Emcor Side Effects

Home › Medicine Side Effects › Emcor

Answer the side-effect intent for emcor without diagnosing; distinguish common from serious reactions and give safe next-step/reporting guidance.

What is Emcor?

Emcor contains the active ingredient Bisoprolol.

• Active ingredient — Bisoprolol
• Registration number — 37/5.2/0010; 37/5.2/0011
• Registration holder — Adcock Ingram Limited

It is approved for:

• ADCO BISOCOR contains the active substances bisoprolol
• Bisoprolol belongs to a group of medicines called beta-blockers
• ADCO BISOCOR is indicated for the management of mild to moderate hypertension and angina pectoris

Common side effects of Emcor

Not everyone gets side effects. The effects below are those listed in the South African approved leaflet, grouped using the leaflet’s own frequency wording.

Frequent side effects

• Drowsiness, unusual tiredness or weakness
• Feeling of coldness or numbness in hands or feet
• Low blood pressure (you may feel light-headed)
• Headache, dizziness and extreme tiredness (these may be mild especially at the beginning of therapy and may often disappear within 1-2 weeks)
• Nausea, vomiting, diarrhoea, constipation
• Decreased sexual ability
• Lack of energy

Less frequent side effects

• Confusion, hallucinations, depression, trouble sleeping, nightmares and vivid dreams, anxiety, memory loss and nervousness
• Allergic runny nose, sneezing and itching, nasal congestion, breathing problems in patients with asthma, chronic lung disease or other problems of the airways
• Dry, sore eyes, irritation and redness of the eye (conjunctivitis)
• Reduced tear flow which may lead to problems if you wear contact lenses
• Skin rash, itching of the skin, swelling under skin (angioedema), appearance or worsening of scaly skin rash (psoriasis)
• Hair-loss (which will grow back after treatment with ADCO BISOCOR is stopped)
• Back pain, joint pain or chest pain, muscle cramps, skeletal muscle disorders, muscle weakness
• Dizziness on standing, fainting, pins-and-needles sensation
• Hearing problems
• Inflammation of the liver which can cause yellowing of the skin or the whites of the eyes and skin and dark urine, toxic liver disease
• Impaired erection
• A decrease in the number of white blood cells
• Certain blood test results for liver function or fat levels differing from normal
• Raynaud’s syndrome (a condition where the blood supply to the tips of the fingers or toes may become restricted so as to cause tissue damage)
• Blue fingers and toes
• Lack of energy (Asthenia)
• Build-up of fluid in body tissue (swelling). Unknown frequency side effects
• Systemic Lupus Erythematosus (also known as ‘lupus’ or ‘SLE’) a disease characterised by inflammation and damage to various body tissues
• Restlessness, loss of contact with reality
• Excessive fibrous tissue forms in the area behind the stomach and intestine leading to block the tubes that carry urine from kidney to bladder. Inflammation in lining of abdomen causing pain and intestinal obstruction
• Stomach cramps, dry mouth, weight gain, inflammation of the mouth or lips
• Heart block (due to electrical signals intermittently fail to conduct)
• Sweating, itching of skin
• Inflammation, excessive fibrous connective tissue or fluid in the lungs leading to breathing difficulties or a sharp stabbing pain in the chest
• Problem in vision (eyes)
• Temporary loss of hearing Side effects are more common in patients with kidney problems

Serious side effects and warning signs

This leaflet does not set out a separate list of serious side effects. The general warning signs below apply to any medicine.

General warning signs that apply to any medicine

How long can side effects last?

How long a side effect lasts depends on the effect, the product, how long it has been used, and the person. Some effects ease within days as the body adjusts. Others continue for as long as the product is used. A few can persist after stopping, and some need review rather than waiting.

• Settling effects — mild effects that ease over the first days or weeks of use
• Ongoing effects — effects that continue while the product is being used and improve after stopping
• Persistent effects — effects that continue after stopping and need medical review
• Delayed effects — effects that appear after weeks or months rather than immediately

Which of these applies to a particular effect is a clinical question. If a side effect is not settling, is getting worse, or is affecting your daily life, that is worth a conversation with a pharmacist or doctor regardless of how long it has been going on.

Factors that may affect side effects

The approved leaflet identifies the following cautions and factors.

Do not use it at all if

• If you are allergic to bisoprolol or any of the other ingredients of ADCO BISOCOR (listed in section 6)
• If you have severe asthma
• If you have severe blood circulation problem in limbs (such as Raynaud’s syndrome), which may cause your fingers and toes to tingle or turn pale or blue. S3
• If you have untreated phaeochromocytoma, which is a rare tumour of the adrenal gland (medulla)
• If you have metabolic acidosis, which is a condition when there is too much acid in the blood
• If you have heart failure
• If you have certain heart condition (sinoarterial block) causing a very slow heart rate or irregular heartbeat
• If you have cardiogenic shock, which is an acute serious heart condition causing low
• blood pressure and circulatory failure
• You have been diagnosed with a condition known as sick sinus syndrome (a group of abnormal heart rhythms presumably caused by a malfunction of the heart’s primary pacemaker)
• If you are pregnant
• If you suffer from a condition marked by excessive production of thyroid hormones

Use with care, and tell your doctor, if

• Do not stop ADCO BISOCOR therapy abruptly, especially if you have coronary heart disease as this may lead to transitional worsening of your heart condition
• If you are due to receive an anaesthetic e.g., before an operation; you should inform the hospital doctor that you are taking ADCO BISOCOR. This medicine may influence how your body react to this situation
• If you suffer from an irregular heartbeat, you experience sudden onset of chest pain, or if you already suffer from a mild form of angina or Prinzmetal’s angina
• If you have any heart problems or first degree heart block (a condition in which nerve signals to the heart are disturbed, possibly causing it occasionally to skip a beat, or beat irregularly)
• If you have liver or kidney problems
• If you are using medicines (verapamil or diltiazem) to treat an irregular heartbeat
• If you suffer from diabetes mellitus (low blood sugar levels may be masked by this medicine)
• If you suffer from phaeochromocytoma (marked by high blood pressure, raised heart
• rate and headache); this condition should be treated first, prior to taking ADCO BISOCOR
• If you are using a medicine that contains clonidine (used to treat high blood pressure)
• If you suffer from or have suffered from psoriasis (marked by severe skin rashes)
• If you are fasting
• If you have a thyroid disorder. The tablets can hide symptoms of an overactive thyroid
• If you have chronic lung disease or asthma please inform your doctor immediately if you start to experience new difficulties in breathing, cough, wheezing after exercise, etc. when using ADCO BISOCOR
• If you are treated for hypersensitivity (allergic) reactions. Bisoprolol may make your allergy worse or often difficult to treat. Children and adolescents
• Safety and efficacy of ADCO BISOCOR have not been established in children

Pregnancy and breastfeeding

• If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, please consult your doctor, pharmacist or other health care provider for advice before taking ADCO BISOCOR
• ADCO BISOCOR is not recommended during pregnancy and breastfeeding

Interactions and medicines to check

The approved leaflet names these interactions.

• Medicines that lower blood glucose
• Medicines used for emotional or psychiatric conditions e.g. phenothiazines
• Medicines that correct the rhythm of your heart
• Certain medicines used to treat high blood pressure, angina pectoris or irregular heartbeat (known as Calcium antagonists of the verapamil type)
• Certain medicines used to treat high blood pressure such as clonidine, methyldopa etc. However, do not stop taking these without checking with your doctor first
• Certain medicines used to treat irregular or abnormal heartbeat. Medicines such as quinidine, disopyramide, lidocaine, phenytoin, flecainides propafenone, amiodarone
• Certain medicines used to treat high blood pressure or angina pectoris (known as Calcium antagonists of the dihydropyridine type (e.g. nifedipine)
• Parasympathomimetics medicines such as acetylcholine, methacholine, carbachol
• Topical application of beta-blockers such as eye drops for treatment of glaucoma
• Insulin and oral mediation used to treat diabetes
• Anaesthetic agents, (for example during surgery)
• Digoxin used to treat heart failure
• Non-steroidal anti-inflammatory medicines, used to treat arthritis, pain or inflammation
• Medicines used to treat acute heart problems (such as isoprenaline, dobutamine) may antagonise the effects of ADCO BISOCOR
• Sympathomimetics such as epinephrine and norepinephrine which are used in the treatment of heart attack and low blood pressure. Epinephrine is also used to treat allergic reactions. Higher doses of adrenaline may be necessary for treatment of allergic reactions if ADCO BISOCOR is taken at the same time
• Any medicine, which can lower blood pressure as a desired or undesired effect such as antihypertensives, certain medicines for depression (tricyclic antidepressants), certain medicines used to treat epilepsy or during anaesthesia (barbiturates), or certain medicines to treat mental illness characterized by a loss of contact with reality (phenothiazines)
• Mefloquine, used for prevention or treatment of malaria
• Depression treatment medicines called monoamine oxidase inhibitors
• Rifampicin, an antibiotic used to treat infections, including tuberculosis (TB)
• Ergotamine derivatives used in the acute treatment of migraine headaches
• Using certain medicines (such as reserpine or guanethidine) causing high blood pressure together with ADCO BISOCOR may cause life-threatening vasoconstriction (constricting of the blood vessels). ADCO BISOCOR with food, drink and alcohol ADCO BISOCOR may be taken with or without food but must be taken in the morning

What to do if you experience side effects

If you think you are having a side effect, the response depends on how severe it is. Use the warning signs above first — if any of those apply, treat it as urgent.

If the symptom is severe or frightening

Get medical help immediately. Call 10177 for an ambulance, or 112 from a mobile phone, or go to the nearest emergency department. Take the product and its packaging with you if you can.

If the symptom is mild but bothering you

• Write down what the symptom is, when it started, and how it relates to when you take the product
• Check the leaflet that came with the product to see whether the symptom is listed
• Speak to your pharmacist — for many questions this is the fastest route to a useful answer
• Contact the prescriber if the symptom is affecting your daily life or is not settling

You can also report a suspected side effect in South Africa. Reporting does not replace getting medical advice, and you do not need to be certain the product was the cause.

When to seek urgent medical help

Some symptoms need medical attention straight away rather than an appointment in a few days. Do not wait to see whether they settle.

Get same-day medical advice if you have

• A high fever, or a rash together with feeling generally unwell
• Yellowing of the eyes or skin, or unusually dark urine
• Unusual bruising or bleeding that you cannot explain
• Severe or persistent vomiting or diarrhoea, especially if you cannot keep fluids down
• A sudden change in mood, or thoughts of harming yourself
• Any symptom that is rapidly getting worse

How to report a suspected side effect in South Africa

South Africa has an official system for reporting suspected side effects, run by the South African Health Products Regulatory Authority (SAHPRA). Reports from the public and from healthcare professionals are how safety signals get detected after a product is already in use.

Who can report

Anyone can report — you do not have to be a healthcare professional, and you do not need to prove that the product caused the problem. A suspicion is enough. Patients, caregivers and family members can all submit a report.

What to have ready

• The name of the product, its strength and form, and the batch number if you have it
• Why it was being used, and when it was started and stopped
• What the suspected reaction was, when it began, and how long it lasted
• Any other medicines, supplements or remedies being used at the same time
• Basic details about the person affected — age and sex are usually enough

How to report

SAHPRA accepts adverse reaction reports through its e-Services reporting system and through the Med Safety mobile app. Healthcare professionals can also report through the same routes. Current forms and access points are published on the SAHPRA site.

• SAHPRA Health Products Vigilance — the main vigilance and reporting hub
• SAHPRA e-Services — current adverse reaction reporting access

For a fuller walkthrough see how to report an adverse drug reaction.

Related pages

• minoxidil side effects

← Back to more medicine side effects.