Tabis Plus 2.5/6.25mg Tablet

Tabis Plus is used to treat high blood pressure (hypertension). It helps lower blood pressure through the combined effects of its two active ingredients.

The dose should be individualized according to the patient's blood pressure response and tolerability.

• Initial therapy: Treatment may be started with the lowest-strength combination, Bisoprolol 2.5 mg + Hydrochlorothiazide 6.25 mg once daily.
• The dose may be gradually increased at approximately 2-week intervals when necessary.
• The maximum recommended combination dose is Bisoprolol 20 mg + Hydrochlorothiazide 12.5 mg once daily.
• The combination may also be used as a replacement for individually adjusted doses of Bisoprolol and Hydrochlorothiazide.
• Patients whose blood pressure is not adequately controlled with Bisoprolol alone may benefit from the combination under medical supervision.

রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন।

Drug Interactions

Tabis Plus may enhance the blood-pressure-lowering effects of other antihypertensive medicines. It should not be combined with other beta-blockers unless specifically directed by a doctor.

Caution is required with medicines such as reserpine, guanethidine, clonidine, verapamil, diltiazem, disopyramide, and digitalis glycosides, as combined use may excessively lower blood pressure or heart rate and may affect cardiac conduction.

Contraindications

Tabis Plus should not be used in patients with:

• Cardiogenic shock
• Overt heart failure
• Second- or third-degree AV block
• Significant sinus bradycardia
• Anuria
• Known allergy to Bisoprolol, Hydrochlorothiazide, or related sulfonamide-derived medicines

Side Effects

Most adverse effects are generally mild and temporary. Possible side effects include:

• Fatigue
• Dizziness
• Headache
• Slow heart rate (bradycardia)
• Low blood pressure, especially on standing
• Palpitations or rhythm disturbances
• Cold hands and feet
• Chest discomfort
• Diarrhea or constipation
• Nausea
• Indigestion
• Rhinitis
• Pharyngitis

Pregnancy & Lactation

Pregnancy: There is limited evidence regarding the safety of this combination during pregnancy. It should only be used when the expected benefit to the mother clearly outweighs the potential risk to the fetus.

Breastfeeding: Hydrochlorothiazide is excreted into breast milk, while small amounts of Bisoprolol may also pass into milk. A doctor should determine whether to continue breastfeeding or discontinue the medicine based on the individual situation.

Precautions & Warnings

Hydrochlorothiazide may increase uric acid levels and can sometimes trigger hyperuricemia or an acute gout attack.

Patients should be monitored for signs of fluid or electrolyte imbalance, such as:

• Dry mouth and excessive thirst
• Weakness or unusual tiredness
• Muscle pain or cramps
• Drowsiness or restlessness
• Low blood pressure
• Reduced urine output
• Rapid heartbeat
• Nausea or vomiting

Low potassium (hypokalemia) may occur during treatment.

If treatment needs to be stopped, Bisoprolol should generally be withdrawn gradually rather than stopped suddenly, under medical supervision, to reduce the risk of complications.

Overdose Effects

An overdose may cause significant slow heart rate, low blood pressure, weakness, and lethargy. Severe cases may lead to confusion, seizures, coma, breathing difficulties, heart failure, bronchospasm, or low blood sugar.

Excess Hydrochlorothiazide may cause substantial fluid and electrolyte loss, potentially resulting in dehydration, low potassium, low sodium, dizziness, muscle cramps, abnormal heart rate, and changes in kidney function. Overdose requires urgent medical evaluation and supportive treatment.

Therapeutic Class

Combined antihypertensive preparations

Storage Conditions

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