Conbis
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 |
|---|---|---|
| conbis 5 mg tablet | ৳ 10.00 | ৳ 100.00 |
| conbis 25 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Conbis contains Bisoprolol Fumarate, a beta-blocker primarily used to treat high blood pressure, angina (chest pain), and heart failure. It works by relaxing blood vessels and slowing heart rate to improve blood flow and reduce blood pressure.
Uses & Indications
Dosage
Adults
Hypertension/Angina: Initially 5 mg once daily, may be increased to 10 mg once daily. Max 20 mg/day. Heart Failure: Initially 1.25 mg once daily for 1 week, gradually increased up to 10 mg once daily over several weeks.
Elderly
No dose adjustment required, but use with caution due to potential for reduced renal/hepatic function.
Renal_impairment
For severe renal impairment (creatinine clearance < 20 mL/min), initial dose 2.5 mg once daily, max 10 mg/day. Individual titration required.
How to Take
Conbis tablets should be taken in the morning with or without food, swallowed whole with some liquid, and not chewed. Do not stop taking this medicine abruptly without consulting your doctor.
Mechanism of Action
Bisoprolol is a highly selective beta-1 adrenergic receptor blocker. It reduces heart rate, myocardial contractility, and cardiac output, leading to a reduction in blood pressure. It also reduces renin release from the kidneys.
Pharmacokinetics
Onset
Onset of action within 2-4 hours, maximal effect within 2-6 hours.
Excretion
Approximately 50% excreted unchanged in urine, 50% as inactive metabolites via urine and feces.
Half life
Plasma elimination half-life is 10-12 hours, allowing once-daily dosing.
Absorption
Well-absorbed from the gastrointestinal tract (approx. 90%), bioavailability is about 90%.
Metabolism
Metabolized in the liver (approx. 50%) to inactive metabolites via CYP2D6.
Side Effects
Contraindications
- Acute heart failure or during episodes of decompensation of heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second or third degree AV block (without a pacemaker)
- Sick sinus syndrome
- Sinoatrial block
- Bradycardia (heart rate < 60 bpm before treatment)
- Severe asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Phaeochromocytoma (untreated)
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any other component of the formulation
Drug Interactions
Clonidine
If clonidine is discontinued, Bisoprolol should be withdrawn several days before to avoid rebound hypertension.
Insulin and oral antidiabetics
May mask symptoms of hypoglycemia; adjust antidiabetic dose if necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Bisoprolol.
Antiarrhythmics (e.g., disopyramide, amiodarone)
Increased risk of cardiac depression.
Calcium channel blockers (e.g., verapamil, diltiazem)
May lead to profound bradycardia and hypotension. Avoid concomitant use.
Other antihypertensives (e.g., ACE inhibitors, diuretics)
Additive hypotensive effects.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive care, including gastric lavage, activated charcoal, and intravenous fluids. Atropine for bradycardia, glucagon for refractory bradycardia, and beta-sympathomimetics for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Acute heart failure or during episodes of decompensation of heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second or third degree AV block (without a pacemaker)
- Sick sinus syndrome
- Sinoatrial block
- Bradycardia (heart rate < 60 bpm before treatment)
- Severe asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Phaeochromocytoma (untreated)
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any other component of the formulation
Drug Interactions
Clonidine
If clonidine is discontinued, Bisoprolol should be withdrawn several days before to avoid rebound hypertension.
Insulin and oral antidiabetics
May mask symptoms of hypoglycemia; adjust antidiabetic dose if necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Bisoprolol.
Antiarrhythmics (e.g., disopyramide, amiodarone)
Increased risk of cardiac depression.
Calcium channel blockers (e.g., verapamil, diltiazem)
May lead to profound bradycardia and hypotension. Avoid concomitant use.
Other antihypertensives (e.g., ACE inhibitors, diuretics)
Additive hypotensive effects.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive care, including gastric lavage, activated charcoal, and intravenous fluids. Atropine for bradycardia, glucagon for refractory bradycardia, and beta-sympathomimetics for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bisoprolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Patent expired, generics available
WHO Essential Medicine
YesClinical Trials
Extensively studied in clinical trials demonstrating efficacy and safety for its approved indications, including the CIBIS-II and CIBIS-III trials for heart failure.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function tests (e.g., creatinine, BUN)
- Liver function tests (periodically)
Doctor Notes
- Careful titration is required, especially in heart failure patients.
- Monitor heart rate and blood pressure regularly.
- Educate patients on the importance of not discontinuing abruptly.
Patient Guidelines
- Do not stop taking Conbis suddenly without consulting your doctor.
- Report any unusual side effects to your doctor immediately.
- Take your medicine at the same time each day.
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
Conbis may cause dizziness or fatigue, especially at the start of treatment or when changing dosage. If affected, avoid driving or operating machinery.
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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