sb-bisop
Generic Name
Bisoprolol Fumarate
Manufacturer
SB Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sb bisop 5 mg tablet | ৳ 10.00 | N/A |
Description
Overview of the medicine
Bisoprolol Fumarate 5 mg Tablet is a cardioselective beta-1 adrenergic receptor blocker used to treat high blood pressure, angina, and chronic stable heart failure.
Uses & Indications
Dosage
Adults
For hypertension/angina, initially 5 mg once daily, maximum 20 mg/day. For chronic stable heart failure, initially 1.25 mg once daily, titrated gradually up to a maximum of 10 mg/day.
Elderly
May require lower starting dose and careful titration, particularly in patients with renal or hepatic impairment.
Renal_impairment
For severe renal impairment (creatinine clearance < 20 mL/min), initial dose 2.5 mg once daily, maximum 10 mg/day. No dose adjustment needed for mild to moderate impairment.
How to Take
Administer orally once daily in the morning, with or without food. Swallow the tablet whole with liquid; do not crush or chew.
Mechanism of Action
Selectively blocks beta-1 adrenergic receptors in the heart, leading to decreased heart rate, reduced myocardial contractility, and lower blood pressure. It also inhibits renin release from the kidneys.
Pharmacokinetics
Onset
2-4 hours
Excretion
Approximately 50% renally excreted unchanged, and 50% eliminated as metabolites via the liver and kidneys.
Half life
10-12 hours
Absorption
Well absorbed orally, about 80% bioavailability. Peak plasma concentrations are achieved within 2-4 hours.
Metabolism
About 50% metabolized in the liver via CYP3A4, resulting in inactive metabolites.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second or third degree AV block (without pacemaker)
- Sick sinus syndrome (without pacemaker)
- Severe bradycardia (<50 bpm)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Late stages of peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
Clonidine
Increased risk of rebound hypertension if clonidine is withdrawn abruptly while on bisoprolol.
Other antihypertensives
Additive hypotensive effects may occur.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
Potentiation of effects on AV conduction time and negative inotropic effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive therapy, including atropine for bradycardia, glucagon, and vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk; caution advised during lactation and monitor the infant for beta-blockade symptoms.
Side Effects
Contraindications
- Acute heart failure or decompensated heart failure requiring intravenous inotropic therapy
- Cardiogenic shock
- Second or third degree AV block (without pacemaker)
- Sick sinus syndrome (without pacemaker)
- Severe bradycardia (<50 bpm)
- Severe bronchial asthma or severe chronic obstructive pulmonary disease
- Late stages of peripheral arterial occlusive disease or Raynaud's syndrome
- Metabolic acidosis
Drug Interactions
Clonidine
Increased risk of rebound hypertension if clonidine is withdrawn abruptly while on bisoprolol.
Other antihypertensives
Additive hypotensive effects may occur.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Class I antiarrhythmics (e.g., disopyramide, quinidine)
Potentiation of effects on AV conduction time and negative inotropic effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, and hypoglycemia. Management involves symptomatic and supportive therapy, including atropine for bradycardia, glucagon, and vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Bisoprolol is excreted in breast milk; caution advised during lactation and monitor the infant for beta-blockade symptoms.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Patent expired, available as generic
WHO Essential Medicine
YesClinical Trials
Bisoprolol's efficacy and safety have been established through extensive clinical trials for hypertension, angina (e.g., ATRAMI), and chronic heart failure (e.g., CIBIS-II, MERIT-HF studies).
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function tests (BUN, creatinine) - especially in elderly or impaired patients
- Electrolytes (potassium)
Doctor Notes
- Emphasize the importance of gradual withdrawal to prevent rebound effects, especially in patients with ischemic heart disease.
- Monitor heart rate and blood pressure regularly, particularly during dose initiation and titration.
- Assess for signs of worsening heart failure (e.g., increased fluid retention, dyspnea) and adjust dose accordingly under strict medical supervision.
- Caution with patients prone to bronchospasm, diabetes, or peripheral arterial disease.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor, preferably at the same time each day.
- Do not stop taking this medicine suddenly without consulting your doctor, as it may worsen your condition or cause serious heart problems.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins.
- Report any unusual symptoms or side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Bisoprolol may cause dizziness, fatigue, or lightheadedness, 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 advised by your doctor to manage blood pressure and heart health.
- Avoid smoking and limit alcohol intake, as these can negatively impact cardiovascular health.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.