The pharmacokinetic characteristics of the two enantiomers are similar. In patients with liver cirrhosis, the rate of elimination of bisoprolol is more variable and significantly slower than that in healthy subjects, with a plasma half-life ranging from 8 to 22 hours. In elderly subjects, mean plasma concentrations at steady state are increased, in party attributed to lower creatinine clearance. However, no significant differences in the degree of bisoprolol accumulation is found between young and elderly populations. Absorption of hydrochlorothiazide is reduced in patients with congestive heart failure.
Plasma concentrations are linearly related to the administered dose.
Concentrations of hydrochlorothiazide are 1.6-1.8 times higher in whole blood than in plasma. Hydrochlorothiazide is eliminated primarily by renal pathways. Plasma concentrations of hydrochlorothiazide are increased and the elimination half-life is prolonged in patients with renal disease. Findings in clinical hemodynamics studies with bisoprolol fumarate are similar to those observed with other beta-blockers. The most prominent effect is the negative chronotropic effect, giving a reduction in resting and exercise heart rate.