Probis Plus 5/6.25

Indications

Probis Plus tablets are prescribed for the management of hypertension, effectively helping to control high blood pressure.
Always take medication as advised by a registered physician.

Pharmacology

Probis Plus combines Bisoprolol Fumarate and Hydrochlorothiazide, which work synergistically to manage hypertension.

• Bisoprolol Fumarate: A cardioselective beta-1 blocker that reduces heart rate and blood pressure without significant sympathomimetic effects.
• Hydrochlorothiazide: A benzothiadiazine diuretic that enhances sodium and chloride excretion to manage fluid retention.

Together, these agents provide enhanced antihypertensive effects while reducing the risk of hypokalemia compared to higher doses of Hydrochlorothiazide alone.

Dosage & Administration

• Initial Therapy: Start with one 2.5/6.25 mg tablet daily. Dosage may be adjusted at 14-day intervals, up to a maximum of 20/12.5 mg once daily.
• Replacement Therapy: This combination can replace individually titrated components for convenience.
• Adjustment Based on Clinical Response: Patients inadequately controlled with Bisoprolol alone may benefit from switching to this combination. Similarly, those experiencing potassium loss with higher Hydrochlorothiazide doses may achieve better results with this formulation.

Always follow the guidance of a registered healthcare professional.

Drug Interactions

Probis Plus may interact with other medications, including:

• Antihypertensive agents: May enhance blood pressure-lowering effects.
• Beta-blockers: Avoid concurrent use to prevent excessive beta-adrenergic blockade.
• Catecholamine-depleting drugs (e.g., reserpine): Can lead to excessive sympathetic activity suppression.
• Clonidine: If discontinuing clonidine, stop Probis Plus several days prior to prevent withdrawal effects.
• Calcium channel blockers (e.g., verapamil, diltiazem) and antiarrhythmics: May increase the risk of bradycardia or AV block.
• Digitalis glycosides: Combined use can slow heart rate further.

Contraindications

Probis Plus is not suitable for patients with:

• Cardiogenic shock
• Overt cardiac failure
• Advanced AV block (second or third degree)
• Marked sinus bradycardia
• Anuria
• Hypersensitivity to Bisoprolol, Hydrochlorothiazide, or sulfonamide-derived drugs

Side Effects

Generally well-tolerated, but some patients may experience:

• Common: Fatigue, dizziness, headache, nausea, and bradycardia
• Less Common: Chest pain, arrhythmia, orthostatic hypotension, cold extremities, or gastrointestinal disturbances

Most side effects are mild and transient.

Pregnancy & Lactation

• Pregnancy: Category C. Use only if benefits outweigh potential risks to the fetus.
• Lactation: Limited data suggest small amounts of Bisoprolol may pass into breast milk. Discontinue nursing or the drug based on its necessity to the mother.

Precautions & Warnings

Monitor for signs of fluid or electrolyte imbalance, such as:

• Thirst, lethargy, muscle cramps, or gastrointestinal disturbances
• Hypokalemia risk, particularly in predisposed individuals

If discontinuing Probis Plus, taper gradually over two weeks to prevent rebound hypertension.

Overdose Management

Symptoms of overdose may include:

• Beta-blocker effects: Bradycardia, hypotension, lethargy, or severe cardiac/respiratory distress
• Thiazide effects: Fluid and electrolyte imbalance, hypokalemia, hypotension, or renal impairment

Treatment should address symptoms and restore fluid and electrolyte balance.

Therapeutic Class

Combination antihypertensive medications.

Storage Instructions

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