Bisoren
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 |
|---|---|---|
| bisoren 5 mg tablet | ৳ 11.50 | ৳ 115.00 |
| bisoren 10 mg tablet | ৳ 18.00 | ৳ 180.00 |
| bisoren 25 mg tablet | ৳ 7.00 | ৳ 70.00 |
| bisoren 125 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Bisoren is a beta-1 selective adrenergic blocking agent primarily used to treat high blood pressure, angina pectoris, and chronic stable heart failure.
Uses & Indications
Dosage
Adults
Hypertension/Angina: Initially 5 mg once daily, adjusted to 10 mg once daily. Maximum 20 mg once daily. Heart Failure: Initially 1.25 mg once daily, gradually increased over weeks to a maximum of 10 mg once daily.
Elderly
No dose adjustment usually required unless severe renal or hepatic impairment. Start with lowest effective dose.
Renal_impairment
For severe renal impairment (creatinine clearance <20 mL/min), initial dose 2.5 mg once daily; maximum 10 mg once daily.
How to Take
Bisoren tablets should be taken orally, once daily in the morning, with or without food. Swallow whole with some liquid, do not chew.
Mechanism of Action
Bisoprolol selectively blocks beta-1 adrenergic receptors in the heart, leading to decreased heart rate, reduced cardiac output, and lower blood pressure. It also reduces myocardial oxygen demand.
Pharmacokinetics
Onset
Onset of action typically within 2 hours, maximum effect within 2-4 weeks for hypertension.
Excretion
Approximately 50% excreted unchanged in urine, and the remaining 50% as inactive metabolites via kidneys.
Half life
Approximately 9-12 hours.
Absorption
Well-absorbed from the gastrointestinal tract (approx. 90%), bioavailability around 80%. Peak plasma concentrations within 2-4 hours.
Metabolism
Metabolized in the liver (approx. 50%) by CYP2D6. Active metabolite formation is negligible.
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 (without a pacemaker)
- Sinoatrial block
- Symptomatic bradycardia (<60 bpm)
- Symptomatic hypotension
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Untreated pheochromocytoma
- Metabolic acidosis
Drug Interactions
NSAIDs
May reduce the hypotensive effect of bisoprolol.
Clonidine
Risk of rebound hypertension if clonidine is stopped abruptly while on bisoprolol.
Other antihypertensives
Additive hypotensive effects.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, AV block, and heart failure.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
May increase AV conduction time and negative inotropic effects.
Storage
Store in a cool, dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management is symptomatic and supportive, including IV atropine for bradycardia, IV fluids and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk, so caution should be exercised 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 (without a pacemaker)
- Sinoatrial block
- Symptomatic bradycardia (<60 bpm)
- Symptomatic hypotension
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Untreated pheochromocytoma
- Metabolic acidosis
Drug Interactions
NSAIDs
May reduce the hypotensive effect of bisoprolol.
Clonidine
Risk of rebound hypertension if clonidine is stopped abruptly while on bisoprolol.
Other antihypertensives
Additive hypotensive effects.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, AV block, and heart failure.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
May increase AV conduction time and negative inotropic effects.
Storage
Store in a cool, dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management is symptomatic and supportive, including IV atropine for bradycardia, IV fluids and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk, so caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in hypertension, angina, and chronic heart failure, including landmark trials like CIBIS-II and MERIT-HF.
Lab Monitoring
- Regular monitoring of blood pressure and heart rate
- Assessment of renal function (serum creatinine, BUN) periodically
- Monitoring of liver enzymes in patients with hepatic impairment
Doctor Notes
- Educate patients on the importance of not discontinuing therapy abruptly.
- Monitor heart rate and blood pressure regularly.
- Exercise caution in patients with asthma/COPD, diabetes, and peripheral vascular disease.
Patient Guidelines
- Take Bisoren exactly as prescribed by your doctor.
- Do not stop taking Bisoren suddenly without consulting your doctor, as this may worsen your condition.
- Inform your doctor if you experience any unusual symptoms or side effects.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Bisoren may cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. 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.
- Avoid smoking and limit alcohol consumption.
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Global Brand Names
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