Bizoran 10/20 Tablet

Combination of a calcium-channel blocker and an ARB for high blood pressure not adequately controlled by either medicine alone, or to replace separate tablets.

Adults: one tablet once daily — 5 mg/20 mg, 5 mg/40 mg or 10 mg/40 mg.

• Usually start with 5/20 mg; increase after 1–2 weeks if needed. Maximum 10 mg/40 mg once daily.
• Take at the same time each day, with or without food.
• Elderly or moderate kidney impairment: maximum olmesartan 20 mg in some guidance; use with caution.
• Not for children under 18.

• Pregnancy
• Severe liver impairment, biliary obstruction
• Severe low blood pressure, shock, severe aortic stenosis, unstable heart failure after a heart attack
• Use with aliskiren in diabetes or kidney impairment
• Allergy to dihydropyridines or olmesartan

Common: ankle and leg swelling, dizziness, headache, tiredness, flushing.

Less common: low blood pressure, palpitations, raised potassium, raised creatinine, nausea.

Rare but serious: sprue-like enteropathy (chronic severe diarrhoea with weight loss), angioedema, kidney failure, chest pain at the start.

• Check kidney function and potassium periodically.
• Avoid dehydration; caution in heart failure and renal artery stenosis.
• Report persistent diarrhoea with weight loss.

Contraindicated in pregnancy (olmesartan). Not recommended while breastfeeding.

• Potassium supplements, spironolactone, salt substitutes (high potassium)
• NSAIDs (reduced effect, kidney risk)
• Lithium (toxicity)
• ACE inhibitors, aliskiren (avoid combining)
• Simvastatin (limit to 20 mg); clarithromycin, itraconazole, grapefruit (raise amlodipine)
• Colesevelam (take this tablet 4 hours before)

Severe low blood pressure, fast or slow heartbeat. Emergency care.

Store below 30°C.