The use of "Concor" during pregnancy

Features of the drug

The active ingredient of the drug "Concor" is bisoprolol, which belongs to the pharmacological group of selective (ie selective action) beta-1-blockers. The tool is widely used to treat arterial hypertension, angina pectoris, various arrhythmias and heart failure.

The main effects of the drug, which are realized through the blockade of receptors in the myocardium:

• decreased strength and heart rate;
• antianginal action (elimination of pain syndrome);
• antiarrhythmic;
• hypotensive;
• antifibrillatory.

Also, the drug reduces the activity of the renin-angiotensin-aldosterone system (RAAS), which leads to the normalization of high blood pressure.

Can I take the drug during pregnancy and in what cases?

Arterial hypertension is a common disorder during the period of bearing a child. Statistics from the World Health Organization show that this pathology develops in almost a quarter of pregnant women. Hypertension is an important risk factor for maternal mortality, complicated and premature birth, and fetal development disorders (due to a decrease in blood supply to the placenta). Therefore, there is a need for the treatment of pathology.

A feature of arterial hypertension in pregnant women is considered to be a limited number of drugs that are safe for the fetus. In such a situation, it is better to resort to non-drug methods, such as physiotherapy exercises, physiotherapy, herbal remedies, which are effective in the early stages.

Consistently high pressure readings require drug correction. At the moment, there is insufficient evidence to support the safety of bisoprolol use in expectant mothers. Therefore, the drug is allowed to be used only in cases where the potential benefit will exceed the likelihood of negative consequences from the fetus.

The instruction for "Concor" during pregnancy contains the following indications:

• increased blood pressure more than 140/90 mm Hg;
• hypertensive crisis;
• signs of damage to target organs (kidney, eyes, brain, heart);
• in the presence of symptoms of gestosis or lesion of the fetoplacental system - the drug is recommended for any blood pressure indicators above normal;
• other exceptional cases to be determined individually.

Accurate readings can only be determined by a specialist cardiologist, whose consultation is required for all symptoms of high blood pressure.

Features of use

If a pregnant woman is prescribed "Concor", you must adhere to the following recommendations:

• exactly take the prescribed dose at the right time of admission, so as not to cause an overdose;
• if any unusual symptoms appear, consult a doctor;
• constantly monitor the pressure and inform the doctor about significant fluctuations;
• periodically conduct clinical examinations of the hemodynamics of the uterus, placenta and the general condition of the fetus.

Lactation

There are no reliable clinical studies on the release of bisoprolol in milk, therefore, it is better to refuse to use the medication during lactation. If it is impossible to cancel the drug, it is necessary to stop breastfeeding and temporarily switch to artificial nutritional mixtures.

Other contraindications

The drug is absolutely contraindicated in the following cases:

• shock of any origin;
• some cardiac arrhythmias: bradycardia (slow heartbeat), 2nd and 3rd degree AV block, weak sinus syndrome;
• hypotension (low blood pressure);
• individual hypersensitivity;
• obliterating diseases of the lower extremities in the terminal stages;
• diabetic foot;
• bronchial asthma;
• decompensated heart failure.

The drug is indicated with caution in the following cases:

• endocrine diseases: diabetes mellitus (risk of hypoglycemia), thyrotoxicosis;
• unstable Prinzmetal angina;
• psoriasis (including in remission);
• pheochromocytoma;
• renal failure.

Overdose

If the dose of Concor is exceeded, the following symptoms may occur:

• arrhythmias (atrioventricular block);
• severe arterial hypotension;
• spasm of the bronchi (manifested by shortness of breath, difficulty in exhaling);
• hypoglycemia (manifested by weakness, trembling hands, severe sweating).

If such signs appear, you should immediately stop taking the medication and consult a doctor.

How does bisoprolol affect the fetus?

So far, there is no complete understanding of the effects of selective beta-blockers on embryonic development. Some studies describe complications such as:

• deterioration of blood flow in the placenta;
• decrease in circulating blood volume and fetal perfusion;
• hypoxia (oxygen starvation) of tissues, which in turn can lead to prenatal disorders. This effect is especially dangerous in the early stages of pregnancy.

If a woman uses bisoprolol in the last trimester, then three days before the expected onset of labor, it is recommended to stop taking the drug. The child should be further examined after birth for the presence of:

• bradycardia;
• signs of hypoglycemia;
• respiratory function disorders.

Alternative drugs

If the use of "Concor" is impossible for one reason or another, the doctor may prescribe alternative remedies to reduce high blood pressure during pregnancy. Most often, drugs of the following pharmacological groups are used:

• selective antagonists of slow calcium channels (Verapamil, Nifedipine, Diltiazem);
• peripheral vasodilators (Hydralazine, Nitroprusside, Minoxidil);
• diuretics ("Hypothiazide").

Before prescribing any medications, it is imperative to consult an obstetrician-gynecologist.

Conclusions

There is no obvious data that would indicate the safety of prescribing bisoprolol during pregnancy. In such controversial cases, doctors recommend refraining from taking this drug. Nevertheless, in the presence of certain indications and an assessment of the possible benefits for the mother and harm to the fetus, "Concor" can be used to treat hypertension in pregnant women.