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Bisten Plus
Edruc Ltd.
Generic: Bisoprolol + Hydrochlorothiazide
Safety Advices
বাংলা
English
UNSAFE
Bisten Plus may cause excessive drowsiness with alcohol.
CONSULT YOUR DOCTOR
Bisten Plus may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
CONSULT YOUR DOCTOR
Bisten Plus is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
CONSULT YOUR DOCTOR
It is not known whether Bisten Plus alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react.
CAUTION
Bisten Plus should be used with caution in patients with kidney disease. Dose adjustment of Bisten Plus may be needed. Please consult your doctor.
Regular blood pressure monitoring is advisable for dose adjustment.
CAUTION
Bisten Plus should be used with caution in patients with liver disease. Dose adjustment of Bisten Plus may be needed. Please consult your doctor.
Medicine Overview of Bisten Plus 2.5mg+6.25mg Tablet
Introduction
Bisten Plus is a medicine used to treat hypertension (high blood pressure). Bisten Plus is a combination of two medicines that helps to control blood pressure when a single medication is not effective. It helps to reduce chances of any future heart attack and stroke. Bisten Plus is taken with or without food preferably in the morning to avoid frequent urination at night. Keep taking it for as long as advised by your doctor. Even if you feel well, do not stop this medicine on your own because high blood pressure often has no symptoms. If you stop taking it,...
... Show moreUses of Bisten Plus
- Hypertension (high blood pressure)
Side effects of Bisten Plus
Common
- Nausea
- Constipation
- Fatigue
- Headache
- Diarrhea
- Dizziness
- Cold extremities
- Slow heart rate
- Increased blood uric acid
- Decreased potassium level in blood
- Glucose intolerance
- Altered blood lipid level
- Decreased magnesium level in blood
- Increased calcium level in blood
How to use Bisten Plus
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Bisten Plus may be taken with or without food, but it is better to take it at a fixed time.
How Bisten Plus works
Bisten Plus is a combination of two blood-pressure lowering medicines: Bisoprolol and Hydrochlorothiazide. Bisoprolol is a beta blocker. It works specifically on the heart to improve its efficiency of pumping blood throughout the body. Hydrochlorothiazide is a diuretic which lowers blood pressure by removing extra water from the body. Over time it also relaxes blood vessels and improves blood flow.
Quick Tips
- It is a combination of two blood pressure lowering medications used for the treatment of high blood pressure.
- It can be taken with or without food.
- Do not stop taking Bisten Plus suddenly as it can cause your blood pressure to rise suddenly thereby increasing the risk of heart attack and stroke.
- It may cause dizziness. If this happens to you, get up slowly when rising from a sitting or lying position.
- It can hide symptoms of low blood sugar if you're diabetic. Monitor your blood sugar levels regularly.
- Bisten Plus may cause dehydration. Drink plenty of fluids and Inform your doctor if you develop extreme thirst, muscle weakness or very dry mouth.
Brief Description
Indication
Hypertension, Congestive heart failure, HTN, Angina pectoris
Administration
May be taken with or without food.
Adult Dose
Adult: PO Initial: 2.5 mg/6.25 mg tablet once daily.
Increase based on clinical response in 2 weeks, Maximum: bisoprolol 20 mg/hydrochlorothiazide 12.5 mg once daily.
Elderly: Dosage adjustment for geriatric patients usually not necessary
Renal Dose
Renal Impairment
Use caution in dosing/titrating patients with renal dysfunction
Cumulative effects of thiazides may develop with impaired renal function
CrCl <40mL/min: half-life of bisoprolol fumarate is increased up to threefold
Contraindication
Low cardiac output and uncompensated cardiac failure; sinus bradycardia, 1st ° heart block, cardiogenic shock, bronchospasm; severe haemorrhage. Pregnancy.
Mode of Action
Bisoprolol fumarate/hydrochlorothiazide is a fixed-combination tablet that combines a Beta adrenergic receptor blocker, bisoprolol fumarate, and a thiazide diuretic, hydrochlorothiazide.
Bisoprolol fumarate, a cardioselective inhibitor of beta(1)-adrenoceptor, has no significant intrinsic sympathomimetic activity or membrane stabilizing activity in its therapeutic dosage; exhibits beta(2)-adrenoceptors inhibition and negative chronotropic effect.
Hydrochlorothiazide is a thiazide diuretic that inhibits Na reabsorption in distal renal tubules resulting in increased excretion of Na+ and water, also K+ and H+ ions.
Precaution
Bronchospastic disease, hyperthyroidism, peripheral vascular disease, undergoing anaesthesia. Monitor blood glucose regularly. May mask symptoms of hypoglycaemia. Elderly. Gradual withdrawal is advised.
Lactation: excreted in breast milk, use caution
Side Effect
1-10% Bisoprolol fumarate Arthralgia (3%), asthenia (2%), cough (3%), diarrhea (4%), dizziness (10%), dry mouth (1%), dyspnea (2%), fatigue (8%), headache (11%), hypoaesthesia (2%), insomnia (3%), nausea (2%), peripheral edema (4%), pharyngitis (2%), rhinitis (4%), sinusitis (2%), upper respiratory infection (5%), vomiting (2% ) Hydrochlorothiazide Anorexia,Epigastric distress,Hypokalemia,Hypotension,Orthostatic hypotension,Phototoxicity Frequency Not Defined Bisoprolol fumarate Aggravate CHF, cold extremeties, decrease HDL, depression, hypotension, increase bronchospasm, increase triglycerides, mask symptoms of hypoglycemia, muscle & joint pain Hydrochlorothiazide Agranulocytosis, anaphylaxis, anemia, Confusion, erythema multiforme skin reactions including Stevens-Johnson syndrome Exfoliative dermatitis including toxic epidermal necrolysis, Hypomagnesemia, hyponatremia, hypochloremia, dizziness, fatigue, headache, hypercalcemia, hyperuricemia, hyperglycemia,...
... Show morePregnancy Category Note
Pregnancy Category: C
Lactation: excreted in breast milk, use caution
Interaction
Bisoprolol : May potentiate AV conduction time and may increase negative inotropic effect w/ class I antiarrhythmic drugs (e.g. quinidine, disopyramide, propafenone). Concomitant catecholamine-depleting drugs (e.g. reserpine, guanethidine) may produce excessive sympathetic activity. May exacerbate rebound HTN upon discontinuance of clonidine treatment. Increased risk of bradycardia w/ digitalis glycosides. Reduced hypotensive effect w/ NSAIDs. Hydrochlorothiazide: Increases toxicity of lithium. May potentiate orthostatic hypotension w/ barbiturates and narcotics. Enhanced neuromuscular blocking action of competitive neuromuscular blockers (e.g. atracurium). Increased hypokalaemic effect w/ corticosteroids, corticotropin, ?2 agonists (e.g. salbutamol). Additive effect w/ other antihypertensives. Potentiation of orthostatic hypotension w/ barbiturates or opioids....
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