Ancor A 2.5/5mg Tablet 1 Strip

✔️ Dosage & Administration

The usual dose is one tablet once daily, provided that the patient's blood pressure has already been adequately controlled with the same doses of amlodipine and bisoprolol administered as separate medicines.

Take the medicine exactly as prescribed by your doctor and preferably at the same time each day.

✔️ Overdose Effects

An overdose of bisoprolol may cause slow heart rate, low blood pressure, bronchospasm, acute heart failure, and low blood glucose.

Excessive amlodipine exposure may cause marked widening of blood vessels, potentially resulting in severe and prolonged hypotension, sometimes accompanied by reflex tachycardia. Severe overdose can be life-threatening.

If an overdose is suspected, seek immediate medical attention. Treatment generally involves stopping the medicine and providing appropriate supportive and symptomatic care.

✔️ Ancor-A Tablet is contraindicated in patients with:

• Acute or decompensated heart failure
• Cardiogenic shock
• Significant obstruction of the left ventricular outflow tract, such as severe aortic stenosis
• Second- or third-degree AV block
• Sick sinus syndrome or sinoatrial block
• Symptomatic bradycardia or hypotension
• Severe bronchial asthma
• Severe peripheral arterial occlusive disease
• Severe Raynaud's syndrome
• Untreated pheochromocytoma
• Metabolic acidosis
• Known hypersensitivity to bisoprolol, amlodipine, dihydropyridine derivatives, or any component of the medicine

✔️ Interaction

Ancor-A may interact with several medicines.

Combinations generally not recommended:

• Verapamil- or diltiazem-type calcium channel blockers
• Centrally acting antihypertensive medicines

Use with caution:

• Strong or moderate CYP3A4 inhibitors or inducers
• Simvastatin
• Tacrolimus
• Cyclosporine
• Class I and Class III antiarrhythmic medicines
• Parasympathomimetic drugs
• Other beta-blockers, including certain ophthalmic beta-blocker eye drops
• Insulin and oral antidiabetic medicines
• Anesthetic agents
• Digitalis glycosides
• NSAIDs
• Sympathomimetic medicines
• Other blood-pressure-lowering medicines

Other medicines that may require consideration include mefloquine, rifampicin, ergotamine derivatives, and MAO inhibitors other than MAO-B inhibitors.

✔️ Side Effects

Common side effects may include:

• Dizziness
• Headache
• Drowsiness
• Palpitations
• Flushing
• Coldness or numbness of the hands and feet
• Nausea, vomiting, diarrhea, constipation, or abdominal discomfort
• Ankle or peripheral edema
• Fatigue

Uncommon side effects may include:

• Insomnia or other sleep disturbances
• Anxiety or mood changes
• Depression
• Numbness or tingling sensations
• Tremor
• Taste disturbances
• Visual disturbances
• Tinnitus
• Slow heart rate
• Low blood pressure
• Fainting
• Worsening of pre-existing heart failure
• Shortness of breath or bronchospasm, particularly in susceptible patients
• Rhinitis
• Indigestion or dry mouth
• Skin reactions such as itching, rash, purpura, or hair loss
• Muscle or joint pain, muscle weakness, or cramps
• Urination-related problems
• Sexual dysfunction
• Chest pain
• General weakness or malaise
• Changes in body weight

Rare side effects may include:

• Allergic skin reactions
• Nightmares, hallucinations, or confusion
• Reduced tear production
• Hearing disturbances
• Allergic rhinitis
• Hepatitis
• Increased triglyceride levels
• Increased liver enzyme levels

✔️ Precautions & Warnings

Ancor-A should be used cautiously in patients with heart failure, as further deterioration of cardiac pumping function may occur.

Do not stop bisoprolol suddenly. Abrupt discontinuation may temporarily worsen the patient's condition, particularly in those with ischemic heart disease. Treatment should generally be reduced gradually under medical supervision.

Special caution is required in patients with:

• Liver impairment
• Bronchial asthma or chronic obstructive airway disease
• Bronchospasm
• Diabetes with significant fluctuations in blood glucose
• Strict fasting
• First-degree AV block
• Prinzmetal's angina
• Peripheral arterial disease
• Psoriasis or a history of psoriasis
• Ongoing desensitization therapy

Bisoprolol may mask some symptoms of hypoglycemia and thyrotoxicosis. Patients with diabetes should monitor their blood glucose regularly.

If surgery requiring general anesthesia is planned, inform the anesthetist that you are taking a beta-blocker. If discontinuation is considered necessary before surgery, it should generally be done gradually and completed approximately 48 hours before anesthesia.

✔️ Storage:

• Store below 30°C.
• Keep in a dry place.
• Protect from direct light.
• Keep out of reach of children.
• Do not use after the expiry date.