Biscard
Generic Name
Bisoprolol Fumarate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| biscard 5 mg tablet | ৳ 10.00 | ৳ 100.00 |
| biscard 25 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Biscard (Bisoprolol Fumarate) is a highly selective beta-1 adrenoceptor blocking agent used to treat high blood pressure (hypertension), angina pectoris (chest pain), and stable chronic heart failure. It works by slowing down the heart rate and relaxing blood vessels.
Uses & Indications
Dosage
Adults
For hypertension and angina: Initially 5 mg once daily, adjusted to 10 mg once daily if necessary. Maximum 20 mg once daily. For stable chronic heart failure: Initially 1.25 mg once daily, gradually increasing based on tolerability, up to a maximum of 10 mg once daily.
Elderly
No dose adjustment is generally required in elderly patients with normal renal and hepatic function.
Renal_impairment
For severe renal impairment (creatinine clearance < 20 mL/min), maximum dose is 10 mg once daily. Close monitoring is advised.
How to Take
Take orally once daily in the morning, with or without food. Swallow the tablet whole with some liquid. Do not chew or crush.
Mechanism of Action
Bisoprolol is a highly selective beta-1 adrenergic blocking agent. It selectively blocks beta-1 adrenergic receptors, primarily in the heart, leading to a reduction in heart rate, myocardial contractility, and blood pressure. It also reduces renin release from the kidneys.
Pharmacokinetics
Onset
Onset of action within 2-4 hours, with maximal effect seen after 2-6 hours.
Excretion
Approximately 50% is excreted unchanged in the urine, and the remaining 50% is excreted as inactive metabolites in the urine and feces.
Half life
Plasma elimination half-life is 10-12 hours.
Absorption
Well absorbed from the gastrointestinal tract (about 90% bioavailability). Peak plasma concentrations occur 2-4 hours after administration.
Metabolism
Metabolized in the liver (approximately 50%) to inactive metabolites. Has a low first-pass effect.
Side Effects
Contraindications
- Acute heart failure or during episodes of decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second or third degree AV block (without a pacemaker)
- Sick sinus syndrome (without a pacemaker)
- Sinoatrial block
- Symptomatic bradycardia (heart rate less than 60 beats/min before start of therapy)
- Symptomatic hypotension
- Severe bronchial asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe forms of peripheral arterial occlusive disease or Raynaud’s syndrome
- Untreated phaeochromocytoma
- Metabolic acidosis
- Hypersensitivity to bisoprolol or any of the excipients
Drug Interactions
Clonidine
Increased risk of rebound hypertension if clonidine is withdrawn abruptly while on bisoprolol.
Beta-agonists
Reduced effectiveness of beta-agonists.
Other antihypertensive agents
Additive hypotensive effect.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of bisoprolol.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia and AV block.
Class I antiarrhythmic drugs (e.g., disopyramide, quinidine)
May potentiate myocardial depressant effect.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management involves discontinuing bisoprolol and supportive treatment. Atropine for bradycardia, glucagon, IV fluids, vasopressors, bronchodilators for bronchospasm may be administered.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether bisoprolol is excreted in human milk. Caution should be exercised when bisoprolol is administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Available in all pharmacies and hospitals nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in various clinical trials demonstrating its efficacy and safety in hypertension, angina, and chronic heart failure. Key trials include CIBIS II and MERIT-HF for heart failure.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function (creatinine, GFR) in patients with kidney impairment
- Liver function tests (if clinically indicated)
Doctor Notes
- Monitor heart rate and blood pressure regularly.
- Use with caution in patients with diabetes (may mask symptoms of hypoglycemia).
- Caution in patients with obstructive airway disease (e.g., asthma, COPD) due to potential for bronchospasm, though beta-1 selectivity minimizes this risk.
- Gradual withdrawal is crucial to avoid adverse cardiovascular events.
Patient Guidelines
- Take Biscard exactly as prescribed by your doctor.
- Do not stop taking this medicine suddenly without consulting your doctor, as it can worsen your condition.
- Inform your doctor if you experience any unusual side effects.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Biscard may cause dizziness or fatigue, especially at the beginning of treatment or when changing doses. Patients should be cautioned about operating machinery or driving until they know how Biscard affects them.
Lifestyle Advice
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress through relaxation techniques.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.