Bisopress
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 |
|---|---|---|
| bisopress 5 mg tablet | ৳ 11.50 | ৳ 115.00 |
Description
Overview of the medicine
Bisoprolol Fumarate is a beta-blocker used to treat high blood pressure, angina pectoris, and stable chronic heart failure.
Uses & Indications
Dosage
Adults
Hypertension/Angina: Initially 5 mg once daily, maximum 10 mg once daily. Chronic Heart Failure: Initially 1.25 mg once daily, titrated gradually over weeks to a maximum of 10 mg once daily.
Elderly
No specific dose adjustment is usually needed, but monitor closely, especially in those with renal or hepatic impairment.
Renal_impairment
For severe renal impairment (CrCl < 20 mL/min), maximum dose is 10 mg/day. No dose adjustment for mild to moderate impairment.
How to Take
Take orally once daily, preferably in the morning, with or without food. Swallow the tablet whole with some liquid.
Mechanism of Action
It selectively blocks beta-1 adrenergic receptors in the heart, leading to a reduction in heart rate, myocardial contractility, and cardiac output, thereby lowering blood pressure.
Pharmacokinetics
Onset
1-2 hours
Excretion
Approximately 50% excreted unchanged in urine, and 50% as metabolites via both renal and hepatic routes.
Half life
10-12 hours
Absorption
Well absorbed orally (80-90%), with approximately 90% bioavailability.
Metabolism
About 50% metabolized by the liver (primarily via CYP2D6).
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Severe bradycardia (heart rate < 60 bpm before treatment)
- Severe asthma or severe chronic obstructive pulmonary disease
- Severe peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
Clonidine
Risk of rebound hypertension if clonidine is discontinued while on bisoprolol.
Other Antihypertensive Drugs
Additive hypotensive effects.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of bisoprolol.
Calcium Channel Blockers (Verapamil, Diltiazem)
Increased risk of bradycardia, AV block, and heart failure.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic treatment, including atropine for bradycardia, glucagon, intravenous fluids, and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, use during lactation should be carefully considered.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Severe bradycardia (heart rate < 60 bpm before treatment)
- Severe asthma or severe chronic obstructive pulmonary disease
- Severe peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
Clonidine
Risk of rebound hypertension if clonidine is discontinued while on bisoprolol.
Other Antihypertensive Drugs
Additive hypotensive effects.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of bisoprolol.
Calcium Channel Blockers (Verapamil, Diltiazem)
Increased risk of bradycardia, AV block, and heart failure.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic treatment, including atropine for bradycardia, glucagon, intravenous fluids, and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, use during lactation should be carefully considered.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 36 months from the date of manufacture, specific to lot.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA/FDA
Patent Status
Generic available (off-patent)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of bisoprolol in the management of hypertension, angina pectoris, and chronic heart failure. Key studies include CIBIS (Cardiac Insufficiency Bisoprolol Study) trials for heart failure.
Lab Monitoring
- Blood pressure and heart rate monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (ALT, AST)
- Blood glucose (in diabetic patients)
Doctor Notes
- Always monitor heart rate and blood pressure at each visit.
- Exercise caution in patients with diabetes, as beta-blockers can mask symptoms of hypoglycemia.
- Avoid use in patients with uncontrolled asthma or severe COPD.
- Gradual withdrawal is crucial to prevent rebound effects.
Patient Guidelines
- Do not stop taking Bisopress abruptly without consulting your doctor, as it can worsen your condition.
- Report any severe dizziness, very slow heartbeat, or breathing difficulties to your doctor.
- Take the medicine consistently at the same time each day.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for the next dose. Do not take a double dose to make up for a forgotten one.
Driving Precautions
Bisoprolol may cause dizziness or fatigue, especially at the start of treatment or when the dose is changed. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain a healthy and balanced diet, low in sodium.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Monitor your blood pressure regularly at home.
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