Conbis
Generic Name
Bisoprolol Fumarate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| conbis 25 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Bisoprolol Fumarate is a cardioselective beta-1 adrenergic blocking agent primarily used to treat hypertension, angina pectoris, and stable chronic heart failure. It works by slowing down the heart rate and relaxing blood vessels.
Uses & Indications
Dosage
Adults
Hypertension/Angina: Initially 5 mg once daily, may be increased to 10 mg once daily. Maximum 20 mg once daily. Stable Chronic Heart Failure: Initially 1.25 mg once daily for one week, then gradually titrated up to a maximum of 10 mg once daily, based on tolerability. Conbis 2.5 mg is typically used in the titration phase for heart failure or as a lower starting dose for hypertension/angina.
Elderly
No dosage adjustment is generally required unless there is severe renal or hepatic impairment.
Renal_impairment
In patients with severe renal impairment (creatinine clearance < 20 mL/min), the maximum daily dose should not exceed 10 mg.
How to Take
Take orally once daily in the morning, with or without food. Swallow the tablet whole with some water; do not chew or crush.
Mechanism of Action
Bisoprolol selectively blocks beta-1 adrenergic receptors, primarily in the heart. This reduces heart rate, myocardial contractility, and cardiac output, leading to a decrease in blood pressure. In heart failure, it helps improve cardiac function and reduce mortality.
Pharmacokinetics
Onset
2-4 hours
Excretion
Approximately 50% renally excreted as unchanged drug and 50% as metabolites.
Half life
9-12 hours
Absorption
Well absorbed (approximately 80-90%) after oral administration. Bioavailability is about 90%. Peak plasma concentrations are reached within 2-4 hours.
Metabolism
Approximately 50% metabolized in the liver to inactive metabolites by 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
- Symptomatic bradycardia (heart rate < 60 bpm before starting treatment)
- Symptomatic hypotension (systolic blood pressure < 100 mmHg)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any component of the tablet
Drug Interactions
Clonidine
If clonidine is discontinued abruptly during concomitant use with a beta-blocker, a rebound hypertensive crisis may occur. Discontinue bisoprolol several days before clonidine withdrawal.
Other antihypertensives
Additive hypotensive effect.
Insulin and oral antidiabetics
Beta-blockers may mask symptoms of hypoglycemia (e.g., tachycardia). Careful monitoring of blood glucose is recommended.
NSAIDs (Non-steroidal anti-inflammatory drugs)
May reduce the hypotensive effect of bisoprolol.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and atrioventricular block. Concomitant use should be avoided or carefully monitored.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
May potentiate effects on atrioventricular conduction time and negative inotropic effect.
Storage
Store in a cool, dry place below 30°C, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management involves symptomatic and supportive treatment. Atropine for severe bradycardia, glucagon for cardiac effects, intravenous fluids and vasopressors for hypotension, bronchodilators for bronchospasm, and diuretics for cardiac decompensation.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Beta-blockers may cause intrauterine growth retardation, bradycardia, and hypoglycemia in the fetus and neonate. Small amounts of bisoprolol are excreted in breast milk; therefore, caution is advised when administering to a nursing mother.
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
- Symptomatic bradycardia (heart rate < 60 bpm before starting treatment)
- Symptomatic hypotension (systolic blood pressure < 100 mmHg)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe forms of peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
- Hypersensitivity to Bisoprolol or any component of the tablet
Drug Interactions
Clonidine
If clonidine is discontinued abruptly during concomitant use with a beta-blocker, a rebound hypertensive crisis may occur. Discontinue bisoprolol several days before clonidine withdrawal.
Other antihypertensives
Additive hypotensive effect.
Insulin and oral antidiabetics
Beta-blockers may mask symptoms of hypoglycemia (e.g., tachycardia). Careful monitoring of blood glucose is recommended.
NSAIDs (Non-steroidal anti-inflammatory drugs)
May reduce the hypotensive effect of bisoprolol.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and atrioventricular block. Concomitant use should be avoided or carefully monitored.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
May potentiate effects on atrioventricular conduction time and negative inotropic effect.
Storage
Store in a cool, dry place below 30°C, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management involves symptomatic and supportive treatment. Atropine for severe bradycardia, glucagon for cardiac effects, intravenous fluids and vasopressors for hypotension, bronchodilators for bronchospasm, and diuretics for cardiac decompensation.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Beta-blockers may cause intrauterine growth retardation, bradycardia, and hypoglycemia in the fetus and neonate. Small amounts of bisoprolol are excreted in breast milk; therefore, caution is advised when administering to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the specific packaging for exact expiry date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (DGDA, FDA, EMA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in clinical trials for its efficacy in hypertension, angina, and chronic heart failure. Key studies include the CIBIS (Cardiac Insufficiency Bisoprolol Study) trials, which demonstrated its benefits in stable chronic heart failure.
Lab Monitoring
- Regular monitoring of blood pressure and heart rate.
- Blood glucose monitoring in diabetic patients.
- Periodic assessment of renal and hepatic function.
Doctor Notes
- Emphasize gradual titration, especially for heart failure patients, to avoid adverse events.
- Monitor for signs of heart failure exacerbation, bradycardia, or hypotension.
- Caution in patients with diabetes (may mask hypoglycemia), asthma/COPD, and severe peripheral vascular disease.
Patient Guidelines
- Do not stop taking Conbis suddenly without consulting your doctor, as this may worsen your condition.
- Take your medicine at the same time each day.
- Inform your doctor about all other medications you are taking.
- Report any unusual or persistent side effects to your doctor.
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 double the dose to catch up.
Driving Precautions
Conbis may cause dizziness or fatigue, particularly at the start of treatment, when the dose is increased, or when changing medication. If affected, avoid driving or operating machinery.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet, regular exercise, limiting sodium intake, avoiding smoking, and moderating alcohol consumption.
- Regularly monitor your blood pressure at home if advised by your doctor.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Conbis Brand
Other medicines available under the same brand name
