PRESCRIPTION NOTICE: Concor 5 mg is a Prescription Only Medicine (POM). It cannot legally be dispensed without a valid prescription from a licensed healthcare provider in Kenya. Do not use this medicine without medical supervision. Do not share this medicine with others even if they appear to have the same condition.
Concor 5 mg Tablets are a prescription-only cardioselective beta-1 adrenergic receptor blocker (beta-blocker) containing bisoprolol fumarate as the active ingredient. Each pack contains 30 film-coated tablets, providing a one-month supply at standard once-daily dosing. Concor is manufactured by Merck KGaA and is one of the most widely prescribed and clinically recognised beta-blockers globally, with an established evidence base spanning hypertension, stable angina pectoris, and chronic heart failure.
Bisoprolol’s high cardioselectivity — its preferential action on cardiac beta-1 receptors over pulmonary beta-2 receptors — makes Concor a preferred beta-blocker in patients where respiratory caution is warranted. If you have been prescribed Concor 5 mg for hypertension treatment in Kenya or cardiac management, this medicine must be used strictly as directed by your healthcare provider. The price of Concor 5 mg in Kenya varies by pharmacy and is dispensed only on presentation of a valid prescription.
Key Benefits
- Highly cardioselective beta-1 blocker — targeted cardiac action with reduced risk of respiratory side effects compared to non-selective beta-blockers
- Effectively lowers and controls blood pressure in patients with hypertension
- Reduces frequency and severity of angina episodes by decreasing myocardial oxygen demand
- Improves survival and cardiac function in patients with stable chronic heart failure when used as part of guideline-directed therapy
- Controls heart rate in patients with tachyarrhythmias and rapid atrial fibrillation
- Once-daily dosing supports long-term treatment adherence
- Proven, well-established safety profile with extensive global clinical use
- Included in international and Kenyan cardiovascular treatment guidelines as a first-line agent
What It Is & How It Works
Active Ingredient
Each film-coated tablet contains:
| Active Ingredient | Strength | Role |
|---|---|---|
| Bisoprolol Fumarate | 5 mg | Cardioselective beta-1 adrenergic receptor blocker — reduces heart rate, blood pressure, and myocardial workload |
How It Works
Bisoprolol fumarate exerts its therapeutic effect by selectively blocking beta-1 adrenergic receptors located primarily in the heart, with minimal activity at beta-2 receptors found in bronchial and vascular smooth muscle. This selectivity is clinically significant and distinguishes bisoprolol from older, non-selective beta-blockers.
Through beta-1 receptor blockade, bisoprolol produces the following pharmacological effects:
- Negative chronotropy — reduces resting and exercise heart rate, decreasing myocardial oxygen demand
- Negative inotropy — reduces the force of cardiac contraction, lowering cardiac output and blood pressure
- Negative dromotropy — slows conduction through the atrioventricular (AV) node, helping to control ventricular rate in atrial fibrillation
- Suppression of renin release — reduces activation of the renin-angiotensin-aldosterone system (RAAS), contributing to blood pressure reduction
- Cardiac remodelling inhibition — in heart failure, chronic adrenergic stimulation causes progressive cardiac damage; bisoprolol blocks this pathway, reducing ventricular remodelling and improving long-term cardiac function
Classification
Concor 5 mg is classified as a Prescription Only Medicine (POM) in Kenya. It must only be initiated, monitored, and adjusted by a licensed healthcare provider. A valid prescription is required for dispensing at any registered pharmacy in Kenya.
Formulation
Film-coated tablets. Each pack contains 30 tablets. Tablets should be swallowed whole with water, with or without food, preferably in the morning.
Uses & Indications
Concor 5 mg Tablets are indicated for the treatment of:
- Hypertension (high blood pressure) — as monotherapy or in combination with other antihypertensive agents
- Stable angina pectoris — to reduce the frequency of angina episodes and improve exercise tolerance
- Stable chronic heart failure with reduced ejection fraction (HFrEF) — as part of guideline-directed medical therapy alongside ACE inhibitors or ARBs and diuretics
- Rate control in stable atrial fibrillation — to control ventricular rate in patients with persistent or permanent atrial fibrillation
IMPORTANT: The decision to initiate, adjust, or discontinue Concor therapy must be made exclusively by a licensed healthcare provider. Do not self-prescribe, self-adjust your dose, or stop taking this medicine without consulting your doctor. Abrupt discontinuation of bisoprolol — particularly in patients with coronary artery disease — can precipitate rebound hypertension, unstable angina, or acute myocardial infarction.
Dosage & Administration
This medicine requires a valid prescription. Use only as prescribed by your healthcare provider. The following dosage information is provided for general reference only and does not constitute prescribing advice.
| Indication | Starting Dose | Usual Maintenance Dose | Maximum Daily Dose |
|---|---|---|---|
| Hypertension | As directed by physician | As directed by physician | As directed by physician |
| Stable Angina | As directed by physician | As directed by physician | As directed by physician |
| Chronic Heart Failure | As directed by physician | As directed by physician | As directed by physician |
| Atrial Fibrillation (Rate Control) | As directed by physician | As directed by physician | As directed by physician |
| Renal or Hepatic Impairment | Dose reduction may be required | As directed by physician | As directed by physician |
Important Dosing Notes for Heart Failure
In chronic heart failure, bisoprolol must be initiated at the lowest possible dose (1.25 mg once daily) and titrated upward slowly — typically doubling the dose every 2 weeks — under close medical supervision. Rapid initiation or up-titration in heart failure patients can precipitate acute decompensation. This titration must be managed exclusively by a physician.
Administration Instructions
- Take this medicine exactly as prescribed — do not increase, decrease, or skip doses without medical advice
- Take once daily, preferably in the morning, with or without food
- Swallow tablets whole with a full glass of water — do not crush, chew, or split unless specifically advised by your doctor
- Take at the same time each day to maintain consistent blood levels
- If a dose is missed, take it as soon as you remember on the same day — if the next day has begun, skip the missed dose and continue as normal; do not double dose
- Do not stop taking this medicine suddenly — always consult your doctor before making any changes; gradual dose reduction over 1–2 weeks is required upon discontinuation
- Attend all scheduled follow-up appointments for blood pressure and heart rate monitoring
Possible Side Effects
Like all medicines, Concor may cause side effects in some patients. Report any new or worsening symptoms to your healthcare provider promptly.
Common
- Fatigue or tiredness — particularly in the first few weeks of treatment; usually improves with continued use
- Cold extremities — hands and feet may feel cold due to reduced peripheral circulation
- Bradycardia (slow heart rate) — heart rate below 50–60 beats per minute; report to your doctor
- Dizziness or light-headedness — particularly upon standing; rise slowly from sitting or lying positions
- Headache
- Nausea or gastrointestinal discomfort
Less Common
- Sleep disturbances, vivid dreams, or nightmares
- Depression or low mood
- Erectile dysfunction in male patients
- Mild bronchospasm — particularly in patients with pre-existing respiratory conditions, despite bisoprolol’s cardioselectivity
- Hypotension (low blood pressure)
WARNING: Rare but serious — seek immediate medical attention if you experience: severe bradycardia (very slow heart rate) or heart block, acute worsening of heart failure symptoms (sudden increase in breathlessness, ankle swelling, weight gain), severe bronchospasm or difficulty breathing, signs of hypoglycaemia unawareness (bisoprolol may mask the tachycardia associated with low blood sugar in diabetic patients), or severe skin reactions.
This is not a complete list of side effects. Report all side effects to your healthcare provider.
Warnings & Precautions
CONTRAINDICATION: Do NOT use Concor if you have acute heart failure or decompensated heart failure requiring intravenous inotropic therapy, cardiogenic shock, second- or third-degree AV block, sick sinus syndrome, sinoatrial block, severe bradycardia (heart rate below 60 bpm at rest before starting treatment), severe hypotension, severe bronchial asthma or severe chronic obstructive pulmonary disease (COPD), severe peripheral arterial occlusive disease, untreated phaeochromocytoma, or metabolic acidosis.
Do Not Use If You:
- Have acute decompensated heart failure or cardiogenic shock
- Have significant bradycardia or advanced heart block without a pacemaker
- Have severe asthma or severe COPD — even cardioselective beta-blockers can cause significant bronchospasm at higher doses
- Are known to be hypersensitive to bisoprolol fumarate or any excipient in the formulation
Use With Caution If You Have:
- Mild to moderate asthma or COPD — use only under specialist supervision with close respiratory monitoring
- Diabetes mellitus — bisoprolol may mask the symptoms of hypoglycaemia (particularly tachycardia); monitor blood glucose carefully
- Peripheral artery disease or Raynaud’s phenomenon — may worsen symptoms of poor circulation
- First-degree AV block — monitor ECG during treatment
- Psoriasis — beta-blockers have been associated with triggering or worsening psoriasis
- Thyrotoxicosis — bisoprolol may mask signs of hyperthyroidism; do not discontinue abruptly as this may precipitate thyroid storm
- Phaeochromocytoma — only use after adequate alpha-blocker therapy has been established
Do Not Combine With:
- Calcium channel blockers of the verapamil or diltiazem type — risk of severe bradycardia, AV block, and cardiac failure; this combination is potentially life-threatening
- Other antiarrhythmic agents (amiodarone, flecainide) — additive risk of bradycardia and AV block
- Clonidine — do not discontinue bisoprolol before clonidine when stopping both medicines; risk of rebound hypertension
- Insulin and oral antidiabetic agents — bisoprolol may mask hypoglycaemia symptoms and prolong recovery from hypoglycaemia
- NSAIDs (ibuprofen, diclofenac) — may reduce the antihypertensive effect of bisoprolol
- Sympathomimetic agents (adrenaline, noradrenaline) — antagonistic interaction; may result in severe hypertension and bradycardia
- Antihypertensive agents and other heart rate-lowering medicines — additive hypotensive and bradycardic effects; monitor closely
CLINICAL NOTE (Kenya-specific): Hypertension and heart failure represent a growing burden of cardiovascular disease in Kenya. Bisoprolol (Concor) is included in the Kenya Essential Medicines List (KEML) and is recommended in the Kenya Clinical Guidelines for cardiovascular disease management. Clinicians and patients in Kenya should be aware that abrupt discontinuation of Concor in patients with coronary artery disease — which may present atypically in Kenyan patients — carries a significant risk of precipitating acute coronary syndrome. Additionally, in resource-limited settings, where regular ECG and echocardiogram monitoring may not always be accessible, clinical assessment of heart rate, blood pressure, and symptom burden at every pharmacy visit is an important safety measure for patients on bisoprolol therapy.
Keep out of reach of children. Store all medicines safely and securely.
Storage Instructions
- Store below 25°C in a cool, dry place
- Protect from direct sunlight, moisture, and excessive heat
- Keep tablets in their original blister packaging
- Store out of reach and sight of children
- Do not use after the expiry date printed on the packaging
- Do not transfer tablets to another container
- Dispose of unused or expired tablets safely at your local registered pharmacy — do not flush down the toilet or discard in household waste
Mandatory Disclaimer
This medicine requires a valid prescription. Do not use without medical advice. Concor 5 mg (Bisoprolol Fumarate) is a Prescription Only Medicine (POM) that must be initiated, monitored, and adjusted exclusively by a licensed healthcare provider. Do not self-prescribe, share this medicine with others, or alter your dose without consulting your doctor. Abrupt discontinuation of this medicine without medical guidance is dangerous and may result in serious cardiac events. Regular medical follow-up — including blood pressure monitoring, heart rate assessment, and periodic cardiac evaluation — is an essential and non-negotiable component of safe Concor therapy. This product information is provided for general educational reference only and does not constitute medical advice or replace the guidance of a qualified healthcare professional.
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