Concor Drug Interactions

The effect and tolerability of medicines can be influenced by simultaneous intake of other medication. Such interactions can also occur if a short time has elapsed since the use of the other medication. Tell the doctor if the patient is taking any other medicine - even those not prescribed by a doctor.
Combinations not recommended: Treatment of stable chronic heart failure: Class-I antiarrhythmic medicines (e.g. quinidine, disopyramide, lidocaine, phenytoin; flecainide, propafenone) may increase the depressant effect of Concor on atrioventricular impulse conduction and the contractility of the heart.
All indications: Calcium antagonists of the verapamil type and to a lesser extent of the diltiazem type may lead to reduced contractility of the heart muscle and delayed atrio-ventricular impulse conduction when used concomitantly with Concor. Especially intravenous administration of verapamil in patients on beta-blocker treatment may lead to profound hypotension and atrioventricular block.
Centrally acting blood pressure-lowering medicines (such as clonidine, methyldopa, moxonidine, rilmenidine) may lead to a reduction of heart rate and cardiac output, as well as to vasodilation due to a decrease in the central sympathetic tonus. Abrupt withdrawal, particularly if prior to beta-blocker discontinuation, may increase risk of "rebound hypertension".
Combinations to be used with caution: Treatment of hypertension or coronary heart disease (angina pectoris): Class-I antiarrhythmic medicines (e.g. quinidine, disopyramide, lidocaine, phenytoin; flecainide, propafenone) may increase the depressant effect of Concor on atrioventricular impulse conduction and the contractility of the heart.
All indications: Calcium antagonists of the dihydropyridine type (e.g. nifedipine, felodipine, amlodipine) may increase the risk of hypotension when used concomitantly with Concor. An increased risk of a further deterioration of the ventricular pump function in patients with heart failure cannot be excluded.
Class-III antiarrhythmic medicines (e.g. amiodarone) may increase the inhibitory effect of Concor on atrio-ventricular impulse conduction.
Topical beta-blockers (e.g. eye drops for glaucoma treatment) may add to the systemic effects of Concor.
Parasympathomimetic medicines may increase the inhibitory effect on atrio-ventricular impulse conduction and the risk of bradycardia when used concomitantly with Concor.
The blood sugar lowering effect of insulin or oral antidiabetic medicines may be increased. Warning signs of reduced blood glucose (hypoglycemia) - especially accelerated heart rate (tachycardia) - may be masked or suppressed. Such interactions are considered to be more likely with nonselective beta-blockers.
Anaesthetic agents may increase the risk of cardiodepressive actions of Concor, leading to hypotension (for further information on general anaesthesia see also Precautions).
Cardiac glycosides (digitalis) may lead to an increase in impulse conduction time and thus reduction in heart rate when used concomitantly with Concor.
Non-steroidal anti-inflammatory medicines (NSAIDs) may reduce the blood pressure-lowering effect of Concor.
β-Sympathomimetics (e.g. isoprenaline, dobutamine) used in combination with Concor may lead to a reduced effect of both agents.
A combination of Concor with sympathomimetics that activate both β- and α-adrenoceptors (e.g. noradrenaline, adrenaline) may intensify the α-adrenoceptor-mediated vasoconstrictor effects of these agents leading to blood pressure increase. Such interactions are considered to be more likely with nonselective beta-blockers.
Antihypertensive agents as well as other medicines with blood pressure lowering potential (e.g. tricyclic antidepressants, barbiturates, phenothiazines) may increase the blood pressure lowering effect of Concor.
Combinations to be considered: Mefloquine may increase the risk of decelerating the heart rate (bradycardia), if used in combination with Concor.
Monoamine oxidase inhibitors (except MAO-B inhibitors) may enhance the hypotensive effect of the beta-blockers. Concomitant use may also be a risk for hypertensive crisis.