Medicine Information

bisoren

Name: bisoren
Brand: bisoren

Tablet5 mgBeta-blockerATC: C07AB07

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

Description

Overview of the medicine

Bisoren 5 mg tablet is a beta-blocker primarily used to treat high blood pressure (hypertension), angina (chest pain), and chronic heart failure.

Uses & Indications

Hypertension (high blood pressure)

Angina Pectoris (chest pain)

Chronic Heart Failure (CHF) in stable patients

Supraventricular arrhythmias

Dosage

Adults

For hypertension/angina: Initially 5 mg once daily, may be increased to 10 mg once daily. Max 20 mg/day. For CHF: Initially 1.25 mg once daily, titrated slowly over weeks to a maximum of 10 mg once daily.

Elderly

No dose adjustment generally required, but close monitoring is advised, especially in severe renal/hepatic impairment.

Renal_impairment

For severe renal impairment (CrCl < 20 mL/min), initial dose 2.5 mg once daily. Max 10 mg/day.

How to Take

Take orally once daily, preferably in the morning, with or without food. Do not chew or crush the tablet.

Mechanism of Action

Bisoprolol selectively blocks beta-1 adrenergic receptors in the heart, leading to a decrease in heart rate, myocardial contractility, and ultimately, blood pressure. It also reduces renin release from the kidneys.

Pharmacokinetics

Onset

Approximately 2-4 hours

Excretion

Approximately 50% renally excreted unchanged, and 50% as metabolites in urine and feces.

Half life

10-12 hours

Absorption

Well absorbed orally (bioavailability ~80-90%). Peak plasma concentration reached in 2-4 hours.

Metabolism

Approximately 50% metabolized in the liver via CYP2D6 to inactive metabolites. The other 50% is excreted unchanged.

Side Effects

Contraindications

Acute heart failure or during episodes of 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 (<50 bpm)
Severe asthma or severe chronic obstructive pulmonary disease (COPD)
Severe peripheral arterial occlusive disease or Raynaud's syndrome
Pheochromocytoma (untreated)

Drug Interactions

NSAIDs

May reduce the hypotensive effect of bisoprolol.

Clonidine

Risk of rebound hypertension upon abrupt withdrawal of clonidine if bisoprolol is also discontinued.

Antiarrhythmics (e.g., disopyramide, quinidine)

Additive negative inotropic/chronotropic effects.

Calcium channel blockers (e.g., verapamil, diltiazem)

Increased risk of bradycardia and AV block. Avoid co-administration.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms: Bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management: Symptomatic and supportive treatment. Atropine for bradycardia, IV fluids for hypotension, bronchodilators for bronchospasm, glucagon for refractory bradycardia/hypotension.

Pregnancy & Lactation

Pregnancy category C. Use only if potential benefit outweighs risk. Excreted in breast milk, so caution advised during lactation.

Side Effects

Contraindications

Acute heart failure or during episodes of 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 (<50 bpm)
Severe asthma or severe chronic obstructive pulmonary disease (COPD)
Severe peripheral arterial occlusive disease or Raynaud's syndrome
Pheochromocytoma (untreated)

Drug Interactions

NSAIDs

May reduce the hypotensive effect of bisoprolol.

Clonidine

Risk of rebound hypertension upon abrupt withdrawal of clonidine if bisoprolol is also discontinued.

Antiarrhythmics (e.g., disopyramide, quinidine)

Additive negative inotropic/chronotropic effects.

Calcium channel blockers (e.g., verapamil, diltiazem)

Increased risk of bradycardia and AV block. Avoid co-administration.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Pregnancy & Lactation

Pregnancy category C. Use only if potential benefit outweighs risk. Excreted in breast milk, so caution advised during lactation.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets30 tablets

Shelf Life

Usually 2-3 years from manufacturing date.

Availability

Pharmacies nationwide

Approval Status

Approved by DGDA (Bangladesh)

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensively studied in numerous clinical trials demonstrating efficacy and safety in hypertension, angina, and chronic heart failure.

Lab Monitoring

Blood pressure monitoring
Heart rate monitoring
Renal function (creatinine, GFR)
Liver function (AST, ALT)
Electrolyte levels

Doctor Notes

Counsel patients on importance of adherence and not stopping abruptly.
Monitor for signs of heart failure exacerbation or bronchospasm.
Caution in patients with diabetes, as it may mask hypoglycemia symptoms.

Patient Guidelines

Take medicine regularly as prescribed by your doctor.
Do not stop taking the medicine abruptly.
Report any unusual side effects to your doctor.
Monitor your blood pressure and heart rate regularly.

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 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 dosage. Patients should be warned about driving or operating machinery until they know how they react to bisoprolol.