Savi Prolol Plus HCT 5/6.25 controls hypertension (3 blisters x 10 tablets)
Dosage form Box of 3 blisters x 10 tablets
Specifications Bisoprolol, hydrochlorothiazide
Ingredient
Thành phần cho 1 viên
| Composition information | Content |
| Bisoprolol | 5mg |
| Hydrochlorothiazide | 6.25mg |
Uses
indications
Saviprolol Plus HCT 5/6.25 drugs are indicated to control hypertension.
Pharmacology
Pharmacological group: Beta blockers combined with thiazide.
ATC code: C07b B07.
bisoprolol fumarate (B) combines hydrochlorothiazide (HCT)
Bisoprolol Fumarate (B) and Hydrochlorothiazide (HCT) have been used individually or combined to treat hypertension. The hypotension effect of these active ingredients is Hiep force; HCT 6.25 mg significantly increases the hypotension effect of Bisoprolol Fumarate. The rate of hypoglycemia of bisoprolol fumarate and HCT 6.25 mg (b/h) is significantly lower than HCT 25 mg. In the clinical trials of Bisoprolol Fumarate and Hydrochlorothiazide, the average change of serum potassium content in patients treated with combination Bisoprolol Fumarate and Hydrochlorothiazide 2.5 mg/6.25 mg, 5 mg/6.25 mg, 10 mg/6.25 mg or less than ± 0.1 MEQ/L. The average change of Potassium content in the serum of patients treated with any Bisoprolol dose combined with HCT 25 mg changes from -0.1 to - 0.3meq/l.
Bisoprolol Fumarate is a selective blocking blockbean (Cardioselective) that has no significant or no sympathetic effects like the internal sympathetic nerve within the scope of treatment. At high doses (≥ 20 mg), Bisoprolol Fumarate also inhibits the beta receptor, located in the bronchial system and blood vessels. To keep the relative selection, it is important to use the lowest dose effectively.
Hydrochlorothiazide is a benzothiadiazine diuretic. Thiazide affects the renal tubular mechanism of electrolyte reabsorption and increases the secretion of sodium and chloride in almost equal amounts. Sodium urinary condition (sodium) will cause loss of secondary potassium.
bisoprolol fumarate
Bisoprolol is a selective blockbuster Beta1 (β1) but has no membrane stability and has no effect like intrinsic sympathetic nerve when used within the scope of treatment. With low doses, Bisoprolol inhibits selectively responding to adrenaline stimulation by competing the receptor of the heart of the heart, but has little effect on the beta2 receptor (β2) adrenaline of bronchial muscles and vascular walls. With high doses (for example 20 mg or more), the selective properties of bisoprolol on receptors B, usually reduced and the drug will compete inhibiting both receptors β1 and β2
Bisoprolol is used to treat hypertension. Bisoprolol's effectiveness is equivalent to other beta blockers. The mechanism of lowering the hypotension of Bisoprolol may include the following factors: reducing heart flow, renal inhibition releases renin and reducing the impact of sympathetic nerve from vasomotor centers in the brain. But the most prominent effect of Bisoprolol is to reduce the heart frequency, both resting and at exertion. Bisoprolol reduces the flow of the heart at a break and when exertion, accompanied by few changes in the volume of blood expeled in every heart, and only increases the right atrial pressure or the pulmonary capillary pressure at rest and exertion. Unless there is a contraindication or an intolerant, beta blockers have been used in combination with transferred enzyme inhibitors, diuretic and heart glycoside to treat heart failure due to left ventricular dysplasia, to reduce progressive heart failure. The good effect of beta blockers in the treatment of congestive heart failure is mainly due to inhibition of the effects of sympathetic nervous system. Using long -term beta blockers, as well as conversion enzyme inhibitors, can reduce heart failure symptoms and improve the clinical condition of people with chronic heart failure. These good effects have been shown in people who are taking an enzyme inhibitor, showing inhibitors in combination of the renin-angiotensin system and sympathetic nervous system are plus effects.
hydrochlorothiazide
Hydrochlorothiazide and thiazide diuretics increase the excretion of sodium chloride and water attached to the mechanism of inhibiting the reabsorption of sodium and chloride ions in the distance. The excretion of other electrolytes also increased especially Potassium and Magnesium, and calcium decreases.
Hydrochlorothiazide also reduces the activity of the carbon dioxide enzyme, which increases the excretion of bicarbonate but this effect is usually small compared to the excretion effect and does not significantly change the urine pH. Thiazide has a moderate diuretic effect, because about 90% of Sodium ions have been reabsorbed before reaching the distance to the distance is the main position of the drug.
Hydrochlorothiazide has the effect of lowering blood pressure, which is probably due to a decrease in plasma volume and extracellular fluid related to sodium cards. Then, during the use of the drug, the effect of lowering blood pressure depends on the decrease in peripheral resistance, through the gradual adaptation of blood vessels from the reduction of Na+concentration. Therefore, the hypotension effect of hydrochlorothiazide is shown slowly after 1-2 weeks, while the diuretic effect occurs quickly and can be seen right after a few hours.
hydrochlorothiazide increases the effects of other antihypertensive drugs.
Dynamic pharmacokinetics
bisoprolol fumarate (B) combined Hydrochlorothiazide (HCT)
In healthy volunteers, both Bisoprolol Fumarate and Hydrochlorothiazide are well absorbed after drinking. There is no vendor for each substance when drinking together in the same pill.
The absorption of Bisoprolol Fumarate and Hydrochlorothiazide is not affected whether used with food. The average peak concentration in the plasma of Bisoprolol Fumarate is about 9 ng/ml, 19 ng/ml and 36 ng/mL occurs about 3 hours after taking the dose of 2.5 mg/6.25 mg, 5 mg/6.25 mg and 10 mg/6.25 mg of combined tablets, respectively. The average peak concentration in the plasma of hydrochlorothiazide reaches 30 ng/ml occurring about 2.5 hours after taking a combination of pills. Increasing the dose increases the plasma concentration ratio of Bisoprolol Fumarate has been observed between 2.5 mg and 5 mg dose, as well as between 5 mg and 10 mg dose. The sale time T1/2 of Bisoprolol Fumarate is from 7 hours to 15 hours and hydrochlorothiazide from 4 to 10 hours.
The percentage of dosage in urine is about 55% for bisoprolol fumarate and about 60% with hydrochlorothiazide.
bisoprolol fumarate
Absolute bioavailability after orally 10 mg of Bisoprolol Fumarate is about 80%. The first metabolism of Bisoprolol Fumarate is about 20%.
Bisoprolol Fumarate's dynamic dynamic data has been tested after a single dose and in a stable state. Linking with serum protein is about 30%. Plasma peak concentration occurs within 2-4 hours after taking the drug in doses from 2.5 mg to 20 mg and the average peak value is from 9 ng/mL at 2.5 mg to 70 ng/ml at 20 mg. When taking Bisoprolol Fumarate with a one -time standard daily, the result is a less than twice -changing plasma peak concentration. The concentration is proportional to oral dose ranges from 2.5 mg to 20 mg.The semi -discharged time of plasma is about 9 - 12 hours and slightly longer in elderly patients, partly due to the reduced renal function. Stable state is achieved within 5 days with a dose once a day. Among both young and elderly people, the accumulation of plasma is low, the accumulated coefficient is between 1.1 to 1.3, and this is expected from the time of selling and taking drugs once a day. Bisoprolol Fumarate is excreted equally by the kidney and no kidney, with about 50% of the dosage appears in urine in the form of constant and 50% in the form of inactive metabolites. In humans, metabolites are known to be unstable or have no pharmacological activity. There are less than 2% of the dose is excreted in the feces. The pharmacokinetic characteristics of the two equiles are similar. Bisoprolol is not metabolized by cytochrome p450 || D6 (Debrisoquin hydroxylase).
For objects with creatinine clearance less than 40 ml/min, the semi -disposal time in plasma increases by three times higher than healthy people. In patients with cirrhosis, Bisoprolol elimination rate is often significantly changed and significantly slower than healthy objects, with the time of selling plasma waste for about 8-22 hours.
In the elderly people, the average plasma concentration in a stable state has been increased, partly due to decreasing creatinine clearance. However, there is no significant difference in the accumulation of Bisoprolol found between the young group and the elderly.
hydrochlorothiazide (HCT)
Hydrochlorothiazide is well absorbed (65% -75%) after drinking. The absorption of hydrochlorothiazide decreases in patients with congestive heart failure.
The concentration of the peak of the mulch is observed within 1-5 hours after taking the drug and is within 70 - 490 ng/mL after the oral dose of 12.5 - 100 mg. Plasma concentrations are linearly related to the dose.
The concentration of hydrochlorothiazide in the blood is 1.6 - 1.8 times higher than in plasma. Linking with serum protein has been reported about 40% to 68%. The sale time in plasma is reported for 6-15 hours. Hydrochlorothiazide is eliminated mainly by kidney.
After the oral dose of 12.5 - 100 mg, 55% - 77% the dose appears in the urine and more than 95% of the absorption dose is excreted in the urine in the form of constant. The plasma concentration of HCT increases and the selling time is prolonged in patients with renal disease.
Before taking Savi Prolol Plus HCT 5/6.25 controls hypertension (3 blisters x 10 tablets)
How to use
oral tablets.
Dosage
Dosage
Bisoprolol therapy is an effective treatment for hypertension in the 2.5 mg doses to 40 mg once daily, while hydrochlorothiazide is effective at the 12.5 mg-50 mg doses.
In clinical trials combining bisoprolol/hydrochlorothiazide when using bisoprolol combinations from 2.5 mg to 20 mg and hydrochlorothiazide doses from 6.25 mg to 25 mg, lowering blood pressure increases in proportion to the dose of each component.
The unwanted effects of Bisoprolol are a mixture of phenomena depending on the dose (mainly slow heart rate, diarrhea, weakness and fatigue) and independent phenomena (for example, sometimes rash) and hydrochlorothiazide are a mixture of events depending on the dose (mainly hypoglyced Potassium blood) and independent phenomena with dosage (for example, pancreatic statues) The amount occurs much more popular than the phenomena independent of the dose.
Clinically treated treatment regimen
Patients with uncontrolled blood pressure with doses of 2.5 mg - 20 mg Bisoprolol can be replaced daily with combination of bisoprolol fumarate + hydrochlorothiazide. Patients with blood pressure are fully controlled at a dose of 50 mg of hydrochlorothiazide daily, but loss of blood potassium significantly with this regimen, can achieve similar blood pressure control without electrolyte disorders if switching to bisoprolol fumarate + hydrochlorothiazide.
Initial therapy
Hematoplasty treatment can be started with the lowest dose of Bisoprolol Fumarate + Hydrochlorothiazide 2.5 mg/6.25 mg (B/HCT) 1 capsule once a day. After adjusting the dose (14 -day distance), it is possible to increase the dose with a combination of bisoprolol fumarate + hydrochlorothiazide up to a maximum recommended dose of 20 mg/12.5 mg (ie twice the dose of 10 mg/6.25 mg) orally once daily when appropriate.
Alternative therapy
This combination can be replaced for individual ingredients when needed to increase the dose.
Definition of treatment
If you want to stop treating with Bisoprolol Fumarate and Hydrochlorothiazide, you need to plan to achieve gradually for about 2 weeks. Patients must be carefully monitored.
Patients with kidney or liver failure
Be cautious when using and adjust the dose in patients with liver failure or kidney dysfunction. Because there is no sign that hydrochlorothiazide can be separated and there are some data that Bisoprolol is not separated, unnecessary to replace drugs in dialysis patients.
Elderly patients
Adjustable dose on the basis of age is usually unnecessary, unless there is significant kidney or liver dysfunction.
In clinical trials, at least 270 patients are treated with bisoprolol fumarate combined with hydrochlorothiazide (HCT) aged 60 or more. HCT significantly adds bisoprolol's hypotension in hypertension patients. There is no overall difference in effectiveness or safety observed between elderly patients and young patients. Another clinical experience report shows that there is no difference in drug response between elderly and younger patients, but the sensitivity of some older individuals cannot be excluded.
Children's patients
There is no data for bisoprolol fumarate and hydrochlorothiazide.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?
In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.
Side Effects
When using Saviprolol Plus HCT 5/6.25 you may experience unwanted effects (ADR):
Unwanted effects are listed according to the organs and the frequency of encounter. The defined frequency is: common (1/100 ≤ ADR
benign, malignant or unknown tumor (including cysts and polyps)
Eyes
heart
circuit
Instructions on how to handle ADR:
Notify the physician with unwanted effects when using the drug.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Savi Prolol Plus HCT 5/6.25 contraindications in the following cases:
Be cautious when using
need to be very careful when taking the drug for patients in the following cases:
Warning
bisoprolol fumarate
heart failure
Parasma stimulation is an essential component that supports circulatory function in the beginning of congestive heart failure, and beta blockers can lead to further decrease in cardiomyopathy and promote more heart failure.
However, in some patients with congested heart failure, compensation may need this medication. In this case, the medication must be used carefully. The drug is only added when it is available for heart failure with basic drugs (diuretics, digitalis, enzyme inhibitors) under the strict control of a specialist.
Patients without heart failure
In some patients with beta blockers can continue to cause heart muscle (pinch) and promote heart failure. Based on the first signs or symptoms of heart failure, it is necessary to consider stopping bisoprolol fumarate and hydrochlorothiazide. In some cases, the treatment with bisoprolol fumarate and hydrochlorothiazide can be continued while heart failure is treated with other drugs.
Sudden stop treatment
Exacections of angina and in some cases, myocardial infarction or ventricular arrhythmia have been observed in patients with coronary artery disease determined after suddenly stopping treatment with beta blockers. Therefore, these patients need to be warned that they are not interrupted or stopped without the doctor's advice. Even in patients without coronary artery disease, it is still recommended to treat the dose reduction from Bisoprolol Fumarate and Hydrochlorothiazide for more than 1 week on the condition that patients must be carefully monitored. If the symptoms occur, it is necessary to re -establish treatment with beta blockers, at least temporarily. If the symptoms of cessation occur, the drug should be used at least for a period of time.
Peripheral vascular disease
Beta blockers can promote or aggravate the symptoms of artery failure in patients with peripheral vascular disease. Caution should be used for these patients.
Bronchospasm
In general, patients with bronchospasm should not use beta blockers. Because it is related to the selection of beta, of Bisoprolol Fumarate, combining Bisoprolol Fumarate + Hydrochlorothiazide can be used cautiously in patients with bronchospasm, who do not respond to drugs or those who cannot tolerate other antihypertensive drugs. Due to the selection of beta, not absolutely (selection decreases when increasing the dose), the lowest possible dose of Bisoprolol Fumarate and Hydrochlorothiazide. Beta's ownership effect, (bronchodilators) can also be effective.
Anesthesia and surgery
In patients with long -term treatment with beta blockers, do not stop the drug before operating surgery.
However, the ability to damage heart response with Adrenergic irritation can increase risks in anesthesia and surgery.
diabetes and hypoglycemia
Beta blockers can cover the manifestations of hypoglycemia, especially tachycardia. Unstolant beta blockers may increase the level of hypoglycemia caused by insulin and slow down the recovery of serum glucose concentrations. Due to the selective nature of beta, this is less likely to happen with Bisoprolol Fumarate. However, it is necessary to warn patients or hypoglycemia, or diabetic patients who are taking insulin or blood glucose oral medications for these possibilities, and must be used with bisoprolol carefully.
In addition, potential diabetes can become a disease and diabetics who are taking Thiazide may require adjusting their insulin dose. Due to the low dosage of hydrochlorothiazide, this may be less likely to happen with a combination of bisoprolol fumarate and hydrochlorothiazide.thyroid poisoning
The beta-adrenergic blocker can cover the clinical signs of hyperthyroidism (hyperthyroidism), such as tachycardia. The sudden stopping of beta blockers can worsen the symptoms of hyperthyroidism or may promote the storm.Kidney disease
Need to adjust the dose of bisoprolol carefully for patients with renal failure or liver failure.
The accumulation of thiazide can develop in patients with impaired renal function. In these patients, Thiazide can cause blood nitrogen. The patient has a creatinine clearance below 40 ml/min, the half -life of plasma of bisoprolol fumarate increases to triple than a healthy person. If the renal failure progresses, it is necessary to stop the bisoprolol fumarate and hydrochlorothiazide.
Liver disease
Bisoprolol Fumarate and Hydrochlorothiazide should be used carefully in patients with impaired liver function or progressive liver disease. Thiazide can change the balance of fluid and electrolytes, which can cause liver coma.
In addition, the elimination of Bisoprolol Fumarate is significantly slower in patients with cirrhosis than healthy people.hydrochlorothiazide
Acute myopia and glaucoma of secondary closing angle (glaucom)
Hydrochlorothiazide, a sulfonamide, can cause its own specific reaction, leading to transient myopia and increased acute glaucoma. Symptoms include an acute impulsive or visual reduction of pain and often occur within hours to a few weeks when starting to take the drug. The angle hypertrophy of the angle if left untreated can lead to permanent vision loss. The main treatment is to stop hydrochlorothiazide as quickly as possible. The treatment or surgery may need to be considered if the internal pressure is still uncontrolled. Risk factors for developing an angle of glaucoma may include a history of sulfonamide or penicillin allergy.
Precautions
The condition of the fluid and electrolyte balance
Although the probability of developing hypoglycemia is limited to bisoprolol fumarate and hydrochlorothiazide (HCT) because of the very low doses of HCT, it should be periodically determined that the electrolytes in the serum and the patient must be monitored the signs of fluid or electrolyte disorders, that is, hypoglycemia, alkali infection with blood reduction alkalis (Hypochloremic) Hemomagnesemia (hypomagnesemia). Thiazide shows that there is an increase in magnesium excretion in the urine, which can cause a reduction in blood magnesium (hypomagnesemia).
However, any chloride ionic deficiency occurs is usually mild and no specific treatment, except for unusual cases (such as liver disease or kidney disease) Chloride replacement may be required in the treatment of metabolic alkaline infections.
Warning signs or symptoms of fluid imbalance and electrolytes include dry mouth, thirst, weakness, indifference, drowsiness, restlessness, muscle pain or cramps, muscle fatigue, hypotension, urinary discharge, fast heart rate and digestive disorders such as nausea and vomiting.
Hypotension can develop, especially with rapid diuretic during severe cirrhosis, during use simultaneously with corticosteroids or epidemic hormones (ACTH) or after prolonged treatment.
Take a full amount of electrolytes will also contribute to lowering blood potassium. Lowering blood potassium and decreased blood magnesium can cause ventricular arrhythmia or increase sensitivity or increase the heart's response too much to the toxic effects of digitalis. Lowering blood potassium can be avoided or supplemented with potassium or increased consumption of potassium -rich foods.
Lowering blood -caused blood sodium can occur in patients with edema in hot weather, appropriate treatment is water limit, not salt water supplement, except for the hypoglysis of blood sottium threatening (rare). In case of salt loss, the appropriate choice is to replace therapy.
Hyperglycemia
Hyperglycemia or acute gout can occur in some patients using thiazide diuretics.
bisoprolol fumarate, used alone or in combination with HCT, are all related to uric acid hypertrophy. However, in clinical trials in the United States, the incidence of uric acid hypertrophy is related to treatment at hydrochlorothiazide (HCT) 25 mg (25%) larger than B/HCT 6.25 mg (10%). Because of the very low dosage of HCT, hyperuricemia hyperuricemia may be less likely to occur with a combination of bisoprolol fumarate + hydrochlorothiazide.
Hyperglycemia
Hyperglycemia can occur with thiazide diuretics. Hence potential diabetes can show when treated with Thiazide.
Other effects
The hypotension effects of the drug can increase in patients with surgery to remove sympathetic nerve.
Armor disease
Thiazide reduces calcium secretion and changes the pathology of parathyroid glands, hypercalcemia and hypoglycemia has been observed in some prolonged thiazide patients.
kidney failure
If the renal failure progresses, it is clear, it is necessary to consider reducing the dose or not to continue treating with diuretics.
Thiazide has been shown to increase the secretion of urine magnesium, which can lead to hypotentia (hypomagnesemia).
Thiazide should be used cautiously in severe kidney disease. In patients with renal disease, Thiazide can cause urea-cumulative cumulative cumulative movements that can be developed in patients with impaired renal function.
The effect of drugs on driving and operating machinery
Experience shows that the treatment does not affect the ability to drive or use the patient's machines.
However, some adverse reactions such as dizziness, headache, and drowsiness are rare but still occur; Hence can affect the ability to drive or operate machinery.
Use drugs for women during pregnancy and lactation
Pregnant women
Thiazide passes through the placenta and appears in the umbilical cord blood. The use of thiazide in pregnant women requires predicting benefits compared to the risks for the fetus. These dangers include jaundice for fetuses or babies, pancreatitis, thrombocytopenia and may have other adverse reactions that have occurred in adults.
breastfeeding women
Bisoprolol Fumarate used mono or combined with HCT has not been studied in mothers who are breastfeeding. Thiazide is excreted through breast milk. A small amount of bisoprolol fumarate ( Drug interaction
bisoprolol fumarate (B) and hydrochlorothiazide (HCT)
Bisoprolol Fumarate + Hydrochlorothiazide can increase the effect of other antihypertensive drugs when used simultaneously. Bisoprolol Fumarate and hydrochlorothiazide should not be used in combination with other beta blockers. Patients who receive drugs decrease/consume catecholamine, such as reserpine or guanethidine, should be closely monitored because of the increase in the effect of beta-adrenergic blockers that can cause excessive decline in sympathetic activity. In patients treated simultaneously with clonidine, if needed to stop treatment, bisoprolol fumarate and hydrochlorothiazide should be discontinued a few days before stopping clonidine.
Bisoprolol Fumarate+Hydrochlorothiazide should be cautious when used with myocardial inhibitors or inhibitors of atrial conduction or depression, such as identified calcium antagonistic drugs (especially phenylalkylamine [Verapamill and benzothiazepine [Diltiazem]) disopyramide.
Both digitalis glycoside and beta blockers slow down the atrial transmission and the heart rate decreases. Simultaneous use may increase the risk of slow heart rate.
bisoprolol fumarate
Simultaneously used with rifampin increases the clearance of bisoprolol fumarate, shortening the sale time. However, it is not necessary to change the starting dose.
Pharmacokinetic research documents do not show clinical interactions related to other simultaneous use, including thiazide and cimetidine diuretics. Bisoprolol Fumarate has no effect on prothrombin time in patients taking stable doses of warfarin.
Risk of anaphylactic reaction: While taking beta blockers, patients with a serious history of allergies to different allergens may have a stronger reaction to the use of repeated drugs or by accident or due to treatment. These patients may not respond to the dose of epinephrine often used to treat allergic reactions.
hydrochlorothiazide
When used simultaneously with the following drugs, there may be interaction with thiazide diuretics including alcohol, sedative or addictive drugs: There may be an increase in the potential of lowering blood pressure.
Diabetes (oral and insulin drugs): Need to adjust the dosage of diabetes drugs due to hypoglycemic glucose.
Other antihypertensive drugs: can occur in a synergistic effect or increase the potential of hypotension.
Cholestyramine and Colestipol: The absorption of hydrochlorothiazide is impaired when there is the presence of the above anion exchange resin. The only dose of cholestyramine and colestipol plastic associated with hydrochlorothiazide and reduces the absorption in the digestive tract to 85% and 43%, respectively.
corticosteroid, ACTH: increases the exhaustion of electrolytes, especially hypoglycemia.
Amine (eg norepinephrine): may reduce response to hypertension amine but not enough to prevent them from using them.
Muscle relaxants, non -reducing groups (for example, tubocurarine): may increase in response to muscle relaxants.
lithium: should not be used with diuretics. Diuretics reduce lithium's kidney clearance and cause high risk of lithium poisoning. Refer to the user manual of lithium preparations before using Bisoprolol Fumarate and Hydrochlorothiazide.
Non -steroid anti -inflammatory drugs: In some patients, when taking nonsteroidal anti -inflammatory drugs can reduce diuretic effects, reduce the secretion of sodium urinary and reduce the hypotension effect of thiazide diuretics, Potassium diuretic. Therefore, when Bisoprolol Fumarate + Hydrochlorothiazide is simultaneously used with nonsteroidal anti -inflammatory drugs, patients need to be closely monitored to determine the desired effect of diuretics. When using Thiazide, sensitive reactions may occur with patients with or without a history of allergies or bronchial asthma. Light -sensitive reactions and may worsen or output the whole body lupus that has been reported in patients using Thiazide. The hypotension effect of Thiazide can increase in patients after removal of sympathetic nerve.
Testing
Based on reports related to Thiazide, Bisoprolol Fumarate + Hydrochlorothiazide can reduce the concentration of ode associated with serum protein but do not give signs of thyroid disorders. Because combined drugs contain thiazide (hydrochlorothiazide), the drug should be discontinued before performing the contour function test.
Tyeum of drugs
Due to the absence of studies on the correlation of the drug, not mixing this drug with other drugs.
Storage
Leave a cool place, avoid light, temperatures below 30⁰C.
To be out of reach of children, read the instructions carefully before use.
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