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Bisoren M 2.5/5 Tablet 1 Strip
Bisoren M Tablet
(Bisoprolol + Amlodipine)
Therapeutic Class: Antihypertensive Agent (Beta-blocker + Calcium Channel Blocker)
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✅ Description:
Bisoren M is indicated for managing hypertension in patients who are already well-controlled on individual components of bisoprolol and amlodipine at the same dose levels. It serves as a substitution therapy for convenience and adherence improvement.
- Amlodipine is a dihydropyridine calcium channel blocker that inhibits calcium ion influx into vascular smooth muscle and cardiac cells. This selective inhibition leads to vasodilation, reducing peripheral vascular resistance and thereby lowering blood pressure.
- Bisoprolol Fumarate is a cardioselective beta-1 adrenergic receptor blocker with negligible activity on beta-2 receptors. It lowers heart rate and cardiac output without significantly affecting bronchial or metabolic beta-2 functions.
Relevant Products / প্রাসঙ্গিক পণ্য
✔️ Dosage & Administration
One tablet once daily is recommended for patients previously maintained on the same doses of bisoprolol and amlodipine as separate agents.
- Elderly: Dose adjustment generally not needed, but monitor response.
- Pediatric: Not established; safety and efficacy data lacking.
- Liver Dysfunction: Amlodipine clearance may be reduced. Use with caution.
- Kidney Dysfunction: Generally, no dose adjustment required in mild-to-moderate impairment. Amlodipine is not dialyzable. In severe renal impairment (CrCl <20 ml/min), the bisoprolol dose should not exceed 10 mg daily.
✔️ Side Effects
Common: Headache, dizziness, drowsiness, flushing, GI upset (nausea, diarrhea), peripheral edema (e.g., ankle swelling), fatigue.
Uncommon: Mood disorders, sleep disturbances, visual issues, tinnitus, AV block, worsening heart failure, bronchospasm, skin rashes, muscle pain or cramps, urinary symptoms, erectile dysfunction, weight changes.
Rare: Allergic skin reactions, hallucinations, hepatitis, elevated liver enzymes or triglycerides, hearing disturbances.
✔️ Drug Interactions
- Avoid Combining With: Verapamil, diltiazem, centrally-acting antihypertensives (e.g., clonidine).
- Use With Caution: CYP3A4 inhibitors/inducers, simvastatin, tacrolimus, cyclosporine, antiarrhythmics (Class I/III), insulin, oral antidiabetics, anesthetics, NSAIDs, digitalis, sympathomimetics, other antihypertensives.
- Consider Potential Interactions With: Rifampicin, mefloquine, ergotamine derivatives, MAO inhibitors (excluding MAO-B inhibitors).
✔️ Not to be used in patients with:
- Acute or decompensated heart failure
- Severe aortic stenosis or cardiogenic shock
- Advanced AV block or sick sinus syndrome
- Symptomatic bradycardia or hypotension
- Severe bronchial asthma or Raynaud’s syndrome
- Untreated phaeochromocytoma
- Metabolic acidosis
- Hypersensitivity to bisoprolol, amlodipine, or similar agents
✔️ Use in Pregnancy & Lactation
Not recommended during pregnancy or breastfeeding due to potential fetal and neonatal risks.
✔️ Overdose Management
Overdose symptoms may include:
- From Bisoprolol: Bradycardia, hypotension, bronchospasm, hypoglycemia, and acute heart failure.
- From Amlodipine: Severe hypotension, reflex tachycardia, potential shock.
Treatment: Discontinue the drug, initiate supportive measures, including cardiovascular support and symptomatic care.
✔️ Precautions & Warnings
- Use cautiously in heart failure, hepatic impairment, and elderly patients.
- Avoid abrupt discontinuation of bisoprolol—taper gradually.
- Monitor patients with respiratory disorders (e.g., asthma, COPD), diabetes (may mask hypoglycemia), or peripheral vascular disease.
- Caution in psoriasis, thyrotoxicosis, or during desensitization therapy.
- Inform the anesthesiologist if undergoing surgery, as beta-blockers may interfere with anesthetic response.
✔️ Storage Conditions
Store below 30°C in a dry place, protected from light.
Keep out of reach of children.
Disclaimer:
ePharma sole intention is to ensure that its consumers get proper
information as musch as possible. Although we do not guarantee the
accuracy and the completeness of the information that provided and
here information is for informational purposes only.
The information contained herein should NOT be used as a substitute
for the advice of a qualified physician. This may not cover
everything about particular health conditions,
lab tests, medicines, all possible side effects, drug interactions,
warnings, alerts, etc. Please consult your healthcare professional
and discuss all your queries related to any disease or medicine. We
intend to support, not replace, the doctor-patient relationship.
