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Introduction About CONCOR PLUS TABLET
CONCOR PLUS TABLET is a combination of Bisoprolol and Hydrochlorothiazide, which belong to the group of medicines called Beta blockers and Thiazide diuretics respectively. It is used to manage hypertension. Hypertension is a condition in which the force of the blood is consistently high against the walls of the arteries, which can increase the risk of heart disease, kidney disease, and stroke.
Take this medicine with or without food. Before taking CONCOR PLUS TABLET, inform your doctor if you are pregnant or breastfeeding. Inform your doctor if you have any problems related to the kidney, liver, lungs, or heart, or if you have other conditions such as diabetes, thyroid problems, psoriasis, metabolic acidosis, non-melanoma skin cancer, or altered electrolyte levels.
CONCOR PLUS TABLET is not recommended for children and adolescents younger than 18 years of age. If you are taking any other medicines for other conditions or have a history of drug allergies, inform your doctor as it may manage drug-related interactions and serious side effects. The most common side effects of CONCOR PLUS TABLET are headache, dizziness, tiredness, weakness, and nausea. Consult your doctor for advice if your symptoms get worse over time.
Uses Of CONCOR PLUS TABLET
- Manage hypertension (high blood pressure)
How CONCOR PLUS TABLET Works
CONCOR PLUS TABLET helps to reduce high blood pressure, where bisoprolol works by reducing the force of contraction of the heart muscles by blocking the effects of certain hormones called adrenaline and making the heart beat more easily, thus lowering the blood pressure, and hydrochlorothiazide is a thiazide-diuretic that works by decreasing the extra fluid volume and also works by managing the reabsorption of sodium in the kidneys, which in turn relaxes the blood vessels and makes the blood flow more easily through the blood vessels, thus lowering the blood pressure.
How to use CONCOR PLUS TABLET
Always take CONCOR PLUS TABLET as directed by your physician. Take this medicine with or without food, swallow the medicine as a whole, and do not crush or chew the medicine. Do not stop taking CONCOR PLUS TABLET without informing your doctor.
Side Effects Of CONCOR PLUS TABLET
Common
- dizziness
- headache
- tiredness, weakness
- low blood pressure
- cold or numbness sensation in hands or feet
- nausea, vomiting
- diarrhea, constipation
- signs of high blood sugar levels (increased thirst, frequent urination, fruity breath odour)
Uncommon
- slow heart rate
- sleep disturbances, depression
- loss of appetite
- stomach pain
- breathing problems in patients with chronic lung disease or asthma
- muscle weakness and cramps
Rare
- blurred vision, reduced tear flow
- hearing problems
- runny nose with irritation
- temporary loss of consciousness due to a fall in blood pressure
- signs of low platelet count (easy bruising or bleeding)
- signs of low white blood cell count (fever, chills, mouth ulcers, sore throat, or repeated infections)
- jaundice (yellowing of skin or white of the eyes and dark urine)
- fainting
- allergic-like reactions such as itching, flushing, and rash
- impaired erection
- nightmares, hallucinations
Stop taking CONCOR PLUS TABLET and contact your doctor immediately if you experience any of the following side effects:
- serious side effects related to heart functions (such as slow or abnormal heartbeat, worsening of heart failure)
- dizziness, weakness or breathing difficulties
How To Manage Side Effects
Headache:
Apply a hot or cold-water bag to your head. Try taking a rest in a quiet and dark room. Drink tea or coffee. Consult your doctor if your symptoms worsen.
Diarrhoea:
Drink plenty of fluids, such as water, fruit juices, or electrolytes (ORS), to avoid dehydration in your body. Consult your doctor if your symptom does not improve.
Constipation:
Consume fiber-rich foods such as fresh fruits and vegetables and whole grain cereals, as well as plenty of fluids. Exercise more regularly and stay active. Consult your doctor if your symptoms worsen.
Nausea and vomiting:
Try to take this medicine with, or just after, a meal or snack, stick to simple meals, and do not eat oil-rich or spicy food. Consult your doctor if your symptom does not improve.
Dizziness:
Lie down until the dizziness passes away, and then move slowly and carefully. Take plenty of rest and drink plenty of fluids. Consult your doctor if your symptoms worsen.
Warning & Precautions
Pregnancy
CONCOR PLUS TABLET is not recommended for use in pregnancy as it may cause serious harm to the pregnancy and unborn child by increasing the risk of miscarriage, premature birth, growth of the baby, low blood sugar level, and decreased heart rate of the newborn baby. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Breastfeeding
CONCOR PLUS TABLET is not recommended for use in breastfeeding women. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Driving and Using Machines
Do not drive or operate any machines if you experience tiredness, dizziness, or drowsiness as it may impair your ability to drive or work. This may usually occur at the beginning of the> management. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Alcohol
Consumption of alcohol is not recommended during management with CONCOR PLUS TABLET as it may increase the risk of orthostatic hypotension (dizziness while standing up from sitting or lying position).
Kidney
CONCOR PLUS TABLET is not recommended for use in severe kidney impairment patients with low urine output or absence of urine output. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Liver
CONCOR PLUS TABLET should be used with caution in patients with mild to moderate liver impairment and it is not recommended for use in patients with severe liver impairment including hepatic precoma and coma. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Allergy
Do not take CONCOR PLUS TABLET if you are allergic to Bisoprolol and Hydrochlorothiazide or sulphonamide groups such as sulfamethoxazole.
Lungs
CONCOR PLUS TABLET is not recommended for use in patients with severe asthma or chronic lung disease. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Heart Disease
CONCOR PLUS TABLET is not recommended for use in patients with acute heart failure, slow or irregular heart rate, low blood pressure and cardiogenic shock. It should be used with caution in patients with chest pain (prinzmetal's angina). Consult your doctor for advice before taking CONCOR PLUS TABLET.
Others
CONCOR PLUS TABLET is not recommended for you, if you have:
- unmanageed phaeochromocytoma
- metabolic acidosis (excess acid in the blood)
- severe blood circulation problems (such as Raynaud’s syndrome causing the tingling sensation in fingers and toes or pale discoloration of the skin)
- severe low levels of sodium in the blood
Before taking CONCOR PLUS TABLET, inform your doctor if you have:
- diabetes
- strict fasting from solid foods
- thyroid problem
- psoriasis (a skin condition)
- management for allergic reactions
- blockage or narrowing of an artery in the legs (peripheral artery disease)
- decreased volume of circulating blood in the body
- ongoing desensitization therapy (for management of allergic reactions such as hay fever)
- simultaneous management with inhalation anaesthetics
- high levels of uric acid in the blood
- non-melanoma skin cancer
- acute myopia and secondary angle-closure glaucoma
- parathyroid disease
- disturbed electrolyte and fluid balance
Use in pediatrics:
CONCOR PLUS TABLET is not recommended for children and adolescents younger than 18 years of age. Consult with your doctor for advice before taking CONCOR PLUS TABLET.
Use in geriatrics:
CONCOR PLUS TABLET should be used with caution in elderly patients above 65 years of age, usually starting the management with the lowest effective dose. Consult with your doctor for advice before taking CONCOR PLUS TABLET.
Interactions
A. Drug-Drug interactions:
Before taking CONCOR PLUS TABLET inform your doctor, if you are taking any of these medicines:
- amiodarone, clonidine, digoxin, quinidine, moxonidine, methyldopa, lidocaine, rilmenidine, verapamil, diltiazem (used to manage low blood pressure or heart problems)
- imipramine, amitriptyline, moclobemide (used to manage depression)
- levomepromazine (used to manage mental illness)
- phenobarbital, phenytoin (used to manage seizures)
- non-steroidal anti-inflammatory drugs such as aspirin, diclofenac, indomethacin, ibuprofen, and naproxen (used to manage pain)
- salbutamol, theophylline (used to manage asthma)
- oxymetazoline, naphazoline (used to manage blocked nose)
- timolol eye drops (used to manage glaucoma)
- mefloquine (used to manage malaria)
- adrenaline, dobutamine, noradrenaline (used to manage shock)
- dihydroergotamine, rizatriptan (used to manage headaches or migraine)
- insulin or oral diabetic agents such as metformin, vildagliptin (used to manage diabetes)
- rifampicin (used to manage infections)
- narcotics such as morphine (used to manage severe pain)
- cholestyramine and colestipol resins (used to manage high cholesterol)
- prednisolone, hydrocortisone (used to manage swelling)
- tubocurarine (used as muscle relaxant)
- lithium (used to manage mental health problems)
- adrenocorticotropic hormone
Overdosage:
If you or anyone else accidentally take too much of CONCOR PLUS TABLET, consult your doctor immediately. Overdosage may cause undesirable effects such as dizziness, tiredness, light-headedness, electrolyte depletion, low heart rate, reduced blood pressure, low blood sugar levels, dehydration problems due to excess urination, breathlessness, or wheezing.
Synopsis
| Drug | : | Bisoprolol, Hydrochlorothiazide |
| Pharmacological Category | : | Beta-blockers, Thiazide diuretics |
| Therapeutic Indication | : | Hypertension |
| Dosage Forms | : | Tablet |
More Information
- Keep CONCOR PLUS TABLET out of reach from children
- Store at normal room temperature
FAQs About CONCOR PLUS TABLET
For how long should I take CONCOR PLUS TABLET?
You should continue taking CONCOR PLUS TABLET unless your doctor tells you to stop the medicine. Blood pressure medicines will usually be taken for a lifetime to manage complications due to high blood pressure. Your doctor may change management with another hypertension drug if you do not attain an effective therapeutic outcome with CONCOR PLUS TABLET.
Can CONCOR PLUS TABLET be taken during pregnancy?
No, CONCOR PLUS TABLET is not recommended for use in pregnancy as it may cause serious harm to the pregnancy and unborn child by increasing the risk of miscarriage, premature birth, growth of the baby, low blood sugar level, and decreased heart rate of the new-born baby. Consult your doctor for advice before taking CONCOR PLUS TABLET.
Does CONCOR PLUS TABLET increase urination?
Yes, CONCOR PLUS TABLET contains hydrochlorothiazide, a diuretic agent that removes excess fluid from the body through the kidneys, leading to increased urination and excretion. Excess water loss in the body may result in dehydration problems. During management with CONCOR PLUS TABLET, if you are always feeling tired and thirsty or have constant muscle cramps, immediately consult your doctor for advice.
Can CONCOR PLUS TABLET cause photosensitivity reactions?
Yes, CONCOR PLUS TABLET may cause patients to become more sensitive to sunlight or ultraviolet radiation. Avoid going out or minimise exposure to natural sunlight or artificial UV rays. While going out, protect your skin by applying sunscreen protection cream with the approval of your doctor, which helps to manage sunburn allergy reactions. Inform your doctor if you have a previous history of skin problems (such as non-melanoma skin cancer) before taking CONCOR PLUS TABLET.
Does CONCOR PLUS TABLET impair the ability to drive?
Yes, CONCOR PLUS TABLET may cause dizziness, drowsiness, or tiredness, usually at the beginning of the management. Do not drive or operate any machines that require concentration because it can impair your ability to drive or work. You may ask someone to drive for you or follow appropriate precautions before driving after consulting with your doctor.
References
1. KD Tripathi. Antiadrenergic drugs (adrenergic receptor antagonists) and drugs for glaucoma & Diuretics. Essentials of medical pharmacology. Seventh edition. 2013. Page –149-151 & 584.
2. R L Luna, W Oigman, J A Ramirez, D Mion, M Batlouni, J C da Rocha, G S Feitosa, I Castro, H de C Chaves Junior, E M God, L N Maia, K C Ortega, A M Raineri. [Efficacy and tolerance of the bisoprolol/hydrochlorothiazide combination in arterial hypertension]. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. October 1998. [Accessed 15th April 2022] https://pubmed.ncbi.nlm.nih.gov/10347937/
3. P K Zachariah, F H Messerli, W Mroczek. Low-dose bisoprolol/hydrochlorothiazide: an option in first-line, antihypertensive treatment. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. October 1993. [Accessed 15th April 2022] https://pubmed.ncbi.nlm.nih.gov/8269444/
4. APL Swift Services (Malta) Limited. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed 15th April 2022] https://www.medicines.org.uk/emc/files/pil.3090.pdf
5. Watson Pharma Private Limited. U.S. Food & Drug Administration. [Revised in August 2020] [Accessed 15th April 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/020504s026lbl.pdf
6. Torrent pharmaceuticals Ltd. CORBIS-H Tablet (Bisoprolol Fumarate and Hydrochlorothiazide). Torrent Pharma. [Revised on April 2021] [Accessed 15th April 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2939.pdf
Useful Diagnostic Tests
- Kidney Function Test
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