Concor 5 mg is a highly selective beta-1 adrenergic receptor blocking agent (beta-blocker) containing bisoprolol fumarate. It is an oral prescription medication indicated for the management of essential hypertension (high blood pressure), chronic stable angina pectoris (chest pain), and stable chronic heart failure with reduced systolic left ventricular function.
By selectively inhibiting heart-specific beta-1 receptors, Concor reduces cardiac responsiveness to sympathetic stimulation (adrenaline and noradrenaline). This targeted pharmacological action decreases resting and exercise heart rate, lowers cardiac output, and reduces systemic vascular pressure, thereby optimizing cardiovascular performance while minimizing impact on bronchial and metabolic pathways.
Active Ingredients & Mechanism of Action
Active Substance
Bisoprolol Fumarate (5 mg per tablet): A synthetic, highly cardioselective beta-1 receptor antagonist without intrinsic sympathomimetic activity (ISA) or clinically relevant membrane-stabilizing activity.
Mechanism of Action
Selective Beta-1 Receptor Blockade: Bisoprolol binds preferentially to beta-1 adrenergic receptors located in the myocardium. By blocking catecholamine binding, it slows the heart rate (negative chronotropic effect) and reduces myocardial contractility (negative inotropic effect).
Renin Secretion Suppression: Bisoprolol inhibits the release of renin from the juxtaglomerular apparatus in the kidneys, suppressing the renin-angiotensin-aldosterone system (RAAS) and contributing to long-term systemic arterial pressure reduction.
Reduction of Myocardial Oxygen Demand: By decreasing heart rate and systolic force, Concor reduces total myocardial workload and oxygen consumption, alleviating ischemic episodes in patients suffering from angina pectoris.
Cardioselectivity Profile: Due to its high affinity for beta1 over beta2 receptors (found in bronchial smooth muscle and blood vessels), Concor exhibits a lower risk of bronchospasm or peripheral vasoconstriction compared to non-selective beta-blockers when administered at recommended therapeutic doses.
Key Medical Indications & Clinical Benefits
Hypertension Management: Effective as monotherapy or in combination with other antihypertensive agents to maintain blood pressure within target clinical thresholds.
Angina Pectoris Prevention: Helps prevent the frequency and severity of exertional chest pain by balancing myocardial oxygen supply and demand.
Stable Chronic Heart Failure Therapy: Used alongside ACE inhibitors, diuretics, and optional cardiac glycosides to improve exercise tolerance, reduce hospitalization rates, and increase survival outcomes in heart failure management.
24-Hour Therapeutic Coverage: Formulated for once-daily dosing due to a plasma elimination half-life of 10–12 hours, providing consistent hemodynamic control throughout a full 24-hour cycle.
Usage Instructions & Dosage Protocol
Important: Concor is a prescription-only medication. Exact dosage titration and administration schedules must be determined and monitored by a qualified healthcare professional.
Standard Dosage for Hypertension & Angina: The typical starting dose is 5 mg once daily. If necessary, a physician may adjust the dose to 10 mg once daily based on clinical response and tolerance.
Dosage in Chronic Heart Failure: Treatment requires a gradual titration phase supervised by a physician, typically starting at 1.25 mg once daily and stepping up slowly over several weeks to a target maintenance dose of up to 10 mg once daily.
Administration: Swallow the tablet whole with a sufficient amount of water in the morning. Tablets can be taken with or without food. Do not crush or chew the tablets.
Missed Dose: Take the missed dose as soon as remembered on the same day. If forgotten until the following day, skip the missed dose and resume the normal daily schedule. Never double the dose to compensate for a missed tablet.
Discontinuation Warning: Do not stop taking Concor abruptly. Abrupt cessation of beta-blocker therapy can precipitate rebound hypertension, worsen angina pectoris, or trigger myocardial infarction. Dose reduction must occur gradually under medical supervision.
Safety Precautions, Warnings & Contraindications
Absolute Contraindications
Hypersensitivity: Known hypersensitivity to bisoprolol fumarate or any of the tablet's excipients.
Acute Heart Failure: Decompensated heart failure or heart failure episodes requiring intravenous inotropic therapy.
Cardiogenic Shock: Severe, life-threatening hypotension secondary to cardiac dysfunction.
Severe Conduction Disorders: Second- or third-degree AV block (without a functioning pacemaker), sinoatrial block, or sick sinus syndrome.
Severe Bradycardia: Resting heart rate below 50–60 beats per minute prior to treatment initiation.
Severe Hypotension: Systolic blood pressure below 100 mmHg.
Severe Bronchial Conditions: Severe bronchial asthma or advanced chronic obstructive pulmonary disease (COPD).
Severe Peripheral Arterial Occlusive Disease: Late stages of peripheral arterial disease or severe forms of Raynaud's syndrome.
Untreated Pheochromocytoma: Must not be administered without concurrent alpha-receptor blocker therapy.
General Precautions & Monitoring
Bronchospasm Risk: Although bisoprolol is cardioselective, caution is required in patients with mild-to-moderate asthma or reactive airway disease. Concomitant bronchodilator therapy may be required.
Diabetes Mellitus: Bisoprolol may mask early symptoms of acute hypoglycemia (especially tachycardia and tremors). Blood glucose monitoring should be maintained.
Thyrotoxicosis: Beta-blockers may mask signs of hyperthyroidism (such as tachycardia).
Renal and Hepatic Function: Dose adjustments may be necessary in patients with severe renal impairment (creatinine clearance less than 20 mL/min) or end-stage hepatic impairment.
Pregnancy & Lactation: Bisoprolol is generally not recommended during pregnancy unless strictly necessary, as beta-blockers reduce placental perfusion and may affect fetal development. Nursing mothers should consult a physician prior to use.
Product Specifications & Storage
Dosage Form: Film-coated tablets.
Strength: 5 mg Bisoprolol Fumarate.
Packaging: 30 tablets per box (blister packaging).
Storage Requirements: Store below 30°C (86°F) in a cool, dry place inside the original packaging. Protect from direct heat, moisture, and light. Keep out of reach and sight of children.
Medication
