سعر بيستول بلس 2.5/6.25 مجم 20 قرص 2024

Bistol plus 2.5/6.25 mg 20 film-coated tablets (bisoprolol fumarate 2.5 mg + hydrochlorothiazide 6.25 mg); Hikma Pharma; price 30.00 EGP (prev 20.00; updated 2024-12-11).

• Hypertension in patients not adequately controlled on monotherapy with bisoprolol or hydrochlorothiazide (EU combination SmPC pattern: Lodoz/Emcoretic class).Population: AdultsFAMHP Belgium

• Common/class effects: bradycardia, fatigue, dizziness, headache, feeling of cold extremities; GI symptoms. Combo: additional thiazide effects (electrolyte disturbance, hyperuricaemia).International label, same formulation · FAMHP Belgium

• Hypersensitivity to bisoprolol, hydrochlorothiazide, other thiazides/sulfonamides or excipients; acute/decompensated heart failure needing IV inotropes; cardiogenic shock; 2nd/3rd-degree AV block without pacemaker; sick sinus syndrome; sinoatrial block; symptomatic bradycardia; severe asthma; severe PAD/Raynaud; untreated phaeochromocytoma; metabolic acidosis; severe renal impairment (CrCl <30 ml/min); severe hepatic impairment; refractory hypokalaemia/hyponatraemia/hypercalcaemia.International label, same formulation · FAMHP Belgium

• Do not stop abruptly (risk of rebound). Caution in diabetes (may mask hypoglycaemia), first-degree AV block, Prinzmetal angina, peripheral arterial disease, strict fasting, ongoing desensitisation therapy. Monitor heart rate/BP. Combination with verapamil/diltiazem-type calcium antagonists not recommended.International label, same formulation · FAMHP Belgium
• Hydrochlorothiazide: monitor electrolytes; photosensitivity; risk of acute angle-closure myopia/glaucoma (sulfonamide); may exacerbate SLE; thiazides can unmask latent diabetes.International label, same formulation · FAMHP Belgium

• Verapamil / diltiazem-type calcium antagonistsMajorNot recommended: negative inotropy and AV conduction; IV verapamil may cause profound hypotension and AV block.FAMHP Belgium
• Insulin and oral antidiabeticsModerateEnhanced hypoglycaemia; symptoms may be masked by beta-blockade.FAMHP Belgium
• Centrally acting antihypertensives (e.g. clonidine)MajorNot recommended: bradycardia/reduced output; rebound hypertension on abrupt clonidine withdrawal.FAMHP Belgium

• Not recommended in pregnancy unless clearly necessary; beta-blockers may reduce placental perfusion; neonatal hypoglycaemia/bradycardia possible. Thiazides (if combo) also generally avoided in pregnancy.International label, same formulation · FAMHP Belgium
• Not recommended during breastfeeding (bisoprolol excretion uncertain; HCTZ passes into milk and may reduce milk production).International label, same formulation · FAMHP Belgium

• Bisoprolol fumarate: Highly beta-1-selective adrenoceptor blocker without intrinsic sympathomimetic or relevant membrane-stabilising activity; reduces heart rate, contractility and sympathetic drive.
• Hydrochlorothiazide: Promotes renal excretion of sodium and chloride, reducing intravascular volume.