Bisoprolol (Fumarate)

Overview

Disodium Pamidronate is a bisphosphonate, inhibits bone resorption and thus reduces bone turn over. Disodium Pamidronate is used in the treatment of bone disorders in which excessive bone resorption is a problem, such as paget`s disease of bone and osteoporosis. Disodium Pamidronate is also used as an adjunct insevere hypercalcaemic conditions especially associated with malignancies.

Categories

Primary Characterstics

Molecular Structure of Bisoprolol (Fumarate)

It is of Synthetic origin and belongs to Phenoxypropanol. It belongs to Beta-1 adrenergic antagonist pharmacological group on the basis of mechanism of action. The Molecular Weight of Bisoprolol (Fumarate) is 384.00.

Its pKa is 9.5.

Indications

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Pharmacokinetics

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Contraindications

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Drug Interactions

Bisoprolol (Fumarate) is known to interact with other drugs, the details of drug interactions is as follows:

Severity N/A

Cimetidine (HCl)

Interaction of Cimetidine (HCl) with Bisoprolol (Fumarate)

Clonidine (HCl)

Interaction of Clonidine (HCl) with Bisoprolol (Fumarate)

Indomethacin

Interaction of Indomethacin with Bisoprolol (Fumarate)

Details: NSAIDs antagonizes antihypertensive effects of beta-blockers.
Adrenaline

Interaction of Adrenaline with Bisoprolol (Fumarate)

Details: Severe hypertension when beta-blockers given with Adrenaline.
Verapamil (HCl)

Interaction of Verapamil (HCl) with Bisoprolol (Fumarate)

Details: Severe hypotension and heart failure when beta-blockers given with Verapamil.
Diltiazem (HCl)

Interaction of Diltiazem (HCl) with Bisoprolol (Fumarate)

Details: Severe hypotension and heart failure when beta-blockers given with Diltiazem.
VORICONAZOLE

Interaction of VORICONAZOLE with Bisoprolol (Fumarate)

Details: Voriconazole may increase the serum concentration of bisoprolol by decreasing its metabolism
Management: Monitor for changes in the therapeutic and adverse effects of both agents if concomitant therapy is initiated, discontinued or if doses are changed.
Indacaterol

Interaction of Indacaterol with Bisoprolol (Fumarate)

Details: Beta-blockers may exacerbate bronchospasms in patients with COPD
Management: monitor closely

Major

Amiodarone (HCl)

Interaction of Amiodarone (HCl) with Bisoprolol (Fumarate)

Details: Amiodarone may enhance the bradycardic effect of Bisoprolol. Possibly to the point of cardiac arrest.
Management: Monitor increased signs and symptoms of bradycardia with Bisoprolol (possibly to the point of cardiac arrest) if amiodarone is initiated/dose increased, or decreased effects if amiodarone is discontinued/dose decreased. Ophthalmic beta-blockers are likely of little concern.
Theophylline

Interaction of Theophylline with Bisoprolol (Fumarate)

Details: Bisoprolol reduces the CYP450 hepatic metabolism of theophylline and its serum levels may be increased.
Management: Closely monitored the increased serum level of theophylline and decreased bronchodilatory effectiveness.

Moderate

Naproxen

Interaction of Naproxen with Bisoprolol (Fumarate)

Details: Naproxen through renal prostaglandin synthesis inhibition reduces the antihypertensive activity of bisoprolol.
Management: Altered antihypertensive response is monitored whenever naproxen is introduced or discontinued in treatment.
Nifedipine

Interaction of Nifedipine with Bisoprolol (Fumarate)

Details: Coadministration additively reduces in heart rate, cardiac conduction and cardiac contractility. While this combination is useful in congestive heart failure, severe hypotension and angina.
Management: Dose of both agents must be adjusted and close clinical monitoring of hemodynamic response must be recommended.
Rifampicin

Interaction of Rifampicin with Bisoprolol (Fumarate)

Details: Metabolism of Bisoprolol accelerated by Rifampicin (plasma concentration significantly reduced)
Digoxin

Interaction of Digoxin with Bisoprolol (Fumarate)

Details: Bisoprolol may potentiate bradycardia due to Digoxin.
Management: Monitor for increased bradycardia if these two agents are used concomitantly. Ophthalmic beta-blockers are likely of little concern.

These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

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Side Effects

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Dosage

Bisoprolol (Fumarate)'s dosage details are as follows:
Dose Single Dose Frequency Route Instructions

Adult Dosage

5 to 20 mg12 (12.5)24 hourlyPOGradually Increased

Paedriatic Dosage (20kg)

No data regarding the Paedriatic dosage details of Bisoprolol (Fumarate) is available.

Neonatal Dosage (3kg)

No data regarding the neonatal dosage details of Bisoprolol (Fumarate) is available.

High Risk Groups

Drug should not be given to Paediatrics, and Pregnant Mothers.

If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

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Warning / Precautions

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Storage Conditions

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Interference in Pathology

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Brands / Trade Names of Bisoprolol (Fumarate)

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