Ancor A (Bisoprolol Fumarate + Amlodipine)

Ancor A is a combination of a selective b1 -blocker, Bisoprolol, and a calcium channel blocker, Amlodipine. Bisoprolol works by relaxing blood vessels and slowing heart rate to improve and decrease blood pressure. Amlodipine blocks the action of calcium on the heart and blood vessels. As a result, blood vessels are relaxed and the heart beats with less force. This lowers the blood pressure; abnormally fast heart beat and protects the heart following a heart attack.

Description

Ancor A is a combination of a selective b1 -blocker, Bisoprolol, and a calcium channel blocker, Amlodipine. Bisoprolol works by relaxing blood vessels and slowing heart rate to improve and decrease blood pressure. Amlodipine blocks the action of calcium on the heart and blood vessels. As a result, blood vessels are relaxed and the heart beats with less force. This lowers the blood pressure; abnormally fast heart beat and protects the heart following a heart attack. This combination allows to increase in the antihypertensive and anti-anginal efficacy by the complementary mechanism of actions of the two active compounds: Vasoselective effect of the calcium channel blocker Amlodipine (decrease of peripheral resistance) and cardio-selective beta-blocker Bisoprolol (decrease of cardiac output).

Presentation

Ancor A 2.5/5 Tablet: Each film-coated tablet contains Bisoprolol Fumarate USP 2.5 mg and Amlodipine Besilate BP equivalent to Amlodipine 5 mg.

Indications

Ancor A is indicated for the treatment of mild to moderate hypertension in adults.

Dosage & Administration

The recommended daily dose is one tablet in the morning with or without food. Treatment with Bisoprolol + Amlodipine (Ancor A) combination must not be stopped abruptly. Gradual reduction of the daily dose is recommended.

Contrainidications

This combination is contraindicated in cardiogenic shock, overt cardiac failure, second or third-degree AV block, marked sinus bradycardia, and known sensitivity to Bisoprolol/Amlodipine.

Warning & Precautions

Side effects

Edema feet, headache, fatigue, leg cramps, dry mouth. Other adverse events reported were gastric irritation, angina, asthma, cold extremities, cough, decrease in libido, dizziness, facial flushing, postural hypotension, skin rash, sleep disturbance, vertigo, alopecia, etc.

Drug interaction

Combinations not recommended: Calcium antagonists of the Verapamil type and to a lesser extent of the diltiazem type; Centrally acting antihypertensive drugs such as Clonidine, Methyldopa, Moxonidine, Rilmenidine. Combinations to be used with caution: CYP3A4 Inhibitors-Protease inhibitors, Azole antifungals, Macrolides like erythromycin or clarithromycin, verapamil or diltiazem; CYP3A4 Inducers – Rifampicin, Hypericum perforatum; Simvastatin; Class-I Antiarrhythmic Drugs – Quinidine, Disopyramide, Lidocaine, Phenytoin, Flecainide, Propafenone; Class-III Antiarrhythmic Drugs – Amiodarone; Parasympathomimetic drugs; Topical beta-blocker containing preparations – Eye drops for glaucoma treatment; Insulin and oral antidiabetic drugs; Anesthetic agents; Cardiac glycosides (Digitalis); Non-Steroidal Anti-Inflammatory Drugs (NSAIDs); Beta- sympathomimetic agents – Isoprenaline, Dobutamine; Sympathomimetics that activate both beta- and alpha-adrenoceptors – norepinephrine, epinephrine; Antihypertensive agents as well as other drugs with blood pressure lowering potential -Tricyclic antidepressants, Barbiturates, Phenothiazines. Combinations to be considered: Mefloquine; Monoamine Oxidase Inhibitors (Except MAO-B Inhibitors); Ergotamine derivatives.

Use in special groups

Use in Pregnancy: FDA pregnancy category C drug. Bisoprolol + Amlodipine combination is not recommended during pregnancy unless clearly necessary.
Use in Lactation: It is not known whether Bisoprolol or Amlodipine is excreted in human milk. Therefore, administration of Bisoprolol + Amlodipine combination is not recommended during breastfeeding.
Children: There is no experience with Bisoprolol + Amlodipine combination in the pediatric population. Therefore, its use cannot be recommended.
Elderly: No dosage adjustment is required. However, caution is advised when the dose is increased.
Renal Impairment: No dosage adjustment is required for patients with mild to moderate renal impairment. In case of severe renal impairment (creatinine clearance <20 mL/min), the daily dose of the Bisoprolol component of Bisoprolol + Amlodipine combination must not exceed 10 mg.
Hepatic Impairment: In case of severe hepatic impairment, the daily dose of the Bisoprolol component in Bisoprolol + Amlodipine combination must not exceed 10 mg.