Bisoloc
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 |
|---|---|---|
| bisoloc 5 mg tablet | ৳ 11.00 | ৳ 110.00 |
| bisoloc 25 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Bisoloc contains Bisoprolol Fumarate, a selective beta-1 adrenergic receptor blocking agent. It is used to treat high blood pressure, angina pectoris, and stable chronic heart failure.
Uses & Indications
Dosage
Adults
Hypertension and Angina: Usually 5-10 mg once daily, maximum 20 mg/day. Chronic Heart Failure: Initial dose 1.25 mg once daily, titrated gradually over weeks to a maximum of 10 mg once daily.
Elderly
No specific dose adjustment is required, but initiation with lower doses and careful monitoring is advised.
Renal_impairment
For severe renal impairment (creatinine clearance <20 ml/min), the dose should not exceed 10 mg once daily. Close monitoring is essential.
How to Take
Take the tablet orally once daily in the morning, with or without food. Swallow whole with some liquid. Do not chew or crush.
Mechanism of Action
Bisoprolol selectively blocks beta-1 adrenergic receptors primarily in the heart, leading to a reduction in heart rate, cardiac contractility, and blood pressure. This reduces the heart's workload and oxygen demand.
Pharmacokinetics
Onset
Onset of action is typically within 1-2 hours.
Excretion
Approximately 50% is excreted unchanged in the urine, and the remainder as inactive metabolites. Renal and hepatic excretion contribute equally.
Half life
Elimination half-life is 10-12 hours, allowing for once-daily dosing.
Absorption
Well absorbed (approximately 80-90%) from the gastrointestinal tract, with high bioavailability (around 90%). Peak plasma concentrations are reached within 2-4 hours.
Metabolism
Approximately 50% is metabolized in the liver to inactive metabolites via CYP2D6.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Severe bradycardia (heart rate <60 beats/min)
- Sick sinus syndrome (unless pacemaker is fitted)
- Second or third-degree AV block (unless pacemaker is fitted)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Pheochromocytoma (unless treated with alpha-blockers)
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any component of the formulation
Drug Interactions
NSAIDs
May reduce the hypotensive effect of Bisoprolol.
Digoxin
May increase digoxin levels and potentiate bradycardia.
Clonidine
If discontinuing clonidine, Bisoprolol should be withdrawn several days before.
Insulin and oral hypoglycemics
May mask symptoms of hypoglycemia (e.g., tachycardia) and reduce their effect.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
May lead to profound bradycardia, AV block, and heart failure. Use with caution.
Other antihypertensives (e.g., ACE inhibitors, diuretics)
May enhance hypotensive effect.
Antiarrhythmics (e.g., Class I antiarrhythmics like Disopyramide)
May potentiate cardiac depressant effects.
Storage
Store in a cool, 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 symptomatic and supportive treatment, including atropine for severe bradycardia, glucagon, IV fluids, and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult a doctor.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Severe bradycardia (heart rate <60 beats/min)
- Sick sinus syndrome (unless pacemaker is fitted)
- Second or third-degree AV block (unless pacemaker is fitted)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Pheochromocytoma (unless treated with alpha-blockers)
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any component of the formulation
Drug Interactions
NSAIDs
May reduce the hypotensive effect of Bisoprolol.
Digoxin
May increase digoxin levels and potentiate bradycardia.
Clonidine
If discontinuing clonidine, Bisoprolol should be withdrawn several days before.
Insulin and oral hypoglycemics
May mask symptoms of hypoglycemia (e.g., tachycardia) and reduce their effect.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
May lead to profound bradycardia, AV block, and heart failure. Use with caution.
Other antihypertensives (e.g., ACE inhibitors, diuretics)
May enhance hypotensive effect.
Antiarrhythmics (e.g., Class I antiarrhythmics like Disopyramide)
May potentiate cardiac depressant effects.
Storage
Store in a cool, 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 symptomatic and supportive treatment, including atropine for severe bradycardia, glucagon, IV fluids, and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory bodies (e.g., DGDA, FDA)
Patent Status
Generic versions available, original patent expired
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in various clinical trials, demonstrating its efficacy and safety in the treatment of hypertension, angina pectoris, and chronic heart failure (e.g., CIBIS trials for CHF).
Lab Monitoring
- Regular monitoring of blood pressure and heart rate.
- Periodic monitoring of renal function and electrolytes, especially in patients with renal impairment.
- Blood glucose monitoring in diabetic patients, as beta-blockers may mask hypoglycemia symptoms.
Doctor Notes
- Use with caution in patients with asthma or other bronchospastic conditions, diabetes mellitus, severe hepatic or renal impairment, and peripheral vascular disease.
- Monitor patients for bradycardia and hypotension, especially at the initiation of treatment and during dose titration.
- Counsel patients on the importance of not discontinuing the medication abruptly.
Patient Guidelines
- Take Bisoloc exactly as prescribed by your doctor.
- Do not stop taking Bisoloc abruptly without consulting your doctor, as it can worsen your condition.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Avoid driving or operating heavy machinery until you know how Bisoloc affects you, as it may cause dizziness.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Bisoloc may cause dizziness, fatigue, or lightheadedness, especially at the beginning of treatment or when changing dosage. Patients should be cautious when driving or operating machinery until they know how they react to the medication.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Quit smoking and limit alcohol consumption.
- Manage stress effectively to support cardiovascular health.
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