Concor Plus Tablets
Bisoprolol + Hydrochlorothiazide
"5mg, 12.5mg"
MERCK KgaA
| Pack size | 30's (10's Blister x 3) |
|---|---|
| Dispensing mode | POM |
| Source | GERMANY |
| Agent | Modern Pharmaceutical Co. |
| Retail Price | 36.50 AED |
Indications
Concor Plus Tablets is used for:
Hypertension, Congestive heart failure, HTN, Angina pectoris
Adult Dose
Adult: PO Initial: 2.5 mg/6.25 mg tablet once daily.
Increase based on clinical response in 2 weeks, Maximum: bisoprolol 20 mg/hydrochlorothiazide 12.5 mg once daily.
Elderly: Dosage adjustment for geriatric patients usually not necessary
Child Dose
Renal Dose
Renal Impairment
Use caution in dosing/titrating patients with renal dysfunction
Cumulative effects of thiazides may develop with impaired renal function
CrCl <40mL/min: half-life of bisoprolol fumarate is increased up to threefold
Administration
May be taken with or without food.
Contra Indications
Low cardiac output and uncompensated cardiac failure; sinus bradycardia, 1st ° heart block, cardiogenic shock, bronchospasm; severe haemorrhage. Pregnancy.
Precautions
Bronchospastic disease, hyperthyroidism, peripheral vascular disease, undergoing anaesthesia. Monitor blood glucose regularly. May mask symptoms of hypoglycaemia. Elderly. Gradual withdrawal is advised.
Lactation: excreted in breast milk, use caution
Pregnancy-Lactation
Pregnancy Category: C
Lactation: excreted in breast milk, use caution
Interactions
Bisoprolol : May potentiate AV conduction time and may increase negative inotropic effect w/ class I antiarrhythmic drugs (e.g. quinidine, disopyramide, propafenone). Concomitant catecholamine-depleting drugs (e.g. reserpine, guanethidine) may produce excessive sympathetic activity. May exacerbate rebound HTN upon discontinuance of clonidine treatment. Increased risk of bradycardia w/ digitalis glycosides. Reduced hypotensive effect w/ NSAIDs.
Hydrochlorothiazide: Increases toxicity of lithium. May potentiate orthostatic hypotension w/ barbiturates and narcotics. Enhanced neuromuscular blocking action of competitive neuromuscular blockers (e.g. atracurium). Increased hypokalaemic effect w/ corticosteroids, corticotropin, ?2 agonists (e.g. salbutamol). Additive effect w/ other antihypertensives. Potentiation of orthostatic hypotension w/ barbiturates or opioids. Reduced antihypertensive effect by drugs that cause fluid retention (e.g. corticosteroids, NSAIDs, carbenoxolone). Enhanced nephrotoxicity of NSAIDs. Reduced therapeutic effect of antidiabetics.
Adverse Effects
Side effects of Bisoprolol + Hydrochlorothiazide :
1-10%
Bisoprolol fumarate
Arthralgia (3%), asthenia (2%), cough (3%), diarrhea (4%), dizziness (10%), dry mouth (1%), dyspnea (2%), fatigue (8%), headache (11%), hypoaesthesia (2%), insomnia (3%), nausea (2%), peripheral edema (4%), pharyngitis (2%), rhinitis (4%), sinusitis (2%), upper respiratory infection (5%), vomiting (2% )
Hydrochlorothiazide
Anorexia, Epigastric distress, Hypokalemia, Hypotension, Orthostatic hypotension, Phototoxicity
Frequency Not Defined
Bisoprolol fumarate
Aggravate CHF, cold extremeties, decrease HDL, depression, hypotension, increase bronchospasm, increase triglycerides, mask symptoms of hypoglycemia, muscle & joint pain
Hydrochlorothiazide
Agranulocytosis, anaphylaxis, anemia, Confusion, erythema multiforme skin reactions including Stevens-Johnson syndrome
Exfoliative dermatitis including toxic epidermal necrolysis, Hypomagnesemia, hyponatremia, hypochloremia, dizziness, fatigue, headache, hypercalcemia, hyperuricemia, hyperglycemia, hyperlipidemia, hypercholesterolemia, muscle weakness or cramps, nausea, purpura, rash, vertigo, vomiting
Potentially Fatal: AV block, bradycardia. Rare but may occur in patients with preexisting cardiac disease. Includes severe bronchospasm, hypoglycaemia, hypotension, orthostatic hypotension, bradyarrhythmias. 'Rebound phenomenon' leading to unstable angina or MI on sudden withdrawal.
Mechanism of Action
Bisoprolol fumarate/hydrochlorothiazide is a fixed-combination tablet that combines a Beta adrenergic receptor blocker, bisoprolol fumarate, and a thiazide diuretic, hydrochlorothiazide.
Bisoprolol fumarate, a cardioselective inhibitor of beta(1)-adrenoceptor, has no significant intrinsic sympathomimetic activity or membrane stabilizing activity in its therapeutic dosage; exhibits beta(2)-adrenoceptors inhibition and negative chronotropic effect.
Hydrochlorothiazide is a thiazide diuretic that inhibits Na reabsorption in distal renal tubules resulting in increased excretion of Na+ and water, also K+ and H+ ions.
Note
Concor Plus "5mg, 12.5mg" Tablets manufactured by MERCK KgaA. Its generic name is Bisoprolol + Hydrochlorothiazide. Concor Plus is availble in United Arab Emirates.
Farmaco UAE drug index information on Concor Plus Tablets is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.