Bisocor Tablet 2.5mg

Indications

Bisocor is indicated for the treatment of:

• Hypertension
• Angina
• Moderate to Severe Heart Failure

Note: Bisocor is not recommended for the emergency treatment of hypertensive crises.

Pharmacology

Bisoprolol Hemifumarate is a highly selective β1 blocker, exhibiting greater affinity for the β1 receptor compared to other available beta-blockers. It selectively blocks β1 adrenergic receptors in the heart and vascular smooth muscle, leading to a reduction in heart rate and cardiac output, which helps decrease arterial hypertension. Unlike non-selective beta-blockers, Bisoprolol does not adversely affect lipid metabolism or the levels of cardioprotective HDL-cholesterol during long-term therapy.

Pharmacokinetics:

• Absorption: Bisoprolol is over 90% absorbed from the gastrointestinal tract, resulting in an absolute bioavailability of 88%. Food intake does not affect absorption.
• Distribution: It is extensively distributed, with a medium distribution volume of 3.51 L/kg.
• Metabolism: Bisoprolol is metabolized primarily through oxidative pathways without conjugation. Major metabolites are renally eliminated and have no pharmacological activity. The drug is mainly metabolized via CYP3A4, with CYP2D6 playing a minor role.
• Elimination: Approximately 50% of Bisoprolol is cleared renally as unchanged drug, and 50% via hepatic metabolism. Its elimination half-life is 10-12 hours.

Dosage & Administration

Adults:

• Hypertension: Start with 5 mg once daily, either alone or in combination with a diuretic. If blood pressure response is inadequate, increase to 10 mg and, if necessary, up to 20 mg once daily. Dose titration intervals should be approximately 2 weeks.

Children: The safety and effectiveness in children have not been established.

Patients with Renal or Hepatic Impairment:

• Start with 5 mg once daily. Due to the risk of accumulation, use caution in dose titration. Bisoprolol is not significantly dialyzable.

Geriatrics: Typically, no dosage adjustment is needed unless there are significant renal or hepatic dysfunctions.

Always consult a physician before starting any medication.

Interactions

• Other β-Blockers: Avoid combining with other β-blockers.
• Catecholamine-Depleting Drugs: Monitor patients closely as there may be excessive sympathetic activity reduction.
• Centrally Active Antihypertensives: May exacerbate rebound hypertension after clonidine withdrawal; manage accordingly.
• Antiarrhythmic Agents: Use with caution alongside myocardial depressants or calcium antagonists, which may lead to severe hypotension and bradycardia.

Contraindications

• Cardiogenic shock
• Overt heart failure
• Second or third-degree A-V block
• Right ventricular failure secondary to pulmonary hypertension
• Sinus bradycardia

Side Effects

Common side effects may include:

• Fatigue
• Dizziness
• Headache
• Gastrointestinal disturbances (nausea, vomiting, diarrhea, constipation, abdominal pain)
• Cold or numb extremities
• Muscle weakness or cramps
• Bronchospasm in patients with asthma or COPD

Pregnancy & Lactation

• Pregnancy: Bisoprolol was not teratogenic in animal studies, but it may pose risks to the fetus. Use only if the benefits outweigh potential risks.
• Lactation: Small amounts may be found in rat milk. It's unclear if Bisoprolol is excreted in human milk; nursing mothers should consider discontinuation if the drug is deemed necessary.

Precautions & Warnings

• Caution is advised for patients with renal or hepatic impairment.
• Patients with a history of severe allergic reactions may be more reactive to allergens and less responsive to standard doses of epinephrine.

Therapeutic Class

• Anti-adrenergic agent (Beta blockers)

Storage Conditions

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

Common Questions about Bisocor 2.5 mg Tablet

What is Bisocor 2.5 mg Tablet?
A beta-blocker medication that lowers blood pressure, reduces heart workload, and prevents chest pain.

What is it used for?
Used to treat high blood pressure, chest pain (angina), and heart failure.

How should it be taken?
Take by mouth once daily, with or without food, preferably at the same time each day.

What are the side effects?
Possible side effects include dizziness, fatigue, headache, slow heart rate, difficulty breathing, and cold extremities.

Is it safe to take?
Generally safe, but consult your doctor if you have conditions like asthma, diabetes, or liver problems.

Should it be taken on an empty stomach?
It can be taken after food, as prescribed.

How should it be stored?
Keep in a cool, dry place, in original packaging, out of reach of children.

Quick Tips

• Bisocor may cause dizziness; rise slowly from sitting or lying positions.
• It may mask symptoms of low blood sugar in diabetics; monitor blood sugar levels.
• Do not abruptly stop taking Bisocor, as this may lead to a sudden increase in blood pressure, raising the risk of heart attack or stroke.