slow pulse rate, AV conduction disturbance, cold extremities, muscle weakness/cramp & reduced lacrimation. May aggravate intermittent claudication & Raynaud's phenomenon, intensify myocardial failure, increase airway resistance, impair glucose tolerance, mask signs of low sugar levels. Fatigue, dizziness, slight headache, perspiration, sleep disturbances, vivid dreams & depressive moods.

Drug Interaction

Reserpine, α-methyldopa, clonidine, guanfacine, nifedipine, rifampicin, Ca-antagonist of the verapamil & diltiazem type, antiarrhythmics, insulin or oral blood sugar-reducing drugs.

Packing/Presentation

2.5mg x 10 x 10's

5mg x 10 x 10's

Pregnancy Category

C; D in 2nd & 3rd trimesters.