Bisopro-A

Indications:

Bisoprolol & Amlodipine Combination is prescribed for the treatment of hypertension as a substitution therapy in patients who have their blood pressure adequately controlled with the individual components of the same doses taken separately.

Note: Always follow the advice of a registered healthcare provider.

Pharmacology:

This combination includes Amlodipine and Bisoprolol Fumarate.

• Amlodipine is a calcium channel blocker (dihydropyridine class) that inhibits the influx of calcium ions into the smooth muscles of blood vessels and heart muscle. It effectively lowers peripheral vascular resistance and reduces blood pressure by relaxing blood vessels.
• Bisoprolol Fumarate is a selective beta1-blocker that primarily targets the heart. It reduces heart rate, cardiac output, and myocardial oxygen demand, making it beneficial in controlling high blood pressure.

Dosage & Administration:

• Adults: One tablet daily, for patients whose hypertension is well-managed with the individual components (Bisoprolol and Amlodipine) at the same dose.
• Note: Always consult your doctor for the correct dosage.

Drug Interactions:

• Combinations not recommended: Verapamil and diltiazem (calcium antagonists), centrally-acting antihypertensive drugs.
• Combinations to be used with caution: CYP3A4 inhibitors/inducers, simvastatin, Tacrolimus, Cyclosporine, antiarrhythmic drugs, insulin, NSAIDs, and others that lower blood pressure.
• Combinations to consider: Mefloquine, Rifampicin, Ergotamine derivatives, MAO inhibitors (except MAO-B inhibitors).

Contraindications:

• Not for use in patients with acute heart failure, cardiogenic shock, severe bronchial asthma, or severe peripheral arterial disease.
• Contraindicated in patients with second or third-degree AV block, symptomatic bradycardia, or hypotension.

Side Effects:

Common side effects include dizziness, fatigue, headache, nausea, swelling (e.g., ankle edema), gastrointestinal discomfort, and cold extremities.
Uncommon side effects may include mood changes, insomnia, hypotension, syncope, visual disturbances, and bronchospasm in asthma patients.
Rare side effects include allergic skin reactions, confusion, liver issues, and increased triglycerides.

Pregnancy & Lactation:

Not recommended during pregnancy or breastfeeding unless absolutely necessary. Always consult a healthcare provider before use.

Precautions & Warnings:

• Use with caution in patients with heart failure, impaired liver function, or bronchospastic diseases (e.g., asthma).
• Bisoprolol can mask symptoms of hypoglycemia in diabetic patients.
• Avoid abrupt withdrawal, especially in ischemic heart disease patients.
• Careful monitoring is required for patients with renal impairment.

Use in Special Populations:

• Elderly: Standard dosing is recommended, though caution should be taken with dose adjustments.
• Children: Safety and efficacy in patients under 18 years have not been established.
• Liver Disease: In severe liver impairment, limit bisoprolol to a maximum of 10 mg daily.
• Renal Disease: No dose adjustment is necessary for mild to moderate renal impairment. For severe renal impairment, bisoprolol should not exceed 10 mg daily.

Overdose Effects:

Overdose symptoms may include bradycardia, hypotension, bronchospasm, and cardiac failure. In case of overdose, discontinue the medication and provide supportive care.

Therapeutic Class:

Anti-hypertensive

Storage Conditions:

• Store in a dry place below 30°C, away from light and moisture.
• Keep out of reach of children.