Bisoren
Generic Name
bisoren-125-mg-tablet
Manufacturer
MediCo Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bisoren 125 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Bisoren 125 mg Tablet is a beta-blocker primarily used to treat high blood pressure (hypertension), angina (chest pain due to heart disease), and chronic stable heart failure. It works by blocking the action of certain natural chemicals in your body, like epinephrine, on the heart and blood vessels.
Uses & Indications
Dosage
Adults
For hypertension and angina: Initially 125 mg once daily. Dosage may be adjusted based on patient response and tolerability, up to a maximum of 250 mg daily. For chronic stable heart failure: Initial dose is lower, typically starting at 1.25 mg once daily and gradually increasing under medical supervision.
Elderly
No specific dose adjustment is generally required, but caution is advised. Start with a lower dose and titrate slowly based on clinical response.
Renal_impairment
For severe renal impairment (creatinine clearance < 20 mL/min), initial dose should be 62.5 mg once daily. Adjust cautiously.
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
Bisoren selectively blocks beta-1 adrenergic receptors in the heart, leading to a decrease in heart rate, myocardial contractility, and cardiac output. This results in reduced blood pressure. It also reduces renin release from the kidneys, contributing to its antihypertensive effect.
Pharmacokinetics
Onset
Onset of action is typically within 1-2 hours.
Excretion
Excreted almost equally via renal (unchanged drug) and hepatic routes.
Half life
Elimination half-life is 10-12 hours.
Absorption
Well absorbed from the gastrointestinal tract, with bioavailability of approximately 80-90%.
Metabolism
Primarily metabolized in the liver (around 50%).
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)
- Severe bradycardia (heart rate < 60 bpm prior to therapy)
- Severe asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe peripheral arterial occlusive disease
- Metabolic acidosis
- Hypersensitivity to Bisoren or any component of the tablet
Drug Interactions
Clonidine
Exacerbation of rebound hypertension if clonidine is withdrawn abruptly.
NSAIDs (e.g., Ibuprofen)
May reduce the antihypertensive effect of Bisoren.
Other antihypertensive agents
Additive hypotensive effects.
Insulin and oral antidiabetics
May potentiate the hypoglycemic effect and mask symptoms of hypoglycemia.
Calcium channel blockers (Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic and supportive measures. Atropine may be used for severe bradycardia, and glucagon for refractory cases. IV fluids and vasopressors may be needed for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoren is excreted in breast milk; therefore, it is not recommended during lactation. Consult your doctor.
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)
- Severe bradycardia (heart rate < 60 bpm prior to therapy)
- Severe asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe peripheral arterial occlusive disease
- Metabolic acidosis
- Hypersensitivity to Bisoren or any component of the tablet
Drug Interactions
Clonidine
Exacerbation of rebound hypertension if clonidine is withdrawn abruptly.
NSAIDs (e.g., Ibuprofen)
May reduce the antihypertensive effect of Bisoren.
Other antihypertensive agents
Additive hypotensive effects.
Insulin and oral antidiabetics
May potentiate the hypoglycemic effect and mask symptoms of hypoglycemia.
Calcium channel blockers (Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic and supportive measures. Atropine may be used for severe bradycardia, and glucagon for refractory cases. IV fluids and vasopressors may be needed for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoren is excreted in breast milk; therefore, it is not recommended during lactation. Consult your doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of beta-blockers, including Bisoren, in the management of hypertension, angina, and chronic stable heart failure, showing significant reductions in cardiovascular events and mortality.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function tests (e.g., serum creatinine, BUN)
- Liver function tests (periodically)
Doctor Notes
- Caution in patients with diabetes as beta-blockers may mask symptoms of hypoglycemia.
- Exercise care in patients with respiratory diseases; use a beta-1 selective agent and the lowest effective dose.
- Gradual dose titration is crucial, especially in heart failure patients.
Patient Guidelines
- Take Bisoren regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking Bisoren abruptly without consulting your doctor, as this can worsen your condition.
- Report any new or worsening symptoms to your doctor immediately.
- If you experience dizziness, avoid driving or operating heavy machinery.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. 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 changing doses. Exercise caution when driving or operating machinery until you know how this medicine affects you.
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.
- Manage stress through relaxation techniques or hobbies.
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