* Indications: & & Management of hypertension. * Contraindications: & & – Not to be used in patients with a known allergic hypersensitivity to any component of the product or to sulphonamide- & & derived drugs. & & – As with other beta-blocker && diuretic combinations, Bisocard Plus is contraindicated in cardiogenic shock, in cases of & & untreated cardiac failure, sinoatrial block, second or third degree atrioventricular block, marked bradycardia or extreme & & hypotension or severe asthma, severe peripheral arterial disease. & & – In patients with severe hypokalaemia or hyponatraemia. * Precautions: & & – In patients with prolonged PR conduction interval, poor cardiac reserve && peripheral circulatory disturbances. & & – In patients with ischaemic heart disease, treatment should not be withdrawn abruptly. & & – Bisoprolol, as cardioselective beta-blocker, is less likely to induce bronchospasm in patients with asthma, caution to be & & taken with patients suffering from asthma or history of obstructive airways disease. As well, it does not appear to have a & & hypoglycaemic effect but caution with diabetic patients since symptoms of hypoglycaemia may be masked. & & – Pregnancy, breast-feeding, myasthenia gravis; patients with a history of hypersensitivity reactions. & & – Low dose of hydrochlorothiazide reduces the elevation in uric acid levels normally associated with higher doses of & & hydrochlorothiazide. However, care should be taken in patients with a predisposition to gout or hyperuricaemia. & & – All patients treated with diuretics should receive periodic monitoring for signs of fluid or electrolyte imbalance. & & Hypokalaemia can be induced as a result of thiazide therapy && potassium levels should be checked. * Dosage && administration: & & Bisoprolol is an effective treatment of hypertension in once-daily doses of 2.5 to 40 mg, while hydrochlorothiazide & & is effective in doses of 12.5 to 50 mg. In clinical trials of bisoprolol/hydrochlorothiazide combination therapy using & & bisoprolol doses of 2.5 to 20 mg && hydrochlorothiazide doses of 6.25 to 25 mg, the antihypertensive effects increased & & with increasing doses of either component. & & One tablet of Bisocard Plus 5 to be taken daily in the morning. * Store at temperature not exceeding 30 degrees C, in dry place. * Manufactured by: GLOBAL NAPI PHARMACEUTICALS (GNP) – Egypt.