Cardobis Plus
Generic Name
Bisoprolol Fumarate + Hydrochlorothiazide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cardobis plus 5 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Cardobis Plus 5 mg Tablet is a combination medication used to treat high blood pressure (hypertension). It contains Bisoprolol, a beta-blocker, and Hydrochlorothiazide, a thiazide diuretic, which work together to lower blood pressure effectively.
Uses & Indications
Dosage
Adults
Usually one tablet once daily in the morning, with or without food.
Elderly
Initial dose may be lower, adjusted based on individual response and renal function.
Renal_impairment
Caution advised; dose adjustment may be necessary for severe impairment (CrCl <30 ml/min).
How to Take
Take orally with water, preferably in the morning. Can be taken with or without food.
Mechanism of Action
Bisoprolol is a selective beta-1 adrenergic receptor blocker that reduces heart rate and cardiac output. Hydrochlorothiazide is a thiazide diuretic that increases the excretion of sodium and water, leading to a decrease in blood volume and peripheral resistance.
Pharmacokinetics
Onset
Blood pressure lowering effect starts within 2-4 hours.
Excretion
Bisoprolol is excreted renally (~50% unchanged). Hydrochlorothiazide is primarily excreted renally (>95% unchanged).
Half life
Bisoprolol: 10-12 hours; Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Bisoprolol is well absorbed (80-90%), while Hydrochlorothiazide is moderately absorbed (60-80%).
Metabolism
Bisoprolol undergoes hepatic metabolism (~50%). Hydrochlorothiazide is minimally metabolized.
Side Effects
Contraindications
- Severe bradycardia
- Cardiogenic shock
- Overt cardiac failure
- Sick sinus syndrome
- Second or third degree AV block
- Severe bronchial asthma or severe COPD
- Severe peripheral arterial occlusive disease
- Metabolic acidosis
- Severe renal impairment (CrCl <30 ml/min)
- Severe hepatic impairment
- Anuria
Drug Interactions
NSAIDs
May reduce the hypotensive effect of both components.
Lithium
Renal clearance reduced by thiazides, increasing lithium toxicity risk.
Corticosteroids
Enhanced potassium loss.
ACE inhibitors/ARBs
Increased risk of hypotensive effect.
Other Beta-blockers
Enhanced hypotensive and bradycardic effects.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and hypotension.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, bradycardia, cardiac failure, bronchospasm, acute renal failure (due to HCTZ). Management is supportive and symptomatic, including gastric lavage or activated charcoal, IV fluids, and atropine for bradycardia.
Pregnancy & Lactation
Generally not recommended during pregnancy unless essential, as both components can affect the fetus. Use during lactation is also generally not recommended due to excretion into breast milk.
Side Effects
Contraindications
- Severe bradycardia
- Cardiogenic shock
- Overt cardiac failure
- Sick sinus syndrome
- Second or third degree AV block
- Severe bronchial asthma or severe COPD
- Severe peripheral arterial occlusive disease
- Metabolic acidosis
- Severe renal impairment (CrCl <30 ml/min)
- Severe hepatic impairment
- Anuria
Drug Interactions
NSAIDs
May reduce the hypotensive effect of both components.
Lithium
Renal clearance reduced by thiazides, increasing lithium toxicity risk.
Corticosteroids
Enhanced potassium loss.
ACE inhibitors/ARBs
Increased risk of hypotensive effect.
Other Beta-blockers
Enhanced hypotensive and bradycardic effects.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and hypotension.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, bradycardia, cardiac failure, bronchospasm, acute renal failure (due to HCTZ). Management is supportive and symptomatic, including gastric lavage or activated charcoal, IV fluids, and atropine for bradycardia.
Pregnancy & Lactation
Generally not recommended during pregnancy unless essential, as both components can affect the fetus. Use during lactation is also generally not recommended due to excretion into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 years from manufacturing date
Availability
Available in 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 Bisoprolol and Hydrochlorothiazide combination in managing essential hypertension.
Lab Monitoring
- Blood pressure
- Heart rate
- Serum electrolytes (potassium, sodium)
- Renal function (creatinine, BUN)
- Liver function tests
- Blood glucose
Doctor Notes
- Regularly monitor blood pressure, heart rate, and serum electrolytes (especially potassium) in patients.
- Caution with patients having pre-existing respiratory conditions, diabetes, or gout due to components.
- Adjust dosage based on patient's response and tolerability, aiming for the lowest effective dose.
Patient Guidelines
- Take the medication exactly as prescribed by your doctor.
- Do not stop taking the medication abruptly without consulting your doctor.
- Monitor your blood pressure regularly as advised by your healthcare provider.
- Report any unusual symptoms or side effects to your doctor immediately.
- Avoid sudden changes in posture to prevent dizziness.
Missed Dose Advice
Take the missed dose as soon as you remember. If it's close to your next dose, skip the missed dose and continue your regular schedule. Do not take a double dose.
Driving Precautions
This medication may cause dizziness, fatigue, or blurred vision, especially at the start of treatment or when changing dose. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy diet, low in sodium and rich in fruits and vegetables.
- Engage in regular physical activity as recommended by your doctor.
- Avoid smoking and excessive alcohol consumption.
- Manage stress through relaxation techniques or other healthy coping mechanisms.
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