Usual Adult Dose for Hypertension

Initial dose: Bisoprolol 2.5 mg-Hydrochlorothiazide 6.25 mg orally once a day
Maximum dose: Bisoprolol 20 mg-Hydrochlorothiazide 12.5 mg orally once a day

Comments:

• Increase the dose every 14 days if optimal response not achieved.
• This drug may be substituted for titrated individual components (e.g., inadequate control on bisoprolol 2.5 to 20 mg or adequate control on hydrochlorothiazide 50 mg but with significant potassium loss).
• Abrupt discontinuation should be avoided; taper therapy gradually over approximately 2 weeks.
• If withdrawal symptoms occur, therapy may be temporarily reinstituted.

Renal Dose Adjustments

Use caution with dose-titration

Liver Dose Adjustments

Use caution with dose-titration

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

No adjustment recommended.

Other Comments

Administration advice:

• If a dose is missed, take it as soon as remembered; if it is close to the next dose, skip the missed dose; do not double the dose.

• This drug interferes with allergic reaction modulation and may increase the risk of anaphylactic reactions; additionally, patients may be refractory to epinephrine in treatment for anaphylactic reactions.
• Patients may experience idiopathic sensitivity reactions, including photosensitivity or activation of systemic lupus erythematosus.

• Heart rate and blood pressure
• Serum electrolytes, periodically

• Warn patients to avoid interruptions or abrupt discontinuation of this drug.
• Instruct the patient to notify their healthcare provider upon signs and symptoms of bradycardia or heart failure (e.g., shortness of breath, edema, and weight gain).
• Inform healthcare professionals when using this drug, especially if surgery is planned.
• Avoid driving or operating machinery until the full effects are known.
• Advise patients to speak to a healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
• Patients with diabetes should be informed that this drug may mask hypoglycemic reactions.
• Advise patients to use sun protection as this drug may cause photosensitivity.
• Tell the patient to monitor for the signs and symptoms of fluid and electrolyte imbalances (e.g., increases in weakness, dry mouth, thirst, lethargy, drowsiness, muscle pain or cramps, tachycardia, nausea, vomiting).