Moderate
Bisoprolol × Hydrochlorothiazide
Selective beta-adrenergic blockers×Thiazide diuretics
Mechanism
Standard combination in hypertension – additive antihypertensive effect. Thiazide diuretic causes hypokalaemia.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
Standard combination (fixed-dose product available). Check potassium 2–4 weeks after start and then annually. If potassium drops below 4.0 mmol/L, add a potassium-sparing component.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.