৳ 40
৳ 4 /unit
৳ 40
৳ 4 /unit
At a glance
Bisoprolol Fumarate is a cardioselective beta-blocker used in the treatment of hypertension, angina pectoris, and moderate to severe heart failure. It slows heart rate and reduces cardiac workload.
Indications
- Hypertension
- Angina pectoris
- Stable chronic heart failure (in addition to ACE inhibitors, diuretics, and cardiac glycosides)
Pharmacology
Bisoprolol Fumarate is a highly cardioselective β1-adrenoceptor blocker that reduces heart rate and cardiac output. At therapeutic doses, it has no effect on β2-receptors. It is almost completely absorbed (88% bioavailability), has a half-life of 10-12 hours, and is metabolized by CYP3A4 (≈95%) and CYP2D6 in the liver.
Dosage
Hypertension and Angina: Initial dose: 5 mg once daily. May be increased to 10 mg and up to 20 mg once daily (2-week interval for titration).
Stable Chronic Heart Failure: Titrate according to the following scheme:
Week 1: 1.25 mg once daily
Week 2: 2.5 mg once daily
Week 3: 3.75 mg once daily
Weeks 4-7: 5 mg once daily
Weeks 8-11: 7.5 mg once daily
Thereafter: 10 mg once daily (maximum)
Renal/Hepatic Impairment: No dose adjustment for mild-moderate impairment. In severe impairment (CrCl <20 mL/min or severe hepatic disease), daily dose should not exceed 10 mg.
Side effects
Common (>1%): Fatigue (8.2%), headache (10.9%), dizziness (3.5%), nausea (2.2%), diarrhea (3.5%), dyspnea (1.5%), bradycardia, cold extremities, muscle weakness/cramps.
Uncommon: Insomnia, depression, vivid dreams, paresthesia, dry mouth, bronchospasm (in asthma/COPD patients).
Use in pregnancy
There are no adequate and well-controlled studies in pregnant women. Animal studies showed no teratogenic effects but fetotoxicity (increased resorptions). Use only if potential benefit justifies risk to the fetus.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Do not stop abruptly (may worsen condition, especially in ischemic heart disease). Withdraw gradually if necessary.
- Diabetic patients should monitor blood glucose regularly (may mask hypoglycemia symptoms).
- Caution in patients with history of severe anaphylactic reactions (usual epinephrine doses may be ineffective).
- Know your response to the medicine before driving or operating machinery.
- Caution in asthma/COPD patients (keep bronchodilator available).
- May mask symptoms of thyrotoxicosis.
Overdose effects
Common signs of overdose: bradycardia, hypotension, congestive heart failure, bronchospasm, and hypoglycemia. Maximum reported overdose: 2000 mg. Treatment: supportive and symptomatic. May require atropine IV, isoproterenol, vasopressors, glucagon, bronchodilators.
Storage conditions
Store in a dry place below 30°C, away from light and heat. Keep out of reach of children.