Probis Plus 5/6.25 Tablet | 10's

✔️ Dosage & Administration | Probis Plus 5/6.25 Tablet

Initial therapy: Start with 2.5/6.25 mg once daily. Dose may be titrated at 14-day intervals, up to a maximum of 20/12.5 mg once daily.

Replacement therapy: Can substitute for patients already stabilized on the individual components.

Clinical adjustment: Patients not adequately controlled with Bisoprolol alone (2.5–20 mg/day) may benefit from the combination. Similarly, patients on higher-dose thiazide therapy experiencing electrolyte disturbances may achieve effective BP control with this combination.

✔️ Overdose Effects | Probis Plus 5/6.25 Tablet

Bisoprolol overdose: bradycardia, hypotension, lethargy, delirium, coma, seizures, respiratory arrest, CHF, bronchospasm, hypoglycemia.

Hydrochlorothiazide overdose: acute fluid and electrolyte depletion; signs include hypotension, tachycardia, muscle cramps, weakness, nausea, renal impairment, electrolyte disturbances (hypokalemia, hyponatremia, alkalosis).

✔️ Side Effects | Probis Plus 5/6.25 Tablet

Generally well tolerated. Possible adverse reactions include:

Cardiac: bradycardia, arrhythmias, palpitations, chest pain, cold extremities, orthostatic hypotension

CNS: fatigue, dizziness, headache

GI: nausea, constipation, dyspepsia, diarrhea

Others: peripheral ischemia, claudication, pharyngitis, rhinitis

✔️ Interaction

Potentiates effects of other antihypertensives.

Should not be combined with other beta-blockers.

Use cautiously with clonidine, catecholamine-depleting drugs (e.g., reserpine, guanethidine), calcium channel blockers (verapamil, diltiazem), antiarrhythmics (e.g., disopyramide), and digitalis glycosides, due to risks of bradycardia, AV block, or excessive reduction in sympathetic tone.

Contraindications

• Cardiogenic shock
• Overt cardiac failure
• Second/third-degree AV block
• Severe sinus bradycardia
• Anuria
• Hypersensitivity to Bisoprolol, Hydrochlorothiazide, or sulfonamide-derived drugs

✔️ Pregnancy & Lactation

Pregnancy: Category C. Should be used only if the expected benefit outweighs potential fetal risk.

Lactation: Thiazides are excreted in breast milk; small amounts of Bisoprolol have been detected in animal studies. Use with caution—decision to discontinue nursing or the drug should be made individually.

✔️ Precautions & Warnings

Risk of hypokalemia, electrolyte imbalance, hyperuricemia, or gout with thiazides.

Monitor for symptoms such as weakness, cramps, hypotension, or GI upset.

Therapy should not be abruptly discontinued—taper gradually over 2 weeks.

✔️ Storage:

Store below 30°C, protected from light and moisture. Keep out of reach of children.