Generic Name: bisoprolol fumarate
Product Name: Bicor
Indication: What Bicor is used for
Bicor is used to treat heart failure. It is usually used in combination with other medicines.
Bicor can help to reduce the number of heart failure episodes needing hospital admission and also the risk of sudden death.
Your doctor may have prescribed Bicor for another reason. Ask your doctor if you have any questions about why Bicor has been prescribed for you.
Bicor is not recommended for use in children, as the safety and efficacy in children have not been established.
Bicor is available only with a doctor’s prescription.
There is no evidence that Bicor is addictive.
Action: How Bicor works
Bicor belongs to a group of medicines called beta-blockers. These medicines work by affecting the body’s response to some nerve impulses, especially in the heart. As a result, it decreases the heart’s need for blood and oxygen and therefore reduces the amount of work the heart has to do. Bicor also slows your heart rate, which in turn increases the efficiency of your heart.
Each Bicor 1.25 mg (Starter Pack) tablet contains 1.25 mg of the active ingredient bisoprolol fumarate.The tablets also contain colloidal anhydrous silica, magnesium stearate, crospovidone, pregelatinised maize starch, maize starch, microcrystalline cellulose, anhydrous calcium hydrogen phosphate, dimethicone 100, purified talc, macrogol 400, titanium dioxide, hypromellose.
Each Bicor 2.5 mg tablet contains 2.5 mg of the active ingredient bisoprolol fumarate. The tablets also contain, colloidal anhydrous silica, magnesium stearate, crospovidone, maize starch, microcrystalline cellulose, anhydrous calcium hydrogen phosphate, dimethicone 100, macrogol 400, titanium dioxide, hypromellose.
Each Bicor 5 mg and 10 mg tablet contains 5 mg and 10 mg of the active ingredient bisoprolol fumarate respectively. These tablets also contain colloidal anhydrous silica, magnesium stearate, crospovidone, maize starch, microcrystalline cellulose, anhydrous calcium hydrogen phosphate, dimethicone 100, macrogol 400, titanium dioxide, hypromellose, iron oxide yellow (CI 77492). Bicor 10 mg tablets also contain iron oxide red (CI 77491).
The tablets are gluten free.
Dose advice: How to use Bicor
Before you take Bicor
When you must not take it
Do not take Bicor if you are allergic to medicines containing bisoprolol or any of the ingredients listed here.
Some of the symptoms of an allergic reaction may include skin rash, itching or hives, swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing, wheezing or shortness of breath.
Do not take Bicor if you have any of the following heart problems:
- Severe heart failure that is not controlled medically;
- Worsening heart failure requiring injection of medicines into a vein;
- Cardiogenic shock, a serious heart condition causing low blood pressure and circulatory failure;
- Certain heart conditions where the electrical activity controlling your heart rate does not work properly, causing a very slow heart rate or uneven heart beating;
- Low blood pressure.
Do not take Bicor if you have any of the following medical conditions:
- Severe asthma or severe chronic obstructive lung disease;
- Severe blood circulation problems in your limbs (such as Raynaud’s syndrome), which may cause your fingers and toes to tingle or turn pale or blue;
- Untreated phaeochromocytoma, a rare tumour of the adrenal gland;
- Metabolic acidosis, a condition when there is too much acid in the blood.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
Before you start to take it
Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.
Tell your doctor if you are pregnant or plan to become pregnant.
Bicor may affect your developing baby if you take it during pregnancy. Your doctor will discuss the risks and benefits of taking Bicor during pregnancy.
Tell your doctor if you are breastfeeding or wish to breastfeed.
Like most beta-blocker medicines, Bicor is not recommended while you are breastfeeding. Your doctor will discuss the risks and benefits of taking Bicor when breastfeeding.
Tell your doctor if you have or have had any of the following medical conditions:
- Asthma, difficulty breathing or other lung problems;
- Certain heart diseases (such as disturbances in heart rhythm or Prinzmetal angina);
- Any allergic conditions;
- Psoriasis, a skin disease with thickened patches of red skin, often with silvery scales;
- Thyroid disorder;
- Any blood vessel disorder causing poor circulation in the arms and legs;
- Kidney problems;
- Liver problems;
- Phaeochromocytoma, a rare tumour of the adrenal gland.
Your doctor may want to take special care if you have any of these conditions.
Tell your doctor if you are going to have anaesthesia (for example for surgery).
Bicor may influence how your body reacts to this situation.
If you have not told your doctor about any of the above, tell them before you start taking Bicor.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines and Bicor may interfere with each other.
Do not take the following medicines with Bicor without special advice from your doctor:
- Certain anti-arrhythmic medicines such as disopyramide, lidocaine, phenytoin or flecainide (used to treat irregular or abnormal heartbeat);
- Certain calcium antagonists such as diltiazem or verapamil (used to treat high blood pressure and angina);
- Certain medicines used to treat high blood pressure such as clonidine, methyldopa or moxonidine.
However, do not stop taking these medicines without checking with your doctor.
Check with your doctor before taking the following medicines with Bicor.
Your doctor may need to check your condition more frequently.
- Anti-arrhythmic medicines such as amiodarone (used to treat irregular or abnormal heartbeat);
- Calcium antagonists such as felodipine or amlodipine (used to treat high blood pressure and angina);
- Certain medicines used to treat arthritis, pain or inflammation, such as ibuprofen or diclofenac;
- Eye drops for glaucoma treatment;
- Insulin and oral drugs for diabetes;
- Anaesthetic agents used in surgery;
- Digoxin, a medicine used to treat heart failure;
- Ergot derivatives, medicines commonly used to treat migraines;
- Rifampicin, a medicine used to treat tuberculosis;
- Tricyclic antidepressants;
- Barbiturates, medicines used to treat epilepsy;
- Phenothiazines, medicines used to treat some mental conditions;
- Mefloquine, a medicine used to treat malaria;
- Adrenaline, a medicine used to treat allergic reactions;
- Certain medicines used to treat depression called monoamine oxidase inhibitors, such as phenelzine or tranylcypromine.
These medicines may be affected by Bicor or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Bicor.
How to take Bicor
How much to take
The usual starting dose is 1.25 mg once daily for a week. If well tolerated, your doctor will gradually increase your dose over the next ten weeks. The usual dose for maintenance therapy is 10 mg once daily.
If your conditions get worse or you no longer tolerate the drug, it may be necessary to reduce the dose again or to interrupt treatment. In some patients, a maintenance dose lower than 10 mg may be sufficient.
Your doctor will tell you what to do. Your doctor will monitor your blood pressure, heart rate and other vital signs carefully after you start treatment with Bicor and during dose increase.
Follow all directions given to you by your doctor and pharmacist carefully.
How to take it
Swallow the tablets with a glass of water.
Do not crush or chew the tablets.
If you crush or chew Bicor tablets, they will not work as well.
When to take it
Take Bicor in the morning, with or without food.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take the missed dose as soon as you remember, and then go back to taking your tablets as you would normally.
Do not take a double dose to make up for the dose you missed.
If you are not sure what to do, ask your doctor or pharmacist.
How long to take it
To properly control your condition, Bicor must be taken every day, usually as a long-term treatment.
Keep taking Bicor for as long as your doctor recommends.
It is very important that you do not stop taking Bicor suddenly.
If you take too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much Bicor. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
Symptoms of an overdose may include slowed heart rate, difficulty breathing, marked drop in blood pressure, severe heart failure, or a decrease in blood sugar.
While you are taking Bicor
Things you must do
Before starting any new medicine, tell your doctor or pharmacist that you are taking Bicor.
Tell all the doctors, dentists and pharmacists who are treating you that you are taking Bicor.
If you become pregnant while taking Bicor, tell your doctor.
If you plan to have surgery, including dental surgery, tell your doctor or dentist that you are taking Bicor.
If you are being treated for diabetes, make sure you check your blood sugar level regularly and report any changes to your doctor.
Bicor may change how well your diabetes is controlled. It may also cover up some of the symptoms of low blood sugar, called hypoglycaemia, such as fast heartbeat. Bicor may make hypoglycaemia last longer. Your dose of diabetic medicines, including insulin, may need to change.
If you are to have any medical tests, tell your doctor that you are taking Bicor.
Bicor may affect the results of some tests.
Visit your doctor regularly so they can check on your progress.
Your doctor may check your eyes, thyroid, lipid, and blood glucose levels.
Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed.
Your doctor may think it is not working effectively and change your treatment unnecessarily.
Things you must not do
Do not stop taking Bicor, or lower the dose, without checking with your doctor.
Stopping Bicor suddenly may cause your condition to worsen or other heart complications may occur.
If you have to stop treatment, your doctor will usually advise you to reduce the dose gradually.
Do not use Bicor to treat any other conditions unless your doctor tells you to.
Do not give Bicor to anyone else, even if they have the same condition as you.
Things to be careful of
Be careful driving or operating machinery until you know how Bicor affects you.
Bicor may cause tiredness, dizziness or lightheadedness in some people, especially after the first dose. If any of these occur, do not drive, operate machinery or do anything else that could be dangerous.
Be careful getting up from a sitting or lying position.
Dizziness, lightheadedness or fainting may occur, especially when you get up quickly. Getting up slowly may help.
Suggestions to help manage your condition
- Physical activity.
- Regular exercise when symptoms are absent or mild helps improve heart function. Before starting any exercise, ask your doctor for advice;
- Weight reduction.
- Your doctor may suggest losing some weight to help lessen the amount of work your heart has to do;
- Eat a healthy low-fat diet which includes plenty of fresh fruit and vegetables, bread, cereals, and fish. Also, try to eat less fat and sugar;
- Salt restriction.
- Too much salt can make your heart failure worse. Try to avoid using salt in cooking and at the table.
After taking Bicor
Keep Bicor where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Keep your tablets in the blister pack until it is time to take them.
If you take the tablets out of the blister pack they may not keep well.
Keep your tablets in a cool dry place.
Bicor 1.25 mg (Starter Pack) and 2.5 mg should be stored below 25°C.
Bicor 5 mg and 10 mg should be stored below 30°C.
Do not store Bicor or any other medicine in the bathroom or near a sink.
Do not leave Bicor in the car or on window sills.
Heat and dampness can destroy some medicines.
If your doctor tells you to stop taking Bicor, or your tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
Schedule of Bicor
Bicor is an S4 – Prescription only Medicine.
Side effects of Bicor
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Bicor.
Bicor helps most people with heart failure, but it may have unwanted side effects in some people.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
- Tiredness, feeling weak;
- Sleep disturbances, nightmares;
- Nausea, vomiting;
- Diarrhoea, constipation;
- Feeling of coldness or numbness in hands or feet;
- Allergic runny nose;
- Hair loss;
- Sexual problems.
Tell your doctor as soon as possible if you notice any of the following:
- Muscular weakness or cramps;
- Dizziness or light-headedness (sometimes with fainting), especially on standing up, which may be due to low blood pressure;
- A very slow heartbeat;
- Irritation or redness of the eye;
- Skin reactions such as rash, flush, itching, worsening of psoriasis;
- Difficulty hearing;
- Swelling of the face, lips, tongue throat which may cause difficulty breathing or swallowing;
- Signs of worsening heart failure such as shortness of breath, sometimes with tiredness or weakness, swelling of the feet or legs due to fluid build up;
- Chest tightness, wheezing, rattly breathing;
- Yellowing of the skin or eyes, dark coloured urine, itching, generally feeling unwell;
- Irregular heartbeat.
The above list includes very serious side effects. You may need urgent medical attention or hospitalisation.
Tell your doctor if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some patients.
For further information talk to your doctor.