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Tensec plus 5 mg/12.5 mg film-coated tablets (bisoprolol, hydrochlorothiazide) – for high blood pressure
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- Stock: Zabrana online prodaje
- Brand: HEMOFARM-EN
- Model: BR-601511162003
Tensec plus is a combination medicine for lowering blood pressure containing two active substances: bisoprolol (5 mg bisoprolol fumarate, a selective beta-blocker) and hydrochlorothiazide (12.5 mg, a thiazide diuretic). The substances complement each other in lowering blood pressure.
Bisoprolol slows the heart rate, reduces the force of heart contraction and renin activity, while hydrochlorothiazide increases the excretion of water and electrolytes. The doctor prescribes Tensec plus when treatment with bisoprolol alone or hydrochlorothiazide alone does not achieve the target blood pressure.
Important warning
- Tensec plus is a prescription-only medicine (regime R in Serbia) intended for adults.
- Do not stop treatment abruptly – the dose is reduced gradually (half dose over 7–10 days), especially in ischaemic heart disease.
- Hydrochlorothiazide increases skin sensitivity to sunlight and, particularly with long-term high-dose use, the risk of non-melanoma skin and lip cancer – protect your skin from sun and UV rays.
- Sudden loss of vision or eye pain may be a sign of choroidal effusion or acute glaucoma – contact a doctor immediately. The medicine may cause a positive doping test.
- This page is for information only and is not an offer to buy the medicine online. Read the official patient leaflet before use.
What is Tensec plus used for and how should it be taken correctly?
Basic information about the medicine
| Name of the medicine | Tensec® plus 5 mg/12.5 mg film-coated tablet |
|---|---|
| Active substances | bisoprolol (bisoprolol fumarate) and hydrochlorothiazide |
| Strength | 5 mg bisoprolol fumarate + 12.5 mg hydrochlorothiazide per film-coated tablet |
| Pharmaceutical form | film-coated tablet (with score line) |
| Therapeutic group | selective beta-adrenergic blockers and thiazides (ATC C07BB07) |
| Pack | 30 film-coated tablets (3 blisters of 10) |
| Marketing authorisation holder / manufacturer | Hemofarm AD Vršac, Serbia |
| Dispensing regime | prescription-only medicine (R) |
What is Tensec plus used for?
To treat high blood pressure (essential hypertension) in adults when monotherapy with bisoprolol or hydrochlorothiazide is not sufficient.
How is it used and dosed?
Swallow the tablet in the morning – on an empty stomach, with or after breakfast – with enough liquid, without chewing. The tablet can be divided into equal doses.
| Usual dose | 1 tablet 5 mg/12.5 mg once daily |
|---|---|
| If blood pressure is not lowered enough | up to 2 tablets once daily (10 mg bisoprolol fumarate + 25 mg hydrochlorothiazide) |
| Ending treatment | gradually – half dose over 7–10 days, as decided by the doctor |
Treatment is usually long term. During treatment, ensure adequate fluid intake and potassium-rich foods (e.g. bananas, vegetables, nuts).
Special patient groups
- Elderly: no dose adjustment is needed.
- Kidney impairment: excretion of hydrochlorothiazide is reduced; in severe impairment the medicine must not be used.
- Children and adolescents: there is no experience – use is not recommended.
Contraindications – when the medicine must not be used
- allergy to bisoprolol, hydrochlorothiazide, other thiazides, sulfonamides or any excipient;
- acute or decompensated heart failure requiring intravenous therapy; cardiogenic shock;
- second- and third-degree AV block without a pacemaker, sick sinus syndrome, sinoatrial block; resting heart rate below 60/min before treatment;
- severe attacks of bronchial asthma; advanced peripheral vascular disease or Raynaud's syndrome; untreated phaeochromocytoma;
- hypokalaemia not responding to treatment, severe hyponatraemia, hypercalcaemia;
- severe kidney impairment (creatinine clearance < 30 mL/min) or acute glomerulonephritis; hepatic coma and precoma;
- metabolic acidosis; gout.
Precautions and warnings
- heart failure, asthma or obstructive lung disease, diabetes with fluctuating blood sugar, strict diet, desensitisation therapy, first-degree AV block, Prinzmetal's angina, peripheral vascular disease, hypovolaemia, liver impairment, psoriasis;
- history of skin cancer or a new skin lesion during treatment; protection from sun and UV rays;
- reduced vision or eye pain (choroidal effusion, acute glaucoma) – higher risk with previous allergy to penicillin or sulfonamides;
- breathing or lung problems after hydrochlorothiazide in the past – seek help immediately if you have difficulty breathing;
- long-term treatment may disturb electrolytes (potassium, sodium, magnesium, chloride, calcium) – the doctor regularly checks electrolytes, creatinine, urea, lipids, uric acid and blood sugar;
- raised uric acid increases the risk of gout attacks; acute cholecystitis has been reported in patients with gallstones;
- inform the anaesthetist before general anaesthesia; the medicine is then usually withdrawn gradually, at the latest 48 hours before surgery.
Interactions with other medicines, food and drink
- not recommended: lithium (increased toxicity), verapamil and diltiazem, centrally acting antihypertensives (clonidine, methyldopa, moxonidine, reserpine);
- use with caution: ACE inhibitors and sartans, nifedipine/amlodipine, barbiturates, phenothiazines, tricyclic antidepressants, antiarrhythmics (lidocaine, flecainide, propafenone, quinidine, disopyramide, amiodarone, sotalol), medicines causing torsades de pointes, parasympathomimetics, beta-blocker eye drops, insulin and oral antidiabetics, anaesthetics, digitalis, NSAIDs and acetylsalicylic acid, sympathomimetics (adrenaline, noradrenaline, decongestants), medicines increasing potassium loss (corticosteroids, ACTH, amphotericin B, furosemide, some laxatives), gout medicines, colestyramine and colestipol;
- take into account: mefloquine, MAO inhibitors, cortisone, high doses of salicylates.
Alcohol may increase the blood-pressure-lowering effect.
Pregnancy and breastfeeding
Tensec plus is not recommended in pregnancy – the medicine crosses the placenta, and use after the third month may harm the foetus and newborn; the doctor will prescribe another medicine. It is also not recommended during breastfeeding. There are insufficient data on effects on fertility.
Driving and using machines
The medicine has no or negligible influence, but due to individual reactions the ability to drive may be reduced – especially at the start of treatment, when changing medicines and with alcohol.
Possible side effects
- Common: increased sugar in urine, increased blood lipids and uric acid, electrolyte imbalance, tiredness, dizziness, headache (at the start, usually resolving within 1–2 weeks), cold or numb hands and feet, nausea, vomiting, diarrhoea, constipation.
- Uncommon: loss of appetite, sleep disorders, depression, slow heart rate, rhythm disorder, worsening heart failure, drop in blood pressure on standing, bronchospasm, abdominal pain, pancreatitis, muscle weakness and cramps, transient increase in creatinine and urea.
- Rare: low white blood cell and platelet counts, nightmares, hallucinations, reduced tear production, visual and hearing disorders, fainting, allergic rhinitis, hepatitis and jaundice, hypersensitivity reactions (including photosensitivity), impotence.
- Very rare and frequency not known: agranulocytosis, metabolic alkalosis, acute respiratory distress, psoriasis, hair loss, cutaneous lupus; interstitial lung disease, acute myopia/glaucoma, choroidal effusion, non-melanoma skin and lip cancer.
Overdose, missed dose and stopping treatment
- Overdose: tell your doctor immediately; slow heart rate, marked drop in blood pressure, acute heart failure, low blood sugar, bronchospasm and major loss of fluid and electrolytes (dizziness, nausea, vomiting, drowsiness, muscle weakness) may occur.
- Missed dose: take it as soon as possible; if it is nearly time for the next dose, continue with the usual schedule. Never take a double dose.
- Stopping treatment: do not stop the medicine without your doctor – the dose is reduced gradually.
When to seek medical help immediately?
- sudden loss of vision or eye pain;
- shortness of breath, difficulty breathing, fever and confusion;
- swelling of the face, lips or throat, severe rash;
- very slow heart rate, fainting, severe dizziness due to low blood pressure;
- severe muscle weakness, cramps, irregular heartbeat (possible potassium disorder);
- sore throat and fever with a tendency to bleed, yellowing of the skin or eyes.
Pharmacist's advice
Take the tablet every morning and do not stop treatment yourself. Drink enough fluid and include potassium-rich foods (bananas, vegetables, nuts) in your diet, as the leaflet advises; take potassium or magnesium supplements or over-the-counter diuretics only on medical advice, because electrolytes are checked by laboratory tests.
Because of hydrochlorothiazide, use high-SPF sun protection, including for your lips, avoid sunbeds and check your skin regularly – show any new or changed skin lesion to your doctor.
Availability and price
Tensec plus is a prescription-only medicine dispensed in pharmacies. ApotekaOnline.rs does not sell medicines online, and this page is for information only – please check availability at a pharmacy.
Related information
For home blood pressure monitoring during treatment, see also the category Blood pressure devices – products in this category do not replace the medicine prescribed for you.
Composition, pack and manufacturer
- active substances: bisoprolol fumarate 5 mg and hydrochlorothiazide 12.5 mg per film-coated tablet;
- excipients – core: anhydrous calcium hydrogen phosphate; microcrystalline cellulose; magnesium stearate; pregelatinised starch; colloidal anhydrous silica; film: hypromellose, dimeticone 350, macrogol 400, titanium dioxide (E171), red iron oxide (E172);
- appearance: round, pink to red film-coated tablets with a score line on both sides, marked “B-H” and “5-12”;
- pack: carton with 3 blisters of 10 film-coated tablets (30 tablets);
- marketing authorisation holder and manufacturer: Hemofarm AD Vršac, Beogradski put bb, Vršac, Serbia;
- authorisation number: 000457645 2023 of 26 September 2024.
Storage
- Keep out of the sight and reach of children.
- Store below 25 °C in the original package.
- Do not use after the expiry date.
Frequently asked questions
How does Tensec plus differ from Tensec?
Tensec contains only bisoprolol, while Tensec plus also contains the diuretic hydrochlorothiazide (12.5 mg). Tensec plus is prescribed when one substance is not enough to reach the target blood pressure and is intended only for hypertension.
Should I avoid the sun while taking Tensec plus?
Yes. Hydrochlorothiazide increases skin sensitivity to sunlight and UV rays, and long-term use may increase the risk of non-melanoma skin and lip cancer. The leaflet advises protecting the skin and contacting the doctor in case of rash, itching or a new skin lesion.
Why does the doctor order blood tests during treatment?
During long-term treatment the doctor regularly checks electrolytes (especially potassium, sodium and calcium), creatinine, urea, cholesterol, triglycerides, uric acid and blood sugar, because hydrochlorothiazide can disturb their levels.
Can I take Tensec plus if I have gout?
No. Gout is a contraindication, and raised uric acid during treatment can trigger a gout attack in predisposed people. Tell your doctor about gout before starting treatment.
Sources
- ALIMS – Patient information leaflet Tensec plus 5 mg/12,5 mg (PIL)
- ALIMS – Summary of product characteristics Tensec plus 5 mg/12,5 mg (SmPC)
Sources checked on: 25 October 2026.
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