EMCONCOR 10 mg FILM-COATED TABLETS

2. What you need to know before you take Emconcor

Do not take Emconcor

Do not take Emconcor if you have any of the following conditions:

• allergy to bisoprolol or any of the other ingredients of this medicine (listed in section 6),
• severe asthma,
• severe circulatory problems in the limbs (such as Raynaud's syndrome), which can cause tingling in the fingers and toes or turn them pale or blue,
• untreated phaeochromocytoma, which is a rare tumour of the adrenal gland,
• metabolic acidosis, which is a disease in which there is too much acid in the blood.

Do not take Emconcor if you have any of the following heart problems:

• acute heart failure
• worsening of heart failure that requires intravenous injection of medicines that increase the heart's pumping force,
• cardiogenic shock, which is a severe heart condition that causes low blood pressure and poor circulation,
• certain heart conditions that cause a very slow or irregular heart rate (second or third degree atrioventricular block, sinoatrial block, sick sinus syndrome),
• a slow heart rate that causes problems,
• low blood pressure that causes problems,

Warnings and precautions

If you have any of the following conditions, tell your doctor before taking Emconcor:

• diabetes,
• strict fasting,
• certain heart conditions such as heart failure, heart rhythm disorders, or severe chest pain at rest (Prinzmetal's angina),
• circulation problems in the legs,
• asthma or chronic respiratory disease. Your doctor may need to adjust the dose of your asthma medication,
• chronic obstructive pulmonary disease (COPD),
• history of scaly skin rash (psoriasis),
• adrenal gland tumour (phaeochromocytoma),
• thyroid disorder.

In addition, tell your doctor if you are going to undergo:

• desensitization treatment (for allergies), because Emconcor may make you more likely to experience an allergic reaction, or make the reaction more severe,
• anaesthesia (for example, for surgery), because Emconcor may affect how your body reacts to this situation.

Children and adolescents

Emconcor is not recommended for use in children and adolescents.

Using Emconcor with other medicines

Tell your doctor or pharmacist that you are taking, have recently taken, or might take any other medicines.

Do not take the following medicines with Emconcor without special advice from your doctor:

• Certain medicines used to treat high blood pressure, angina, or irregular heartbeats (such as verapamil and diltiazem).

• Certain medicines used to treat high blood pressure, such as clonidine, methyldopa, and moxonidine. However, do not stop taking these medicines without consulting your doctor first.

Consult your doctor before taking the following medicines with Emconcor; your doctor may need to monitor your condition more frequently:

• Certain medicines used to treat high blood pressure or angina.

• Certain medicines used to treat irregular heartbeats.

• Certain eye drops used to treat glaucoma (which contain beta-blockers).

• Certain medicines used to treat Alzheimer's disease, dementia, or glaucoma.

• Medicines used in emergency situations to treat severe circulatory disorders.

• Insulin or other medicines used to treat diabetes.

• Anaesthetics (for example, during surgery).

• Medicines used to treat heart failure (digoxin).

• Non-steroidal anti-inflammatory drugs (NSAIDs) used to treat arthritis, pain, or inflammation.

• Epinephrine, a medicine used to treat severe allergic reactions and cardiac arrest.

• Any medicine that may lower blood pressure as a desired or undesired effect, such as antihypertensives or certain medicines for depression.

• Mefloquine, used to prevent or treat malaria.

Pregnancy and breastfeeding

There is a risk that using Emconcor during pregnancy may harm the baby.

If you are pregnant or planning to become pregnant, tell your doctor. Your doctor will decide whether you can take Emconcor during pregnancy.

It is not known whether Emconcor passes into human breast milk. Breastfeeding is not recommended during treatment with Emconcor.

Driving and using machines

Your ability to drive or use machines may be affected depending on how you tolerate the medicine. Be especially careful at the start of treatment and when changing doses or medication, and also when combined with alcohol.

Important information about some of the ingredients of Emconcor

Athletes are informed that this medicine contains a component that may result in a positive doping test.

3. How to take Emconcor

Follow exactly the instructions for administration of this medicine given by your doctor or pharmacist. If you are unsure, consult your doctor or pharmacist again.

Treatment with Emconcor should be started gradually with low doses, which should be increased gradually. In all cases, the dose should be adjusted individually, particularly according to heart rate and therapeutic success.

Dosage

For both indications, the normal dose is one Emconcor 5 mg or half a tablet of Emconcor 10 mg (equivalent to 5 mg of bisoprolol) once a day.

If necessary, the dose can be increased to one Emconcor 10 mg tablet or two Emconcor 5 mg tablets (equivalent to 10 mg of bisoprolol) once a day.

The maximum recommended dose is 20 mg once a day.

Duration of treatment

Treatment with Emconcor is usually long-term.

Dosage in case of hepatic or renal impairment

In patients with mild to moderate hepatic or renal impairment, no dose adjustment is normally required. In patients with severe renal impairment (creatinine clearance <20 ml min) and in patients with severe hepatic impairment, the daily dose should not exceed 10 mg.< p>

Dosage in the elderly

No dose adjustment is required in the elderly.

Method of administration

Take the tablet with a little water in the morning, with or without food. Do not crush or chew the tablet.

If you take more Emconcor than you should

If you have taken more Emconcor than you should, tell your doctor immediately. Your doctor will decide what actions are necessary.

The symptoms of an overdose include slow heart rate (bradycardia), difficulty breathing (bronchospasm), severe low blood pressure, acute heart failure, or low blood sugar levels.

In case of overdose or accidental ingestion, contact the Toxicology Information Service: Tel. 91.562.04.20.

If you forget to take Emconcor

Do not take a double dose to make up for forgotten doses. Take your usual dose the next morning.

If you stop taking Emconcor

Never stop taking Emconcor except on the advice of your doctor. Otherwise, your condition may worsen. Treatment should not be stopped abruptly, especially in patients with ischaemic heart disease. If you need to stop treatment, your doctor will tell you how to reduce the dose gradually.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Emconcor can cause side effects, although not everybody gets them.

These side effects are listed below according to their frequency of possible occurrence:

Common(may affect up to 1 in 10 people):

• fatigue, dizziness, headache: These side effects occur especially at the start of treatment. They are usually mild and disappear in 1-2 weeks
• feeling of cold or numbness in hands or feet
• stomach or intestinal problems such as nausea, vomiting, diarrhoea, or constipation

Uncommon(may affect up to 1 in 100 people):

• slow heart rate (bradycardia)
• worsening of heart failure
• weakness
• sleep disturbances
• depression
• low blood pressure
• heart rate problems
• respiratory problems in patients with asthma or chronic respiratory disease
• muscle weakness and muscle cramps

Rare(may affect up to 1 in 1,000 people):

• increased levels of fat in the blood
• decreased tear production (consider this if you wear contact lenses).
• hearing problems
• allergic rhinitis
• increased levels of certain liver enzymes (ALAT, ASAT), liver inflammation (hepatitis)
• allergic reactions such as itching, redness, skin rash. You should consult your doctor immediately if you experience more severe allergic reactions, which can include swelling of the face, neck, tongue, mouth, or throat, or difficulty breathing
• erectile dysfunction
• nightmares, hallucinations
• fainting

Very rare(may affect up to 1 in 10,000 people):

• eye irritation and redness (conjunctivitis)
• appearance or worsening of scaly skin rash (psoriasis); psoriasis-like rash
• hair loss

If you experience any side effects, talk to your doctor or pharmacist, even if it is not listed in this leaflet.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if it is a possible side effect not listed in this leaflet. You can also report side effects directly through the Spanish Medicines and Healthcare Products Agency (AEMPS) website: www.notificaRAM.es.

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Emconcor

No special storage conditions are required.

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date is the last day of the month shown.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and further information

Composition of Emconcor

• The active substance is bisoprolol fumarate. Each Emconcor 10 mg tablet contains 10 mg.

• The other ingredients are:

Tablet core: anhydrous colloidal silica, magnesium stearate, crospovidone, microcrystalline cellulose, maize starch, anhydrous calcium hydrogen phosphate.

Coating: titanium dioxide (E 171), macrogol 400, dimeticone, yellow iron oxide (E 172), hypromellose.

Appearance of the product and pack contents

Emconcor 10: Orange, scored, coriform tablets.

Packs of 60 tablets.

Marketing authorisation holder and manufacturer:

Marketing authorisation holder:

Merck, S.L.

María de Molina, 40

28006, Madrid

Spain

Manufacturer:

Merck Healthcare KGaA

Frankfurter Strasse 250

D-64293 Darmstadt

Germany

or

Merck, S.L.

Merck Industrial Estate, 08100

Mollet del Vallés (Barcelona)

Spain

Date of last revision of this leaflet: 11/2020

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Healthcare Products (AEMPS) http://www.aemps.gob.es/