No

Antihypertensive Agent, Combination

Treatment of hypertension

C/D (2nd and 3rd trimesters)

>10%: Central nervous system: Fatigue

1% to 10%:

Cardiovascular: Chest pain, edema, bradycardia, hypotension

Central nervous system: Headache, dizziness, depression, abnormal dreams

Dermatologic: Rash, photosensitivity

Endocrine & metabolic: Hypokalemia, fluid and electrolyte imbalances (hypocalcemia, hypomagnesemia, hyponatremia), hyperglycemia

Gastrointestinal: Constipation, diarrhea, dyspepsia, nausea, insomnia, flatulence

Genitourinary: Micturition (frequency)

Hematologic: Rarely blood dyscrasias

Neuromuscular & skeletal: Arthralgia, myalgia

Ocular: Abnormal vision

Renal: Prerenal azotemia

Respiratory: Rhinitis, cough, dyspnea

Decreased effect/levels with barbiturates, rifampin, sulfinpyrazone

Decreased effect of oral hypoglycemics; decreased absorption with cholestyramine and colestipol

Increased effect with furosemide and other loop diuretics

Increased toxicity/levels of lithium

Increased effect/toxicity/levels of and with flecainide

Increased levels/toxicity of lidocaine

Adults: Oral: Dose is individualized, given once daily

Combination therapy for the treatment of hypertension should be individualized for each patient. Potential advantages for bisoprolol and hydrochlorothiazide combination therapy may include improved compliance and synergistic reductions in blood pressure with an accomplished reduction in side effects. Beta-blockers and thiazide diuretics are first-line therapies for the treatment of hypertension.

No information available to require special precautions

Noncardioselective beta-blockers (ie, propranolol, nadolol) enhance the pressor response to epinephrine, resulting in hypertension and bradycardia. This has not been reported for bisoprolol, a cardioselective beta-blocker. Therefore local anesthetic with vasoconstrictor can be safely used in patients medicated with bisoprolol. Many nonsteroidal anti-inflammatory drugs such as ibuprofen and indomethacin can reduce the hypotensive effect of beta-blockers after 3 or more weeks of therapy with the NSAID. Short-term NSAID use (ie, 3 days) requires no special precautions in patients taking beta-blockers.

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to get pregnant. Consult prescriber if breast-feeding.

Monitor blood pressure, EKG

Tablet:

Bisoprolol fumarate 5 mg and hydrochlorothiazide 6.25 mg

Bisoprolol fumarate 10 mg and hydrochlorothiazide 6.25 mg