Bipinor Plus 5 mg+12.5 mg

INDICATIONS

This combination is indicated in essential hypertension.

PHARMACOLOGY

Nebivolol & Hydrochlorothiazide combination has an additive antihypertensive effect, reducing blood pressure to a greater degree than either component alone. This combination has mild vasodilating properties which reduces heart rate and blood pressure in hypertensive patients. Hydrochlorothiazide affects the renal tubular mechanisms of electrolyte reabsorption which directly increase the excretion of sodium and chloride in approximately equivalent amounts. The diuretic action of Hydrochlorothiazide reduces plasma volume, increases plasma renin activity and increases aldosterone secretion.

DOSAGE & ADMINISTRATION

Once daily, preferably at the same time every day. Use in children is not recommended.

INTERACTION

Nebivolol:

Class I & III Antiarrhythmics, Calcium channel blocker (Verapamil/Diltiazem)
Centrally-acting antihypertensives, Anaesthetics
Antipsychotics, Antidepressants, NSAIDs

Hydrochlorothiazide:

Drugs affecting Potassium & Calcium level
Non-steroidal anti-inflammatory drugs (NSAIDs)
Concomitant administration of this combination with Antipsychotics, Tricyclic Antidepressants & Barbiturates may enhance the hypotensive effect and lead to postural hypotension.

SIDE EFFECTS

Nebivolol: Headache, Dizziness, Tiredness, Diarrhoea, Constipation, Nausea etc. Hydrochlorothiazide: Vertigo, Itchiness, Rash, Increased sensitivity of skin to sunlight etc.

PREGNANCY & LACTATION

This combination is not recommended during pregnancy. It is also not recommended for mothers who are breast-feeding

PRECAUTIONS & WARNINGS

Nebivolol: Beta-blockers should not be used in patients with untreated Congestive Heart Failure (CHF) & bradycardia. In patients with Chronic Obstructive Pulmonary Diseases (COPD), beta-blockers should be used with caution as airway constriction may be aggravated.Hydrochlorothiazide: In patients with renal disease, thiazides may increase azotaemia. If progressive renal impairment becomes evident, careful reappraisal of therapy is necessary. Thiazides can cause fluid or electrolyte imbalance. Thiazides may decrease urinary calcium excretion and may cause slight elevation of serum calcium in the absence of known disorders of calcium metabolism

THERAPEUTIC CLASS

Combined antihypertensive preparations

STORAGE CONDITIONS

Protect from light & moisture. Store below 30°C. Keep out of reach of children.