Concore AM Special Precautions

Due to the bisoprolol component, Bisoprolol + Amlodipine (Concore AM) must be used with caution in: Diabetes mellitus showing large fluctuations in blood glucose values; symptoms of hypoglycemia (e.g. tachycardia, palpitations or sweating) can be masked; Strict fasting; Ongoing desensitization therapy: As with other beta-blockers, bisoprolol may increase both the sensitivity towards allergens and the severity of anaphylactic reactions. Epinephrine treatment may not always yield the expected therapeutic effect; First degree AV block; Prinzmetal's angina; Peripheral arterial occlusive disease (aggravation of symptoms might happen especially when starting therapy).
Patients with psoriasis or with a history of psoriasis should only be given beta-blockers (e.g. bisoprolol) after carefully balancing the benefits against the risks.
Under treatment with bisoprolol of the symptoms of thyrotoxicosis may be masked. In patients with phaeochromocytoma bisoporolol must not be administered until alpha-receptor blockade. In patients undergoing general anaesthesia beta-blockade reduces the incidence of arrhythmias and myocardial ischemia during induction of anaesthesia and intubation, and the post-operative period. It is currently recommended that maintenance beta-blockade be continued perioperatively. The anaesthetist must be aware of beta-blockade because of the potential for interactions with other drugs, resulting in bradyarrhythmias, attenuation of the reflex tachycardia and the decreased reflex ability to compensate for blood loss. If it is thought necessary to withdraw beta-blocker therapy before surgery, this should be done gradually and completed about 48 hours before anaesthesia.
Although cardioselective (beta1) beta-blockers may have less effect on lung function than non-selective beta-blockers, as with all beta-blockers, these should be avoided in patients with obstructive airway diseases, unless there are compelling clinical reasons for their use. Where such reasons exist, Bisoprolol + Amlodipine (Concore AM) may be used with caution. In bronchial asthma or other chronic obstructive lung diseases, which may cause symptoms, bronchodilating therapy is recommended. Occasionally, an increase of the airway resistance may occur in patients with asthma, requiring a higher dose of beta₂-stimulants.
Effects on the ability to drive and use machines: Bisoprolol + Amlodipine (Concore AM) can have minor or moderate influence on the ability to drive and use machines. Some adverse reactions to Bisoprolol + Amlodipine (Concore AM), e.g. dizziness, headache, or fatigue, may affect the patient's ability to concentrate and react and may therefore constitute a risk in situations where these abilities are of special importance, e.g. driving or using machines.