Introduction About BISOTRAK T 2.5MG TABLET

BISOTRAK T 2.5MG TABLET is used to manage hypertension, angina (chest pain) and heart failure in adults. It is a combination of Bisoprolol and Telmisartan which works by relaxing your blood vessels supplying the heart which in turn reduces strain on the heart. It is also used to reduce the risk of cardiovascular events such as heart attack or stroke in adults who are known to have a reduced or blocked blood supply to the heart or legs and had a stroke or with a high risk of diabetes.

Your doctor may check your kidney function test, blood pressure and the amount of electrolytes (Ex. potassium) in your body prior to the management or at regular intervals during management with this medicine. BISOTRAK T 2.5MG TABLET is not recommended for use in patients having severe liver problems such as cholestasis or biliary obstruction (flow of bile from liver stops or slows). BISOTRAK T 2.5MG TABLET should be used with caution in patients having diabetes, kidney disease, heart problems and raised aldosterone levels.

BISOTRAK T 2.5MG TABLET is not recommended for use in early pregnancy and must not be taken by women who are pregnant for more than 3 months and it is not recommended for use in breastfeeding women. BISOTRAK T 2.5MG TABLET is not recommended for use in children and adolescents (up to the age of 18 years) and it should be used with caution in elderly patients (aged 65 years and above). The most common side effect of taking BISOTRAK T 2.5MG TABLET is low blood pressure. Consult your doctor if the symptom worsens.

Uses Of BISOTRAK T 2.5MG TABLET

• Management of hypertension (high blood pressure), angina and heart failure

How BISOTRAK T 2.5MG TABLET Works

BISOTRAK T 2.5MG TABLET contains two medicines namely, bisoprolol and telmisartan. Bisoprolol works by blocking beta-1 receptors in the heart, which slows the heart rate, reduces the force of the heart's contractions, and lowers blood pressure. This helps the heart work more efficiently and reduces its workload, making bisoprolol effective for high blood pressure, chest pain (angina), and heart failure.

Telmisartan is an Angiotensin Receptor Blocker. It works by blocking the angiotensin receptor in the body which helps in keeping the blood vessels relaxed, thus lowering the strain on heart and enables heart to pump blood more easily.

How to use BISOTRAK T 2.5MG TABLET

Take BISOTRAK T 2.5MG TABLET as advised by your physician. Swallow this medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of BISOTRAK T 2.5MG TABLET for you depending upon your age, body weight and disease condition.

Side Effects Of BISOTRAK T 2.5MG TABLET

How To Manage Side Effects

Diarrhea

Drink lot of fluids such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own to manage without consulting your doctor.

Dizziness Or Drowsiness

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines while you are feeling dizzy. Do not consume too much of alcohol, as it can aggravate your dizziness. Consult your doctor if the symptom did not improve.

Nausea And Vomiting

Take BISOTRAK T 2.5MG TABLET with or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals. Consult your doctor if your symptom does not improve.

Stomach Pain

Try to rest and relax. Try to have smaller and frequent meals. Keep a heat pad on your stomach. If the symptom does not improve, consult your doctor.

Warning & Precautions

Pregnancy

Contraindicated

BISOTRAK T 2.5MG TABLET is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may cause serious harm to the baby if used after 3 months of pregnancy. Consult your doctor before taking BISOTRAK T 2.5MG TABLET.

Breastfeeding

Contraindicated

BISOTRAK T 2.5MG TABLET is not recommended for use in breastfeeding women. Your doctor may choose another management especially if you want to breast-feed when your baby is new-born or born prematurely. Consult your doctor for advice before taking BISOTRAK T 2.5MG TABLET.

Driving and Using Machines

Use with Caution

Do not drive or operate any machines if you feel dizzy or tired after taking BISOTRAK T 2.5MG TABLET. Consult your doctor before taking BISOTRAK T 2.5MG TABLET.

Alcohol

Consult your doctor

Avoid consumption of alcohol as it may increase the risk of low blood pressure.

Kidney

Use with Caution

BISOTRAK T 2.5MG TABLET should be taken with caution in patients with kidney disease, kidney artery stenosis (narrowing of blood vessels to one or both the kidneys) and with a history of kidney transplant. Consult your doctor before taking BISOTRAK T 2.5MG TABLET.

Liver

Consult your doctor

BISOTRAK T 2.5MG TABLET is not recommended for use in patients with severe liver problems such as cholestasis or biliary obstruction (flow of bile from liver stops or slows). BISOTRAK T 2.5MG TABLET should be used with caution in patients with liver diseases. Consult your doctor before taking BISOTRAK T 2.5MG TABLET.

Allergy

Contraindicated

BISOTRAK T 2.5MG TABLET is not recommended for use if you are allergic to Telmisartan or Bisoprolol.

Lungs

Contraindicated

BISOTRAK T 2.5MG TABLET is not recommended for use if you have severe asthma. Therefore, consult your doctor for advice.

Use In Pediatrics

Contraindicated

BISOTRAK T 2.5MG TABLET is not recommended for use in children and adolescents (under 18 years of age). Consult your child’s doctor for advice.

Use In Geriatrics

Use with Caution

BISOTRAK T 2.5MG TABLET should be used with caution in elderly patients (aged 65 years and above). Consult your doctor before taking this medicine.

Interactions

A. Drug-Drug interactions:

Before taking BISOTRAK T 2.5MG TABLET, inform your doctor if you are taking any of the following medicines:

• Angiotensin converting enzyme inhibitors (Ex. enalapril, lisinopril, ramipril), angiotensin II receptor antagonists (Ex. candesartan, irbesartan) and aliskiren (medicines used to manage high blood pressure)
• Digoxin (used to manage heart failure and abnormal heart rhythm)
•  Medicines containing lithium (used to manage some types of depression)
• Medicines that may increase blood potassium levels such as salt substitutes containing potassium
• Non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen (medicines used to manage pain and inflammation
• Heparin (used to manage or manage blood clot)
• Immunosuppressive agents such as ciclosporin or tacrolimus (used to manage organ rejection after transplant)
• Antibiotic trimethoprim (medicine used to manage urinary tract infections)
• Diuretics such as furosemide, hydrochlorothiazide and potassium-sparing diuretics (Ex. amiloride, spironolactone) (used to manage oedema or high blood pressure)
• Corticosteroids such as dexamethasone, hydrocortisone (used to manage inflammatory conditions)
• Baclofen (used for muscle spasm)
• Amifostine (medicine used in cancer chemotherapy)
• Barbiturates such as phenobarbital, pentobarbital (used to manage seizures)
• Antidepressants such as citalopram, fluoxetine, paroxetine (used to manage depression)
• Narcotics such as morphine and codeine (used to manage moderate to severe pain)

Overdosage:

If you or anyone else accidentally take too much of BISOTRAK T 2.5MG TABLET, consult your doctor immediately or visit the nearby hospital. The most common symptoms of overdose are low blood pressure, fast or slow heartbeat, dizziness, elevated levels of creatinine and sudden kidney failure.

Synopsis

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References

1. KD. Tripathi. Drugs Affecting Renin Angiotensin System. Essentials of medical pharmacology. Eighth edition. 2019. Page-535-538.

2. Philippe Gosse. A Review of Telmisartan in the Treatment of Hypertension: Blood Pressure Control in the Early Morning Hours. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. September 2006. [Accessed on 7th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1993985/

3. Manjula S*and Krishna Kumar M. Expert Opinion on the use of Bisoprolol+Telmisartan Combination in Indian Patients with Hypertension. Cardio-Biology and Clinical Sciences. Open Science Publications. [Published in January 2024]. [Accessed on 10th July 2024] https://www.opensciencepublications.com/wp-content/uploads/IJCBCS-2454-5945-7-113.pdf

4. Bisoprolol fumarate 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg or 10 mg film-coated tablets bisoprolol fumarate. EMC. UK. [Revised in December 2021]. [Accessed on 10th July 2024] https://www.medicines.org.uk/emc/files/pil.13703.pdf

5. Telmisartan. EMC. UK. [Revised in November 2023]. [Accessed on 10th July 2024] https://www.medicines.org.uk/emc/files/pil.9981.pdf

Useful Diagnostic Tests

• Cardiac Risk Profile