Bisopar 10
Bisopar 10 - Image 2
Bisopar 10 - Image 3
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Bisopar 10

Contains: Bisoprolol Fumarate 5 mg + S(-)Amlodipine 5 mg
Therapeutic Class: Antihypertensive (Beta-blocker + Calcium Channel Blocker combination)
Schedule: Schedule H (Prescription drug)

Bisopar 10 is a fixed-dose combination tablet used primarily for the management of hypertension (high blood pressure) and angina pectoris. It combines two pharmacologically distinct agents:

  • Bisoprolol, a cardioselective beta-1 adrenergic receptor blocker,

  • S(-)Amlodipine, the active enantiomer of amlodipine, a dihydropyridine calcium channel blocker.

The combination offers complementary mechanisms: Bisoprolol reduces heart rate and myocardial oxygen demand, while S(-)Amlodipine promotes vasodilation and lowers peripheral resistance, improving blood pressure control and reducing cardiac workload.

Usage of Bisopar 10

  • Management of essential hypertension (primary high blood pressure)

  • Treatment of stable angina

  • May be used in hypertensive patients with concomitant cardiac conditions like arrhythmias or left ventricular hypertrophy

  • Suitable as a step-down therapy or in cases requiring dual antihypertensive agents for better compliance

Common Side Effects

  • Bisoprolol-related:

    • Bradycardia

    • Fatigue or dizziness

    • Cold extremities

    • Sleep disturbances

    • Masking signs of hypoglycemia (in diabetics)

  • S(-)Amlodipine-related:

    • Peripheral edema (less frequent vs racemic amlodipine)

    • Headache

    • Flushing

    • Palpitations

    • Dizziness

Precautions

  • Use cautiously in patients with:

    • Asthma, COPD (Bisoprolol can cause bronchospasm)

    • Diabetes mellitus (may mask hypoglycemia symptoms)

    • Peripheral vascular disease

    • Severe hepatic impairment (Amlodipine metabolism is hepatic)

    • AV block or heart failure (monitor heart rate and ECG)

  • Avoid abrupt discontinuation – may precipitate angina or myocardial infarction

  • Monitor blood pressure, heart rate, and renal/hepatic parameters regularly

Drug Interactions

  • With other antihypertensives: Additive hypotensive effect

  • With calcium channel blockers (verapamil/diltiazem): Risk of bradycardia and heart block

  • With anti-diabetics (insulin/sulfonylureas): Bisoprolol may mask hypoglycemia

  • With NSAIDs: May reduce antihypertensive effect

  • CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): May increase amlodipine levels

  • CYP3A4 inducers (e.g., rifampicin, phenytoin): May decrease amlodipine efficacy

Dosage and Administration

  • Once daily, preferably in the morning

  • Can be taken with or without food

  • Individual titration may be required based on patient response

Storage

  • Store in a cool, dry place below 25°C

  • Protect from light and moisture

Patient Counselling Tips

  • Advise on the importance of adherence to dosage schedule

  • Educate about possible dizziness — caution while driving or operating machinery

  • Instruct patients to report slow heart rate, chest pain, or swelling in legs immediately

  • Encourage lifestyle modifications like diet control, exercise, and smoking cessation

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