Bisopro-Plus
Generic Name
Bisoprolol Fumarate + Hydrochlorothiazide
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bisopro plus 5 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Bisopro-Plus 5 mg Tablet is a combination medicine used to treat high blood pressure (hypertension). It contains Bisoprolol, a beta-blocker, and Hydrochlorothiazide, a diuretic. This combination helps to relax blood vessels and remove excess water and salt from the body, thereby lowering blood pressure.
Uses & Indications
Dosage
Adults
Typically, one tablet (Bisoprolol 5 mg + Hydrochlorothiazide 6.25 mg) once daily, usually in the morning. Dosage may be adjusted by the physician based on individual response.
Elderly
No specific dose adjustment is generally required, but caution is advised, and lower starting doses may be considered, especially with renal impairment.
Renal_impairment
Dosage adjustment is recommended for patients with severe renal impairment (creatinine clearance < 30 mL/min). This combination is not recommended for severe renal failure.
How to Take
Take the tablet whole with water, usually in the morning, with or without food. Do not crush or chew.
Mechanism of Action
Bisoprolol selectively blocks beta-1 adrenergic receptors, reducing heart rate and cardiac output. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubules, increasing the excretion of sodium, chloride, and water, leading to a reduction in blood volume and blood pressure.
Pharmacokinetics
Onset
Bisoprolol: 2-4 hours; Hydrochlorothiazide: 2 hours.
Excretion
Bisoprolol is excreted equally via renal and non-renal routes. Hydrochlorothiazide is primarily excreted unchanged by the kidneys.
Half life
Bisoprolol: 9-12 hours; Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Bisoprolol is well absorbed from the GI tract (bioavailability ~90%). Hydrochlorothiazide is absorbed moderately (bioavailability 60-80%).
Metabolism
Bisoprolol is ~50% metabolized in the liver to inactive metabolites. Hydrochlorothiazide is not significantly metabolized.
Side Effects
Contraindications
- Acute heart failure
- Cardiogenic shock
- Severe bradycardia (<50 bpm)
- Severe hypotension
- Severe asthma or COPD
- Anuria or severe renal impairment (CrCl < 30 mL/min)
- Hypersensitivity to components or sulfonamides
Drug Interactions
NSAIDs
May reduce the antihypertensive effect of bisoprolol and hydrochlorothiazide.
Lithium
Renal clearance of lithium is reduced by hydrochlorothiazide, increasing lithium toxicity risk.
Digitalis glycosides
Increased risk of digitalis toxicity due to hypokalemia caused by HCTZ.
Calcium channel blockers (e.g., verapamil, diltiazem)
May increase risk of bradycardia, hypotension, and AV conduction disturbances.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic and supportive treatment, including IV atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the second and third trimesters due to potential fetal harm (e.g., intrauterine growth restriction, bradycardia, neonatal hypoglycemia). Caution advised during lactation as both components can pass into breast milk.
Side Effects
Contraindications
- Acute heart failure
- Cardiogenic shock
- Severe bradycardia (<50 bpm)
- Severe hypotension
- Severe asthma or COPD
- Anuria or severe renal impairment (CrCl < 30 mL/min)
- Hypersensitivity to components or sulfonamides
Drug Interactions
NSAIDs
May reduce the antihypertensive effect of bisoprolol and hydrochlorothiazide.
Lithium
Renal clearance of lithium is reduced by hydrochlorothiazide, increasing lithium toxicity risk.
Digitalis glycosides
Increased risk of digitalis toxicity due to hypokalemia caused by HCTZ.
Calcium channel blockers (e.g., verapamil, diltiazem)
May increase risk of bradycardia, hypotension, and AV conduction disturbances.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic and supportive treatment, including IV atropine for bradycardia, vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the second and third trimesters due to potential fetal harm (e.g., intrauterine growth restriction, bradycardia, neonatal hypoglycemia). Caution advised during lactation as both components can pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Bisoprolol and Hydrochlorothiazide combination in treating hypertension, showing superior blood pressure reduction compared to monotherapy.
Lab Monitoring
- Blood pressure and heart rate monitoring
- Serum electrolytes (especially potassium, sodium, magnesium, calcium)
- Renal function (creatinine, BUN)
- Liver function tests
Doctor Notes
- Emphasize slow titration of beta-blocker if individual components are initiated separately before combination therapy.
- Monitor electrolytes regularly, especially potassium, due to the diuretic component.
- Consider the risk of hyperglycemia and hyperuricemia with long-term HCTZ use.
Patient Guidelines
- Take as directed by your doctor, usually once daily in the morning.
- Do not stop taking this medicine abruptly without consulting your doctor.
- Report any unusual symptoms or side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment or when changing doses. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Adopt a healthy diet low in sodium and high in potassium (unless contraindicated).
- Engage in regular physical activity.
- Limit alcohol intake and quit smoking.
- Manage stress effectively.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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