BISOPROLOL,PERINDOPRIL

Background and Date of Approval

Bisoprolol is an antihypertensive agent that belongs to the class of beta1-selective adrenoceptor antagonists. It received U.S. FDA approval in 1986 for the treatment of hypertension, angina pectoris, and chronic heart failure. Perindopril is an angiotensin-converting enzyme (ACE) inhibitor indicated for the management of elevated blood pressure and other cardiac conditions. It obtained U.S. FDA approval in 1993.

Uses

Bisoprolol has been approved to treat: Hypertension (high blood pressure) Angina pectoris (chest pain) Chronic heart failure Perindopril is used to treat: Hypertension Heart failure To reduce the risk of cardiac events in patients with stable coronary artery disease

How is it administered?

Bisoprolol : The recommended initial dose is 5 mg per day. The usual dosage is 10 mg once daily, with a maximum daily dose of 20 mg. It should be taken in the morning with food. Swallow the tablets whole with water. Do not crush, chew, or break them. Perindopril : The initial recommended dose is 4 mg once daily, which may be increased to 8 mg once daily based on patient response. It should be taken in the morning before meals.

Side Effects

Bisoprolol and Perindopril are commonly prescribed for heart conditions, but they may cause certain side effects. Here are some potential side effects: Fatigue and dizziness Slow heart rate (bradycardia) Low blood pressure (hypotension) Cold hands and feet Shortness of breath or wheezing (especially in asthma patients) Sleep disturbances, including nightmares Depression or mood changes Dizziness and lightheadedness Dry, persistent cough Low blood pressure Increased potassium levels (hyperkalemia) Headache and fatigue Nausea and digestive issues Swelling of the face, lips, or throat (rare but serious allergic reaction)

Warnings

Bisoprolol : Contact your physician immediately if you experience allergies to Bisoprolol and its ingredients. Inform your physician if you have kidney or liver conditions. Before taking this medication, let your medical professional know if you have a medical history of severe asthma or chronic lung disease, slow or irregular heart rate, heart failure, cardiogenic shock, metabolic acidosis, or untreated pheochromocytoma. Perindopril : Inform your physician if you have a history of angioedema, kidney impairment, or are on diuretic therapy. Monitor for signs of hypotension, especially after the first dose.

Precautions

Bisoprolol : Consult your doctor before using this medication if you are pregnant or planning to have a baby. Avoid breastfeeding your baby while on the treatment, as it is not known whether Bisoprolol passes into the breast milk and affects the baby. Perindopril : Use caution if you are pregnant or planning to become pregnant, as ACE inhibitors can cause injury or death to the developing fetus.

Word of Advice

This combination should be avoided by pregnant or breastfeeding women, patients with severe kidney or liver disease, asthma, very low heart rate, or a history of angioedema. Always inform your doctor about your medical history before starting this medication.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC10220120/ https://pubmed.ncbi.nlm.nih.gov/37029871/ https://catalogues.ema.europa.eu/node/4275/administrative-details

Frequently Asked Questions

What is the combination of Bisoprolol and Perindopril used for?

This combination is used to treat high blood pressure (hypertension) and stable coronary artery disease (CAD). It helps improve heart function by reducing heart rate and relaxing blood vessels, making it easier for the heart to pump blood.

How does Bisoprolol + Perindopril work?

Bisoprolol is a beta-blocker that reduces heart rate and strain on the heart, while Perindopril is an ACE inhibitor that relaxes blood vessels, lowering blood pressure. Together, they provide a dual-action effect to manage hypertension and heart-related conditions.

Can I stop taking Bisoprolol + Perindopril suddenly?

No, stopping this medication suddenly can cause rebound hypertension, irregular heartbeats, or worsening heart conditions. Always consult your doctor before making any changes to your treatment.

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS