Bisoprolol Fumarate + Hydrochlorothiazide

Adults: Bisoprolol works well for hypertension at once-daily doses of 2.5 to 40 mg, and hydrochlorothiazide works well at doses of 12.5 to 50 mg. In clinical trials of the bisoprolol and hydrochlorothiazide combination, bisoprolol doses were 2.5 to 20 mg and hydrochlorothiazide doses were 6.25 to 25 mg. The blood pressure lowering effect grew as the dose of either component went up. For initial therapy, treatment can start with the lowest dose of this combination, one 2.5/6.25 mg tablet once daily. The dose can then be raised at 14 day intervals, as appropriate, up to the maximum recommended dose of 20/12.5 mg once daily. For replacement therapy, the combination can be used in place of the individual components once their doses have been titrated. Treatment can also be guided by clinical effect. A patient whose blood pressure is not adequately controlled with 2.5 to 20 mg of bisoprolol daily may be given this combination instead. Some patients have their blood pressure adequately controlled with 50 mg of hydrochlorothiazide daily but lose a significant amount of potassium on it. If these patients are switched to this combination, they may get similar blood pressure control without the electrolyte disturbance.