Fixocard
Generic Name
Bisoprolol Fumarate
Manufacturer
Hypothetical Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| fixocard 5 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Bisoprolol is a beta-1 selective adrenergic blocking agent primarily used for hypertension, angina pectoris, and chronic stable heart failure. It reduces heart rate and blood pressure by blocking beta-1 receptors in the heart.
Uses & Indications
Dosage
Adults
Hypertension/Angina: Initially 5 mg once daily. May be increased to 10 mg once daily, maximum 20 mg/day. Chronic Heart Failure: Start with 1.25 mg once daily, slowly titrate up to a maximum of 10 mg once daily.
Elderly
No specific dosage adjustment needed for elderly patients with normal renal function. Initiate with lower doses for heart failure.
Renal_impairment
For severe renal impairment (CrCl <20 mL/min) or severe hepatic impairment, do not exceed 10 mg daily.
How to Take
Take Fixocard tablets orally once daily in the morning, with or without food. Swallow the tablet whole with water; do not chew or crush it.
Mechanism of Action
Fixocard (Bisoprolol) selectively blocks beta-1 adrenergic receptors in the heart, leading to decreased heart rate, myocardial contractility, and ultimately reduced cardiac output and blood pressure. It also reduces renin release from the kidneys.
Pharmacokinetics
Onset
Antihypertensive effect observed within 2-4 hours, full effect within 2 weeks. Antianginal effect within 2 hours.
Excretion
Approximately 50% excreted unchanged in urine, the remaining 50% as inactive metabolites via renal and non-renal routes.
Half life
10-12 hours, allowing for once-daily dosing.
Absorption
Well absorbed (approx. 90%) from the GI tract; bioavailability is about 80%. Peak plasma concentrations within 2-4 hours.
Metabolism
Partially metabolized (approx. 50%) in the liver by CYP3A4 to inactive metabolites.
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
- Severe bradycardia (heart rate <50 bpm)
- Severe asthma or severe chronic obstructive pulmonary disease (COPD)
- Severe peripheral arterial occlusive disease or Raynaud's syndrome
- Hypotension (systolic blood pressure <100 mmHg)
- Metabolic acidosis
- Known hypersensitivity to Bisoprolol or any excipients
Drug Interactions
Clonidine
Risk of rebound hypertension if clonidine is withdrawn abruptly while on beta-blocker. If co-administration is necessary, gradually taper clonidine after stopping bisoprolol.
Rifampicin
May decrease the half-life of bisoprolol, requiring dose adjustment.
Other beta-blockers (e.g., eye drops)
Additive effects on heart rate and blood pressure; avoid concurrent use.
NSAIDs (e.g., Ibuprofen, Indomethacin)
May reduce the hypotensive effect of bisoprolol.
Calcium Channel Blockers (Verapamil, Diltiazem)
Increased risk of bradycardia and hypotension; avoid co-administration, or monitor closely.
Antidiabetic drugs (Insulin, Oral Hypoglycemics)
Beta-blockers may mask symptoms of hypoglycemia; monitor blood glucose closely.
Storage
Store in a cool, 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 treatment; administer atropine for severe bradycardia, vasopressors for hypotension, and intravenous beta-stimulants for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts are excreted in breast milk; consult a doctor before breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture when stored as recommended.
Availability
Pharmacies nationwide
Approval Status
Approved by FDA and DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Bisoprolol has been extensively studied in various clinical trials, including CIBIS-II and MERIT-HF, demonstrating its efficacy and safety in chronic heart failure. Other trials support its use in hypertension and angina.
Lab Monitoring
- Blood pressure and heart rate monitoring regularly
- Renal function (BUN, creatinine) particularly in patients with kidney impairment
- Liver function tests (ALT, AST) periodically
- Blood glucose levels (in diabetic patients)
Doctor Notes
- Caution should be exercised in patients with asthma or COPD, and a lower dose may be required.
- Gradual withdrawal is essential to avoid rebound effects, especially in ischemic heart disease.
- Monitor for signs of worsening heart failure, bradycardia, and hypotension, especially during initiation and dose titration.
Patient Guidelines
- Do not stop taking Fixocard abruptly without consulting your doctor, as it may worsen your condition or cause serious heart problems.
- Take this medicine at the same time each day to help you remember.
- Report any new or worsening symptoms, especially shortness of breath, swelling of ankles, or unusual weight gain, to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Fixocard may cause dizziness or fatigue, especially at the start of treatment or when changing doses. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet low in sodium and saturated fats.
- Engage in regular physical activity as recommended by your doctor.
- Avoid smoking and limit alcohol consumption to help manage your condition.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.