How does it work?

This medicine contains two active ingredients, bisoprolol fumarate and hydrochlorothiazide. Bisoprolol belongs to a group of medicines called beta-blockers, which block beta receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals as they are responsible for the body's reaction to stressful situations. Blocking the beta receptors in the heart causes the heart to beat more slowly and with less force. This reduces the pressure at which blood is pumped out of the heart to the rest of the body. This is just one of the ways in which beta blockers help to reduce blood pressure, however the whole mechanism is not fully understood. Hydrochlorothiazide is known as a thiazide diuretic. Thiazide diuretics act in the kidney to remove water from the blood into the urine, by causing an increase in the removal of salts such as potassium and sodium from the blood. This removal of salts causes water to be drawn out of the blood and into the kidneys, where it is then excreted in the urine. Removing water from the blood decreases the volume of fluid circulating through the blood vessels. The drop in fluid volume results in a drop in the pressure of the fluid within the blood vessels, which helps to lower high blood pressure. It also decreases the effort required by the heart to pump blood around the body. The combination of these two medicines is particularly useful in treating high blood pressure.

What is it used for?

High blood pressure

Warning!

This medicine may mask the symptoms of low blood sugar such as increased heart rate, tremor and nausea. People with diabetes should carefully monitor their blood sugar.

You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

It is recommended that individuals taking this medicine have their fluid and salt (electrolyte) balance monitored regularly.

If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.

As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist.

If you should require local or general anaesthesia, it is important that you inform your anaesthetist you are taking this medicine.

Use with caution in

Changes in the heart monitoring trace

Diabetes

Family history of asthma

Gout

Heart failure

History of chronic obstuctive pulmonary disease

Narrowing of arteries in the extremities (peripheral arterial disease)

Not to be used in

Allergy to medicines from the sulphonamide group, eg the antibiotic sulphamethoxazole

Allergy to thiazides

Breastfeeding

Children

Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)

Failure of the heart to maintain adequate circulation (cardiogenic shock)

Heart attack

Low blood potassium levels (hypokalaemia)

Low blood pressure (hypotension)

Low blood sodium levels (hyponatraemia)

Pregnancy

Severe kidney failure

Severe liver failure

Severe or poorly controlled asthma

Slow heart rate of less than 50 beats per minute (bradycardia)

Uncontrolled heart failure

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy. Seek medical advice from your doctor.

This medicine passes into breast milk. It is recommended that mothers should avoid using this medicine while breastfeeding. Seek medical advice from your doctor.

Label warnings

Do not stop taking this medication except on your doctor's advice.

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