Bisoren Plus 5mg+6.25mg Tablet 1 Strip

✔️ Directions for Use:

• Take the medicine exactly as your doctor instructs.
• Swallow the tablet whole; do not chew, break, or crush.
• Can be taken with or without meals, but it’s best to take it at a consistent time daily.

✔️ Side Effects of Bisoren Plus 5mg+6.25mg Tablet

• Nausea, constipation, and fatigue
• Headache, dizziness, and diarrhea
• Cold hands and feet, slower heart rate
• Elevated blood uric acid levels
• Reduced potassium and magnesium levels in the blood
• Increased blood calcium levels
• Impaired glucose tolerance and altered lipid profiles

✔️ Extended Side Effects of Bisoren Plus 5mg+6.25mg Tablet

• Bisoprolol-related (1–10%): Joint pain, weakness, cough, dry mouth, sleep disturbances, shortness of breath, peripheral swelling, cold extremities, sinus infections
• Hydrochlorothiazide-related: Stomach upset, appetite loss, lightheadedness, electrolyte imbalances (e.g., hypokalemia, hypercalcemia), increased blood sugar, cholesterol, and uric acid levels
• Rare but serious reactions: Allergic reactions, skin rashes (including Stevens-Johnson syndrome), severe electrolyte disturbances, arrhythmias, or worsening heart conditions
• Potentially fatal: AV block, severe bradycardia, bronchospasm, severe hypotension, rebound angina, or myocardial infarction if stopped abruptly

✔️ Mode of Action (Pharmacology): Bisoren Plus 5mg+6.25mg Tablet

Bisoprolol: A cardioselective beta-1 blocker with no notable intrinsic sympathetic activity. Reduces heart rate and contractility.

Hydrochlorothiazide: A diuretic that blocks sodium reabsorption in the distal kidney tubules, promoting excretion of sodium, water, potassium, and hydrogen ions.

✔️ Dosage and Administration of Bisoren Plus 5mg+6.25mg Tablet

• Adults: Start with 2.5 mg Bisoprolol / 6.25 mg Hydrochlorothiazide once daily. Dosage may be adjusted after two weeks based on response.
  Maximum Dose: 20 mg Bisoprolol / 12.5 mg Hydrochlorothiazide per day.
• Elderly: Typically, no specific dose adjustment needed, but close monitoring is required.

Administration: Can be taken with or without food.

✔️ Drug Interactions

Bisoprolol:

• May intensify bradycardia with digitalis
• Interaction with Class I antiarrhythmics (e.g., quinidine) may slow AV conduction
• NSAIDs may reduce their blood pressure-lowering effects
• Risk of excessive sympathetic inhibition with drugs like reserpine

Hydrochlorothiazide:

• Can increase lithium toxicity
• May amplify the effects of other antihypertensives
• Raises the risk of low potassium with corticosteroids or beta-2 agonists
• May reduce the effects of anti-diabetic drugs
• Enhances the side effects of NSAIDs and some muscle relaxants
• Can worsen dehydration and cause fluid/electrolyte imbalances

✔️ Renal Dose Adjustment: Bisoren Plus 5mg+6.25mg Tablet

• Use caution in patients with kidney impairment.
• In patients with a creatinine clearance <40 mL/min, the half-life of bisoprolol may increase up to threefold.
• Monitor for the cumulative effects of hydrochlorothiazide.

✔️ Contraindications

• Acute heart failure or significantly low heart output
• Slow heart rate (sinus bradycardia), certain heart conduction blocks
• Cardiogenic shock, severe bleeding
• Asthma or other bronchospastic conditions
• Pregnancy (Category C – use only if needed)

✔️ Precautions

• Use with caution in patients with respiratory conditions, thyroid disorders, and poor circulation.
• Monitor blood sugar in diabetic patients—symptoms of hypoglycemia may be masked.
• Should be withdrawn gradually to avoid rebound effects.
• Use cautiously in breastfeeding; the drug may pass into breast milk.

✔️ Storage:

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.