Bisoloc
Generic Name
Bisoprolol Fumarate
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bisoloc 25 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Bisoloc 25 mg Tablet contains Bisoprolol Fumarate, a cardioselective beta-blocker used to treat high blood pressure, angina pectoris, and stable chronic heart failure. It works by slowing down the heart rate and relaxing blood vessels, thereby improving blood flow.
Uses & Indications
Dosage
Adults
For hypertension and angina, initial dose is usually 5 mg once daily, adjusted up to a maximum of 20 mg once daily. For stable chronic heart failure, initial dose is 1.25 mg once daily, gradually increased to a maximum of 10 mg once daily. Bisoloc 25 mg is a higher strength, typically used when lower doses are insufficient or for specific indications under strict medical supervision.
Elderly
No specific dose adjustment is required for elderly patients with normal renal and hepatic function. However, treatment should be initiated with the lowest possible dose and titrated cautiously.
Renal_impairment
For severe renal impairment (creatinine clearance <20 mL/min) or severe hepatic impairment, the maximum daily dose should not exceed 10 mg.
How to Take
Take orally once daily in the morning, with or without food. Swallow the tablet whole with water; do not chew or crush.
Mechanism of Action
Bisoprolol selectively blocks beta-1 adrenergic receptors in the heart, leading to a reduction in heart rate and contractility. This decreases cardiac output and blood pressure. It also reduces renin release from the kidneys.
Pharmacokinetics
Onset
Onset of action within 2-4 hours; full therapeutic effect may take up to 2 weeks.
Excretion
Approximately 50% excreted unchanged in urine, and the remainder as inactive metabolites via urine and bile.
Half life
Elimination half-life is 9-12 hours.
Absorption
Well absorbed orally, with approximately 90% bioavailability. Peak plasma concentrations are achieved within 2-4 hours.
Metabolism
Approximately 50% metabolized in the liver to inactive metabolites by CYP2D6; the other 50% is excreted unchanged.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second- or third-degree AV block (without a pacemaker)
- Sick sinus syndrome
- Severe bradycardia (<50 beats/min)
- Severe hypotension
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Late stages of peripheral arterial occlusive disease and Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
NSAIDs
May reduce the antihypertensive effects of bisoprolol.
Clonidine
Increased risk of rebound hypertension if clonidine is withdrawn abruptly while on bisoprolol. Withdraw bisoprolol several days before discontinuing clonidine.
Insulin and Oral Hypoglycemics
Bisoprolol may mask symptoms of hypoglycemia (e.g., tachycardia, palpitations). Adjust dose of antidiabetic agents as needed and monitor blood glucose closely.
Calcium Channel Blockers (Verapamil, Diltiazem)
Increased risk of bradycardia, AV block, and heart failure. Avoid concomitant use or monitor closely.
Storage
Store in a dry place below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive treatment, including atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in small amounts into breast milk; caution is advised when administered to a nursing mother.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second- or third-degree AV block (without a pacemaker)
- Sick sinus syndrome
- Severe bradycardia (<50 beats/min)
- Severe hypotension
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Late stages of peripheral arterial occlusive disease and Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
NSAIDs
May reduce the antihypertensive effects of bisoprolol.
Clonidine
Increased risk of rebound hypertension if clonidine is withdrawn abruptly while on bisoprolol. Withdraw bisoprolol several days before discontinuing clonidine.
Insulin and Oral Hypoglycemics
Bisoprolol may mask symptoms of hypoglycemia (e.g., tachycardia, palpitations). Adjust dose of antidiabetic agents as needed and monitor blood glucose closely.
Calcium Channel Blockers (Verapamil, Diltiazem)
Increased risk of bradycardia, AV block, and heart failure. Avoid concomitant use or monitor closely.
Storage
Store in a dry place below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive treatment, including atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in small amounts into breast milk; caution is advised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in the treatment of hypertension, angina pectoris, and stable chronic heart failure. Key trials include CIBIS-II and MERIT-HF, which established its role in heart failure management.
Lab Monitoring
- Blood pressure
- Heart rate
- Renal function (creatinine, BUN)
- Liver function tests (ALT, AST)
- Electrolytes (for heart failure patients)
Doctor Notes
- Always emphasize gradual withdrawal of bisoprolol to prevent rebound phenomena, especially in patients with ischemic heart disease.
- Monitor heart rate, blood pressure, and signs of heart failure regularly.
- Caution in patients with obstructive airway disease; use cardioselective beta-blockers at the lowest effective dose.
- Review drug interactions, especially with calcium channel blockers and clonidine.
Patient Guidelines
- Do not stop taking Bisoloc abruptly without consulting your doctor, as this may worsen your condition.
- Take your medicine exactly as prescribed by your doctor, preferably in the morning.
- Monitor your blood pressure and heart rate regularly as advised by your healthcare provider.
- Inform your doctor about any new or worsening symptoms, especially shortness of breath or swelling in the ankles.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Bisoloc may cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. If you experience these symptoms, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in saturated fats and sodium.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively.
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