What is the difference between bisoprolol fumarate and bisoprolol hemifumarate

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To make sure it's safe for you, tell your doctor before starting bisoprolol if you have:. Your doctor may advise you to take your first dose before bedtime as it can make you feel dizzy. If you do not feel dizzy after having the first dose, take bisoprolol in the morning.

Take bisoprolol even if you feel well, as you'll still be getting the benefits of the medicine. For high blood pressure or angina, you'll usually start on 5mg to 10mg once a day. If this dose isn't working well enough your blood pressure doesn't go down enough, or your angina keeps happening , your doctor may increase it up to 20mg.

For heart failure, you'll usually start at a low dose of 1. The dose is usually increased slowly over a few months. Bisoprolol does not usually upset your stomach, so you can take it with or without food. Swallow the tablets whole with a drink of water. Some brands have a score line to help you break the tablet to make it easier to swallow. If you miss a dose of bisoprolol, take it as soon as you remember that day.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. If you take too much bisoprolol, contact your doctor or nearest hospital straight away. An overdose of bisoprolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling. The amount of bisoprolol that can lead to an overdose varies from person to person. Take the bisoprolol packet or leaflet inside it, plus any remaining medicine, with you. Like all medicines, bisoprolol can cause side effects in some people, but many people have no side effects or only minor ones.

These common side effects happen in more than 1 in people. They're usually mild and shortlived. Talk to your doctor or pharmacist if the side effects bother you or last more than a few days:.

It happens rarely, but some people have serious side effects when taking bisoprolol. In rare cases, bisoprolol may cause a serious allergic reaction anaphylaxis. These are not all the side effects of bisoprolol. For a full list, see the leaflet inside your medicine packet. If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking bisoprolol.

There may be other blood pressure-lowering medicines that are safer for you. Labetalol is a similar medicine that's often recommended for high blood pressure in pregnancy. There's not a lot of information about the safety of bisoprolol if you're breastfeeding.

Small amounts of bisoprolol may get into breast milk and this can cause low blood pressure in your baby. Talk to your doctor, as other medicines for high blood pressure might be better while you're breastfeeding. There are some medicines that may interfere with the way bisoprolol works. There's very little information about taking herbal remedies and supplements with bisoprolol.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Like other beta blockers, bisoprolol works by changing the way your body responds to some nerve impulses, especially in the heart.

It slows down your heart rate and makes it easier for your heart to pump blood around your body. Bisoprolol starts to work after about 2 hours to reduce high blood pressure, but it can take 2 to 6 weeks to fully take effect.

If you're taking bisoprolol for high blood pressure , you may not feel any different when you take bisoprolol. This doesn't mean the medicine isn't working and it's important to keep taking it. If you're taking bisoprolol for angina , it'll probably take a couple of weeks before you feel better. Until then, you'll still have bouts of chest pain. You may even find the pain gets worse to start with. Make sure you have your medicine spray or tablets for treating angina attacks with you at all times, and use it if you need to.

If you're taking bisoprolol for heart failure , it may take several weeks, even months, before you feel better. Usually, treatment with bisoprolol is long term, even for the rest of your life. Stopping bisoprolol can make your blood pressure rise, and this may increase your risk of heart attack and stroke.

If you're bothered by side effects, your doctor may be able to prescribe a different blood pressure-lowering medicine. If you stop taking bisoprolol, it'll take 2 to 3 days for it to be completely out of your body. Bisoprolol works as well as other beta blockers for reducing blood pressure, but it's less likely to cause side effects. Other beta blockers, such as propranolol, work on the heart, but affect other parts of the body as well.

There are lots of other medicines to lower your blood pressure and treat chest pain or heart failure. Beta blockers aren't usually the first choice treatment for high blood pressure. The medicine your doctor prescribes depends on your age and ethnicity. If you're under 55, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker. If you're 55 or older, or you're any age and of African Caribbean or black African origin, you'll usually be offered a calcium channel blocker.

Sometimes you may have to try other blood pressure-lowering medicines if you get side effects. Many people need to take a combination of different blood pressure-lowering tablets. Tell your doctor that you're taking bisoprolol if you're going to be put to sleep have a general anaesthetic for an operation. Or if you're going to have a major operation, such as a caesarean section, without a general anaesthetic. The kinetics of bisoprolol are linear and independent of age. The pharmacokinetic characteristics of the two enantiomers are similar.

Metabolism of the drug by CYP2D6 is not clinically significant. The known metabolites are labile and have no known pharmacologic activity. Approximately half of the administered dose is excreted unchanged in urine. The present study evaluated the bioavailability of two different oral bisoprolol film-coated tablet formulations following single dosing in healthy adult subjects in order to prove the bioequivalence between both preparations. This randomized, single-blind, two-period, two-sequence crossover study involved 18 healthy subjects under fasting condition with a 1-week washout period.

Pregnancy tests for women were performed just before taking the drug in each period. Written informed consent from all study subjects was obtained prior to any trial-related activities, and the investigator retained the consent forms.

The test preparation bisoprolol fumarate 5 mg film-coated tablets, batch no was manufactured by PT Ferron Par Pharmaceuticals Tangerang, Indonesia.

The reference preparation bisoprolol hemifumarate 5 mg film-coated tablets, batch no L was the innovator product Concor 5 mg; Merck Indonesia, Jakarta, Indonesia and purchased from the local pharmacy. Subjects attended Equilab International, Jakarta, the night before drug administration and they were requested to fast from any food and drink except mineral water from 9 pm. In the morning approximately 6 am of the dosing day day 1 , after an overnight fast, a predose pharmacokinetic blood sample was taken.

Right afterwards, the study drug one film-coated tablet of the test drug or the reference drug was given at 7 am with mL water. The date and the time of taking each sample were recorded. Lunch and dinner were provided 4 hours and 10 hours after drug administration, respectively.

The amount of food and water intake and physical activity for each individual subject were standardized during the sampling days. Xanthine-containing food or beverages and fruit juices were not allowed for 24 hours before and during the entire sampling days.

From each subject, venous blood samples 10 mL were drawn immediately before taking the drug control , and 5 mL each at 0. One week after the first dosing ie, washout period , the same procedure was repeated with the alternate drug.

The blood samples collected at each time point from all subjects were centrifuged at rpm for 15 minutes to separate the plasma, and then the plasma was transferred to a clean tube. The date and time of taking each sample were recorded in the case report forms. The standard calibration curve of bisoprolol ranged from 0. In terms of selectivity, the chromatograms showed there were no interfering substances in six blank plasma samples, and the lowest concentration coefficient of variation was 7. Stability of the samples under frozen conditions, at room temperature, and during a freeze—thaw cycle was also determined.

The procedures described were applied for the extraction of subject samples, calibration, and quality-control standards. Plasma sample was dispensed in an appropriate tube, and then an appropriate solvent was added. The content of the tube was shaken and centrifuged. Calibration standards, controls, and samples were processed in batches. The mobile phase was formic acid in acetonitrile:ammonium acetate in such a composition so as to obtain the mass transition ion pair value of All chromatograms in the same batch were processed automatically by software using the same processing parameters: integration, peak-to-peak amplitude, and peak detection.

Manual integration was performed only when necessary.