Indications

Sulfonylurea as Bisoprolol & Amlodipine combined therapy is indicated for the treatment of hypertension in patients who are adequately managed with the individual medications given concurrently at the same dose levels as in the combination but as separate tablets.

Pharmaceutical Name

Incepta Pharmaceuticals Ltd.

Pharmacology

Bisoprolol Hemi fumarate is the most selective ß1 blocker. It displays the highest level of affinity for the ß1 receptor than any other beta-blocker available up to now. Selectively blocks ß1 adrenergic receptor in the heart and vascular smooth muscle and reduces heart rate and cardiac output resulting in a decrease in arterial hypertension. Lipid metabolism can be adversely affected by ß-blockers, in patients with nonß1 selective ß1-blocker, but Bisoprolol does not cause any change in the cholesterol fraction including the cardioprotective HDL-cholesterol, in long-term therapy.

Dosage & Administration

Hypertension: The dose of Bisoprolol must be individualized to the needs of the patient. The usual starting dose is 5 mg once daily. In some patients, 2.5 mg may be an appropriate starting dose. If the antihypertensive effect of 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily.

Angina: Usually 10 mg once daily (5 mg may be adequate in some patients) max 20 mg daily.

Heart Failure: Initially 1.25 mg once daily (in the morning) for 1 week then, if well tolerated, increased to 2.5 mg once daily for 1 week, then 3.75 mg once daily for 1 week, then 5 mg once daily for 4 weeks, then- 7.5 mg once daily for 4 weeks, then 10 mg once daily maximum 10 mg daily.

Interaction

Bisoprolol should not be combined with other ß-blocking agents.

Contraindications

In patients with cardiogenic shock, overt heart failure, second- or third-degree A-V block, right ventricular failure secondary to pulmonary hypertension and sinus bradycardia.

Side Effect

Gastrointestinal disturbances, bradycardia, hypotension, headache, fatigue, sleep disturbances, dizziness, vertigo, thrombocytopenia, visual disturbances, alopecia may occur.

Pregnancy & Lactation

The safety of bisoprolol during pregnancy has not been established. No data is available for lactation.

Precautions & Warnings

Monitoring of renal, hepatic, and hematopoietic function should be performed at regular intervals during long-term treatment with bisoprolol.

Therapeutic Class

Anti-hypertensive.

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.