Concor AM

Description overdue on 04/10/2014

• Latin name: Concor AM
• ATC code: C07EB
• Active substance: Bisoprolol and amlodipine (Bisoprolol + Amlodipine)
• Manufacturer: EGIS PHARMACEUTICALS (Hungary)

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• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• To receive Concor AM
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Analogs
• Babies
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

• One tablet Konkor AM 5 + 5 contains 5 mg amlodipine   and 5 mg of bisoprolol fumarate.
• One tablet Konkor AM + 5 10 contains 10 mg of amlodipine 5 mg bisoprolol fumarate.
• One tablet Konkor 10 AM + 5 contains 5 mg of amlodipine and 10 mg bisoprolol fumarate.
• One tablet Konkor AM + 10 10 contains 10 mg of amlodipine and 10 mg bisoprolol fumarate.

Excipients: magnesium stearate, sodium carboxymethyl starch, microcrystalline cellulose, colloidal silica.

Product form

The drug is available in tablets close to white color, oblong, biconcave, with a notch on one side and the inscription «MS» on the other, odorless.

Ten tablets in a blister, three of these in paper blister package.

Pharmacological action

The drug has antihypertensive   action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Concor AM has expressed antianginal   and antihypertensive   effect due to the action of two components: amlodipine   and bisoprolol.

Amlodipine   inhibits calcium channels reduces the transmembrane calcium ion transit myocytes. Antihypertensive effect is due to the relaxing effect on the muscle cells of blood vessels, causing a decrease in vascular resistance.

Causes of anti-anginal action is not fully understood, and perhaps associated with the effects listed below:

• expansion of large arteries and arterioles of the heart improves the oxygen supply of all areas of the myocardium;
• increased peripheral small arteries reduces afterload; so how Amlodipine   causes tachycardia , The myocardial oxygen consumption decreases.

Bisoprolol - Selective Beta-blockers It does not cause membrane stabilizing effect. In general, no effect on the resistance of respiratory tract and metabolic processes involving beta-adrenergic receptors.
Bisoprolol does not have a significant inverse inotropic action. The greatest effect occurs four hours after administration.

The maximum antihypertensive effect occurs within two weeks after starting therapy. Bisoprolol also lowers the activity sympathoadrenal.

Pharmacokinetics

Amlodipine   quickly adsorbed after administration. The highest concentration in the blood occurs after 7-12 hours. Food does not affect the absorption of the substance. Bioavailability is approximately 65-80%.

At 93-98% binds to proteins of blood. Subjected to intensive changes in the liver. 90% of the received material is converted to a pharmacologically inactive derivative pyridine . 10% is excreted by the kidneys in the original form. The half - 35-50 hours.

Bisoprolol is absorbed from the intestine by 90%. The highest concentration in the blood occurs three hours later. Receiving Food does not affect the bioavailability.
Binding proteins of the blood was 30%. All water-soluble metabolites and excreted by the kidneys. The half-life of bisoprolol is 11-13 hours.

Indications

Hypertension : Single-component replacement therapy drugs bisoprolol   and amlodipine in similar doses.

Contraindications

Contraindications to receive amlodipine :

• the first 28 days myocardial infarction ;
• unstable angina (not including Prinzmetal angina );
• expressed aortic stenosis .

Contraindications to receive bisoprolol :

• decompensated heart failure Requiring inotropic therapy;
• bradycardia ;
• sinoatrial block;
• heavy bronchial asthma   or COPD;
• AV-block 2-3 degrees ;
• pheochromocytoma (without alpha-blockers );
• disorders of the peripheral arterial circulation ;
• metabolic acidosis.

Contraindications to receiving combination Amlodipine / bisoprolol :

• hypotension ;
• age less than 18 years;
• cardiogenic shock ;
• hypersensitivity   means the components.

Be wary of: hepatic   or renal failure , Chronic course Heart Failure , Severe Diabetes . hyperthyroidism . Prinzmetal angina, psoriasis, AV-blockade first degree, general anesthesia,   hypotension, aortic   or mitral stenosis.

Side effects

Adverse effects amlodipine .

• From the senses: loss of . noise in ears .
• From the hematopoietic system: thrombocytopenia, leukopenia.
• On the part of metabolism: hyperglycemia.
• From the nervous system: peripheral neuropathy, hypoesthesia, drowsiness . paraesthesia, tremor, headache, muscle hypertension, insomnia, dizziness, depression . mood changes .
• From the digestive system: abdominal pain . nausea . dyspepsia . dryness of mucous membranes of the mouth . gastritis . pancreatitis .
• From the tepatobiliarnoy system: hepatitis, hyperbilirubinemia.
• From the circulatory system: palpitations . decompression . myocardial infarction . arrhythmia . vasculitis.
• With the genitourinary system: pollakiuria, nocturia.
• From the musculoskeletal system: myalgia, swelling of the ankles . arthralgia, convulsions muscle .
• Skin: increased sweating, Stevens-Johnson syndrome, alopecia, itch . rash . exfoliative dermatitis.
• From the respiratory system: rhinitis . cough . breathlessness .
• Allergic reactions: angioedema . hives .
• General disorders: swelling . fatiguability . asthenia . chest pain .
• Laboratory data: weight change   and liver enzymes .

Adverse effects bisoprolol .

• From the senses: conjunctivitis . hearing loss .
• On the part of metabolism: increased content   triglycerides.
• From the nervous system: insomnia . dizziness . depression . headache . fainting .
• From the circulatory system: bradycardia,   marked reduction of pressure violation of AV-conduction, orthostatic hypotension.
• From the digestive system: vomiting, nausea . diarrhea . constipation, hepatitis.
• From the respiratory system: bronchospasm   in patients with asthma.
• Skin: reaction hypersensitivity . alopecia .
• From the musculoskeletal system: convulsions muscle muscular weakness .
• Laboratory findings: elevated levels liver transaminases.

To receive Concor AM

Instructions for receiving 5/5 mg Concor AM and instructions on how to receive other forms of release agents are identical and reported that the drug is preferably taken in the morning, without chewing.

The suggested daily dose - one tablet a day. Titration provides physician individually for each patient after using monocomponent products containing ingredients that are available as part of Concor AM.

Drug treatment is usually carried out for a long time. Older people are usually prescribed dose means. With increasing doses caution is required. Treatment should not be discontinued abruptly because this can cause a temporary deterioration (particularly those with coronary heart disease ).

Overdose

Overdose amlodipine   manifested a strong decrease in pressure tachycardia   and severe peripheral vasodilation.

Treatment: Reception Activated Carbon , Gastric lavage, monitoring of the heart and lungs, diuresis and blood volume; maintenance of the cardiovascular system. Intensive symptomatic therapy. Application and vasoconstrictor calcium gluconate.

Overdose bisoprolol   shown AV-block,   pressure reduction, expressed bradycardia, bronchospasm, acute coronary insufficiency and hypoglycaemia.

Treatment: symptomatic therapy.

Cooperation

Amlodipine

Amlodipine   enhances the effects of other antihypertensive agents.

Bisoprolol

Introduction verapamil   makers beta-blockers,   cause AV-blockade   and over hypotension.

Antihypertensives central mechanism of action ( clonidine, moxonidine, methyldopa, rilmenidine ) When used with bisoprolol   lead to a slowing of heart rate, decrease in cardiac output and vasodilation.

Nifedipine   when used with bisoprolol   increased risk of hypotension .

The antiarrhythmic agents of the first class when used with bisoprolol   lower the AV-conduction and the ability of the myocardium to contract.

Parasympathomimetics   when used with bisoprolol   strengthen violation of AV-conduction and increases the possibility of bradycardia.

NSAIDs   reduce the hypotensive effect bisoprolol.

Terms of sale

The drug is available by prescription.

Storage conditions

Keep away from children. Store in a dry, dark place.

Shelf life

Three years.

Cautions

During treatment, it is recommended to use caution when driving a car.

Analogs

The analog of the drug is Alotendin .

Babies

The tool is not recommended for use in those aged less than 18 years, so the data on the efficacy and safety available.

During pregnancy (and lactation)

If absolutely necessary are allowed to use the drug during pregnancy or lactation.

Reviews for Concor AM

As patients and doctors, Concor AM Comments on the 5 + 5, and other dosage positive, reports of side effects is small.

Price Concor AM where to buy

In Russia, the price of Concor the 5 + 5 mg of 300-357 rubles, and the price of Concor AM 10 ± 10 mg - 475-660 rubles.

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