Lodoz

Per 2.5/6.25 mg FC tab Bisoprolol fumarate 2.5 mg, hydrochlorothiazide 6.25 mg. Per 5/6.25 mg FC tab Bisoprolol fumarate 5 mg, hydrochlorothiazide 6.25 mg

Mild to moderate HTN.

Adult Initially one 2.5/6.25 mg tab once daily, may be increased to 5/6.25 mg tab once daily. Max: Bisoprolol 10 mg, hydrochlorothiazide 6.25 mg once daily.

May be taken with or without food: Take in the morning. Swallow whole, do not chew/crush.

Hypersensitivity to bisoprolol, hydrochlorothiazide, other thiazides, sulphonamides. Severe asthma, uncontrolled heart failure, cardiogenic shock, sick sinus syndrome, SA block, 2nd- or 3rd-degree AV block w/o pacemaker, symptomatic bradycardia, pheochromocytoma (except after prior α-receptor blocker therapy), Raynaud's phenomenon & peripheral arterial disorders in severe forms, metabolic acidosis. Combination w/ sultopride. Refractory hypokalaemia. Severe renal & hepatic failure.

Positive doping test result. May affect ability to drive & use machines. Not recommended during pregnancy. Ped patients. Bisoprolol: Hypersensitivity. Asthma & COPD; cardiac failure; Prinzmetal's angina; peripheral arterial occlusive disease; pheochromocytoma; 1st-degree AV block; diabetes; psoriasis; thyrotoxicosis. Avoid abrupt interruption of treatment especially in CAD (angina pectoris). Competitive athletes. Strict fasting. General anaesth. Combination w/ verapamil, diltiazem or bepridil. Hydrochlorothiazide: Non-melanoma skin cancer; choroidal effusion, acute myopia, secondary angle-closure glaucoma; photosensitivity; acute resp distress syndrome. Periodic monitoring of serum electrolytes (especially K, Na, Ca), creatinine, urea, serum lipids (cholesterol, triglycerides), uric acid, blood glucose. Avoid combination w/ lithium. Not to be taken during lactation. Elderly.

Dizziness, headache; feeling of coldness or numbness in extremities; GI complaints eg, nausea, vomiting, diarrhoea, constipation; fatigue.

Increased risk of ventricular arrhythmias, notably torsades de pointes w/ antiarrhythmic drugs class IA (eg, quinidine, hydroquinidine, disopyramide), III (eg, amiodarone, sotalol, dofetilide, ibutilide); non-antiarrhythmic drugs eg, astemizole, bepridil, cisapride, diphemanil, IV erythromycin, halofantrine, lumefantrine, methadone, moxifoxacin, pentamidine, sotalol, IV spiramycin, sparfloxacin, terfenadine, vincamine, some antipsychotics like pimozide, haloperidol, benzamides. Risk of hypokalemia & -ve AV conduction effect w/ digitalis glycosides. Increased risk of hypotension w/ other antihypertensive agents, tricyclics, phenothiazines, baclofen, amifostine. Reduced antihypertensive efficiency w/ NSAIDs; corticosteroids, tetracosactide. Bisoprolol: Increased risk of ventricular arrhythmias or torsades de pointes w/ sultopride. Risk of bradycardia, negative influence on contractility & AV conduction w/ verapamil, diltiazem, bepridil; propafenone, cibenzoline, flecainide. Decreased central sympathetic tonus w/ centrally-acting antihypertensive drugs eg, clonidine, methyldopa, moxonidine, rilmenidine. Increased lidocaine plasma levels. Mask warning signs of hypoglycemia w/ antidiabetics eg, insulin, sulphonylureas, glinides. Increased risk of bradycardia w/ other bradycardia-inducing drugs eg, anticholinesterases, digitalis glycosides, mefloquine. Increased risk of hypotension w/ dihydropyridine type Ca channel blockers eg. nifedipine, amlodipine. Additive systemic effect w/ topical β-blockers. Hydrochlorothiazide: Increased lithium plasma levels. Reduced glomerular blood flow w/ systemic NSAIDs, ASA. Hypo- or hyperkalemia w/ K-sparing diuretics. Increased risk of hypokalaemia w/ hypokalemic drugs eg, IV amphotericin, systemic corticosteroids, tetracosactide, stimulating laxatives. Decreased BP &/or acute renal failure w/ ACE inhibitors, AIIA. Symptomatic hyponatremia w/ carbamazepine. Increased risk of acute renal failure w/ iodinated contrast media. Reduced absorption by resins. Attenuated effect w/ uric acid-lowering agents. Hypercalcemia w/ Ca salts. Increased risk of creatininemia w/ cyclosporine.

Beta-Blockers / Diuretics

C07BB07 - bisoprolol and thiazides ; Belongs to the class of selective beta-blocking agents in combination with thiazides. Used in the treatment of cardiovascular diseases.

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