Piramil biso

Poland
Brand name Piramil biso
Form capsules, hard
Active substance / Dosage
ramipril · 10 mg
bisoprolol fumarate · 10 mg
Prescription type Prescription only
ATC code
C09BX
Registration number 100445437
Manufacturer Adamed Pharma S.A. Lek Pharmaceuticals d.d.

Table of Contents

Package leaflet: Information for the patient

Piramil Biso, 2.5 mg + 1.25 mg, hard capsules
Piramil Biso, 2.5 mg + 2.5 mg, hard capsules
Piramil Biso, 5 mg + 2.5 mg, hard capsules
Piramil Biso, 5 mg + 5 mg, hard capsules
Piramil Biso, 10 mg + 5 mg, hard capsules
Piramil Biso, 10 mg + 10 mg, hard capsules
Ramipril + Bisoprolol fumarate

Read carefully the entire leaflet before taking this medicine, as it contains important information for you.
Keep this leaflet, as you may need to read it again.
If you have any further questions, please consult your doctor, pharmacist, or nurse.
This medicine has been prescribed for a specific individual. Do not pass it on to others.
The medicine may harm others, even if their symptoms are the same as yours.
If you experience any adverse effects, including any possible adverse effects not listed in this leaflet, inform your doctor, pharmacist, or nurse. See section 4.

Table of contents:

  1. What Piramil Biso is and what it is used for
  2. What you should know before taking Piramil Biso
  3. How to take Piramil Biso
  4. Possible side effects
  5. How to store Piramil Biso
  6. Contents of the pack and other information

1. What Piramil Biso is and what it is used for

Piramil Biso contains two active substances, bisoprolol fumarate and ramipril, in a single capsule:
Ramipril is an angiotensin-converting enzyme inhibitor (ACEI). It works by dilating blood vessels, which makes it easier for the heart to pump blood.
Bisoprolol fumarate belongs to a group of medicines called beta-blockers. Beta-blockers slow down the heart rate and help the heart pump blood more effectively throughout the body.
Piramil Biso is used to treat high blood pressure (hypertension) and/or chronic heart failure with left ventricular dysfunction (a condition in which the heart cannot pump enough blood to meet the body's needs, resulting in breathlessness and swelling), and/or to reduce the risk of cardiovascular events such as myocardial infarction in patients with chronic coronary artery disease (a condition in which blood supply to the heart is reduced or blocked), who have previously had a heart attack and/or undergone a surgical procedure to improve blood supply to the heart by widening the blood vessels that supply it, or in patients with diabetes and at least one cardiovascular risk factor.
Instead of taking bisoprolol fumarate and ramipril in separate capsules, you will take only one capsule of Piramil Biso, which contains both active substances in the specified amounts.

2. Important information before using Piramil Biso

When not to use Piramil Biso

  • if the patient is allergic to bisoprolol or any other beta-blocking agent, to ramipril or any other ACE inhibitor, or to any of the other ingredients of this medicine (listed in section 6);
  • if the patient has heart failure which has suddenly worsened and (or) requires hospital treatment;
  • if the patient has cardiogenic shock (a severe heart condition caused by very low blood pressure);
  • if the patient has a heart disease characterised by slow or irregular heartbeat (second- or third-degree atrioventricular block, sinoatrial block, sick sinus syndrome);
  • if the patient has a slow heartbeat;
  • if the patient has very low blood pressure;
  • if the patient has severe asthma or severe chronic lung disease;
  • if the patient has severe circulatory disorders in the limbs (such as Raynaud's syndrome), which may cause tingling, paleness or blueness of the fingers and toes;
  • if the patient has an untreated phaeochromocytoma, a rare tumour of the adrenal gland;
  • if the patient has metabolic acidosis, a condition in which the blood contains too much acid;
  • if during previous treatment with an ACE inhibitor the patient experienced symptoms such as: wheezing, swelling of the face, tongue or throat, intense itching or severe skin rash, or if such symptoms occurred in a blood relative under any circumstances (a condition called angioedema);
  • if the patient is more than 3 months pregnant (it is also advisable to avoid using Piramil Biso during early pregnancy - see section "Pregnancy");
  • if the patient has diabetes or kidney problems and is being treated with a blood pressure-lowering medicine containing aliskiren;
  • if the patient is undergoing dialysis or blood filtration by another method. Depending on the device used, Piramil Biso may not be suitable for the patient;
  • if the patient has kidney disorders which reduce blood supply to the kidneys (renal artery stenosis);
  • if the patient is being treated with a combination medicine containing sacubitril and valsartan, used in the treatment of heart failure (see "Warnings and precautions" and "Piramil Biso with other medicines").

Warnings and precautions
Before starting to use Piramil Biso, discuss this with your doctor or pharmacist if:

  • the patient has diabetes;
  • the patient has kidney problems (including patients after kidney transplantation) or is undergoing dialysis;
  • the patient has liver disease;
  • the patient has been diagnosed with narrowing of the aortic or mitral valve, narrowing of the main blood vessel leading from the heart (aortic stenosis), hypertrophic cardiomyopathy (a heart muscle disease), or renal artery stenosis (narrowing of the arteries supplying blood to the kidneys);
  • the patient has abnormally increased levels of a hormone called aldosterone in the blood (primary hyperaldosteronism);
  • the patient has heart failure or any other heart disease, such as heart rhythm disorders or severe chest pain at rest (Prinzmetal's angina);
  • the patient has been diagnosed with a collagenosis (connective tissue disease), such as systemic lupus erythematosus or scleroderma;
  • the patient is on a low-salt diet or uses salt substitutes containing potassium (high potassium levels in the blood may cause changes in heart rate);
  • the patient has recently had diarrhoea or vomiting, or is dehydrated (Piramil Biso may cause low blood pressure);
  • the patient is undergoing LDL apheresis (removal of cholesterol from the blood using a special device);
  • the patient is undergoing desensitisation treatment to reduce allergic reactions to bee or wasp stings;
  • the patient is fasting or on a diet;
  • the patient is undergoing anaesthesia and (or) surgery;
  • the patient has circulatory disorders in the limbs;
  • the patient has asthma or chronic lung disease;
  • the patient has (or has had) psoriasis;
  • the patient has a tumour of the adrenal gland (phaeochromocytoma);
  • the patient has thyroid disorders (Piramil Biso may mask symptoms of hyperthyroidism);
  • angioedema (a severe allergic reaction characterised by swelling of the face, lips, tongue or throat, difficulty swallowing or breathing) occurs. This reaction may occur at any time during treatment. If such symptoms occur, stop taking Piramil Biso and contact your doctor immediately;
  • the patient is of Black race, as there is a higher risk of angioedema, and the medicine may be less effective in lowering blood pressure compared to patients of other races;
  • the patient is taking any of the following medicines used to treat high blood pressure:
    • angiotensin II receptor antagonists (ARBs) (also known as sartans - e.g. valsartan, telmisartan, irbesartan), especially if the patient has kidney problems related to diabetes;
    • aliskiren. The doctor may monitor kidney function, blood pressure, and blood electrolyte levels (e.g. potassium) at regular intervals. See also information in section "When not to use Piramil Biso".
  • the patient is taking any of the following medicines, which increase the risk of angioedema:
    • racecadotril (used to treat diarrhoea);
    • sirolimus, everolimus, temsirolimus and other medicines belonging to the group of drugs called mTOR inhibitors (used to prevent rejection of transplanted organs);
    • sacubitril (available in a combination medicine containing sacubitril and valsartan), used in the treatment of chronic heart failure.

Do not suddenly stop taking Piramil Biso, as this may cause a severe worsening of heart function. Treatment should not be stopped abruptly, especially in patients with coronary artery disease.
The patient should inform the doctor if she thinks she is (or might be) pregnant. Piramil Biso is not recommended during early pregnancy and must not be taken if the patient is more than 3 months pregnant, as the medicine may cause serious harm to the unborn child if used during this period (see section "Pregnancy").

Children and adolescents
Piramil Biso is not recommended for use in children and adolescents under 18 years of age.

Piramil Biso with other medicines
Tell your doctor or pharmacist about all medicines the patient is currently taking or has recently taken, as well as any medicines the patient plans to take. Other medicines may affect the action of Piramil Biso, or Piramil Biso may alter the effects of other medicines. This type of interaction may result in one or both medicines being less effective. It may also increase the risk or severity of adverse effects.

Tell your doctor if the patient is taking any of the following medicines:

  • medicines used to control blood pressure or heart conditions (such as amiodarone, amlodipine, clonidine, digitalis glycosides, diltiazem, disopyramide, felodipine, flecainide, lidocaine, methyldopa, moxonidine, procainamide, propafenone, quinidine, rilmenidine, verapamil);
  • other medicines used to treat high blood pressure, including angiotensin II receptor antagonists (ARBs), aliskiren (see also information in sections "When not to use Piramil Biso" and "Warnings and precautions"), or diuretics (medicines that increase urine production);
  • potassium-sparing medicines (e.g. triamterene, amiloride), potassium supplements or salt substitutes containing potassium, or other medicines that may increase potassium levels in the body (such as heparin and co-trimoxazole, also known as a combination medicine containing trimethoprim and sulfamethoxazole);
  • potassium-sparing medicines used in heart failure treatment: eplerenone and spironolactone at doses of 12.5 mg to 50 mg per day;
  • sympathomimetic medicines used to treat shock (adrenaline, noradrenaline, dobutamine, isoprenaline, ephedrine);
  • estramustine used to treat cancer;
  • medicines most commonly used to treat diarrhoea (racecadotril) or to prevent rejection of transplanted organs (sirolimus, everolimus, temsirolimus and other medicines belonging to the group of drugs called mTOR inhibitors). See section "Warnings and precautions";
  • a combination medicine containing sacubitril and valsartan (used in the treatment of chronic heart failure). See sections "When not to use Piramil Biso" and "Warnings and precautions";
  • lithium used to treat mania or depression;
  • certain medicines used to treat depression, such as imipramine, amitriptyline, monoamine oxidase inhibitors (MAO inhibitors; except MAO-B inhibitors);
  • certain medicines used to treat schizophrenia (antipsychotics);
  • certain medicines used to treat epilepsy (phenytoin, barbiturates such as phenobarbital);
  • anaesthetics used during surgical procedures;
  • vasodilators, including nitrates (medicines that cause blood vessels to widen);
  • trimethoprim used to treat infections;
  • immunosuppressive medicines (reducing the body's immune response), such as cyclosporine, tacrolimus, used in the treatment of autoimmune disorders or after organ transplantation;
  • allopurinol used to treat gout;
  • parasympathomimetic medicines used to treat diseases such as Alzheimer's disease or glaucoma;
  • locally applied beta-blockers used to treat glaucoma (increased eye pressure);
  • mefloquine used to prevent or treat malaria;
  • baclofen used to treat muscle stiffness in diseases such as multiple sclerosis;
  • gold salts, especially when administered intravenously (used to treat symptoms of rheumatoid arthritis);
  • medicines used to treat diabetes, such as insulin, metformin, linagliptin, saxagliptin, sitagliptin, vildagliptin;
  • non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac or high doses of acetylsalicylic acid, used to treat joint inflammation, headache, pain or inflammatory conditions.

Piramil Biso with food, drink and alcohol
It is recommended to take Piramil Biso before meals.

Pregnancy and breastfeeding
If the patient is pregnant or breastfeeding, suspects she may be pregnant, or is planning to become pregnant, she should consult her doctor or pharmacist before using this medicine.

Pregnancy
The patient should inform her doctor if she thinks she is (or might be) pregnant. Usually, the doctor will advise stopping Piramil Biso before becoming pregnant or as soon as pregnancy is confirmed, and will recommend another medicine instead. Piramil Biso is not recommended during early pregnancy and must not be taken if the patient is more than 3 months pregnant, as the medicine may cause serious harm to the unborn child if used after the third month of pregnancy.

Breastfeeding
Inform the doctor if the patient is breastfeeding or starts breastfeeding. Piramil Biso is not recommended for breastfeeding women. The doctor may choose an alternative treatment if the patient wishes to breastfeed, especially if the baby is a newborn or was born prematurely.

Driving and using machines
Piramil Biso usually does not affect alertness, but some patients may experience dizziness or fatigue related to low blood pressure, especially at the beginning of treatment, after changing medication, or when combined with alcohol. In such cases, the ability to drive or operate machinery may be impaired.

Lactose
Piramil Biso 2.5 mg + 1.25 mg contains 40.97 mg lactose (20.49 mg glucose and 20.49 mg galactose) per dose. This should be taken into account in patients with diabetes.
Piramil Biso 2.5 mg + 2.5 mg contains 40.97 mg lactose (20.49 mg glucose and 20.49 mg galactose) per dose. This should be taken into account in patients with diabetes.
Piramil Biso 5 mg + 2.5 mg contains 81.94 mg lactose (40.97 mg glucose and 40.97 mg galactose) per dose. This should be taken into account in patients with diabetes.
Piramil Biso 5 mg + 5 mg contains 81.94 mg lactose (40.97 mg glucose and 40.97 mg galactose) per dose. This should be taken into account in patients with diabetes.
Piramil Biso 10 mg + 5 mg contains 163.88 mg lactose (81.94 mg glucose and 81.94 mg galactose) per dose. This should be taken into account in patients with diabetes.
Piramil Biso 10 mg + 10 mg contains 163.88 mg lactose (81.94 mg glucose and 81.94 mg galactose) per dose. This should be taken into account in patients with diabetes.

Sodium
Piramil Biso contains less than 1 mmol sodium (23 mg) per capsule, meaning the medicine is considered "sodium-free".

3. How to use Piramil Biso

This medicine should always be taken exactly as instructed by your doctor or pharmacist. If in doubt,
consult your doctor or pharmacist.
The recommended dose is one capsule once daily. The capsule should be swallowed with a glass of water,
in the morning before a meal.

Patients with kidney disease
In patients with moderate kidney disease, the doctor will adjust the dose of Piramil Biso. Piramil Biso
is not recommended for patients with severe kidney disease.

Patients with liver function disorders
The doctor will closely monitor patients with mild or moderate liver disease when starting treatment with Piramil Biso.

Use in children and adolescents
Piramil Biso is not recommended for use in children and adolescents.

Taking more Piramil Biso than recommended
If you have taken more capsules than recommended, contact your doctor or pharmacist immediately.
The most likely symptoms of overdose include low blood pressure, which may cause dizziness or fainting (if this occurs, placing the patient in a lying position with elevated legs may help), severe breathing difficulties, tremors (due to decreased blood sugar levels), and slowed heart rate.

If you miss a dose of Piramil Biso
It is important to take the medicine regularly every day, as this ensures optimal effectiveness. If you miss a dose of Piramil Biso, take the next dose at your usual time. Do not take a double dose to make up for the missed dose.

Stopping Piramil Biso treatment
Do not stop treatment with Piramil Biso suddenly or change the dose without consulting your doctor, as this may significantly worsen heart function. Therapy should not be abruptly discontinued, especially in patients with coronary artery disease.

If you have any further questions regarding the use of this medicine, consult your doctor, pharmacist, or nurse.

4. Possible adverse reactions

Like all medicines, this medicine can cause adverse reactions, although not everyone experiences them.
You should stop taking this medicine and contact your doctor immediately if
any of the following adverse effects occur:

  • severe dizziness or fainting caused by low blood pressure (common – occurs in no more than 1 in 10 people);
  • worsening heart failure causing significant shortness of breath and/or fluid retention in the body (common – occurs in no more than 1 in 10 people);
  • swelling of the face, lips, mouth, tongue or throat, difficulty breathing (angioedema; uncommon – occurs in no more than 1 in 100 people);
  • sudden onset of wheezing, chest pain, shortness of breath or difficulty breathing (bronchospasm; uncommon – occurs in no more than 1 in 100 people);
  • extremely rapid or irregular heartbeat, chest pain (angina) or heart attack (very rare – occurs in fewer than 1 in 10,000 people);
  • muscle weakness in arms or legs, or difficulty speaking, which may be signs of stroke (very rare – occurs in fewer than 1 in 10,000 people);
  • pancreatitis, which may cause severe abdominal pain radiating to the back and very poor general condition (very rare – occurs in fewer than 1 in 10,000 people);
  • yellowing of the skin or eyes (jaundice), which may be a sign of liver inflammation (very rare – occurs in fewer than 1 in 10,000 people);
  • skin rash, often beginning with red, itchy spots on the face, arms or legs (erythema multiforme; very rare – occurs in fewer than 1 in 10,000 people).

Piramil Biso is generally well tolerated, but as with other medicines, patients may
experience various adverse reactions, especially at the beginning of treatment.
You should inform your doctor or pharmacist immediately if any of the following
adverse effects occur in the patient:
Very common (occurs in more than 1 in 10 people):

  • slow heartbeat;

Common (occurs in no more than 1 in 10 people):

  • headaches;
  • centrally-mediated dizziness;
  • fainting, abnormally low blood pressure, especially when standing or changing quickly to an upright position;
  • numbness of hands or feet;
  • sensation of coldness in hands or feet;
  • cough;
  • shortness of breath;
  • sinusitis or bronchitis;
  • chest pain;
  • gastrointestinal disturbances such as nausea, vomiting, abdominal pain, indigestion or difficulty digesting, diarrhoea, constipation;
  • allergic reactions such as rash, itching;
  • muscle cramps, muscle pain;
  • feeling of fatigue;
  • tiredness;
  • higher than usual potassium levels in blood laboratory tests.

Uncommon (occurs in no more than 1 in 100 people):

  • peripherally-mediated dizziness;
  • taste disturbances;
  • tingling sensation (paresthesia);
  • visual disturbances;
  • tinnitus (sensation of noise in the ears);
  • nasal congestion, difficulty breathing or worsening of asthma;
  • runny nose, nasal mucosal congestion;
  • hot flushes;
  • mood changes;
  • sleep disturbances;
  • depression;
  • dry mouth;
  • sweating;
  • kidney disorders;
  • increased daytime urine output (urination);
  • impotence;
  • increased eosinophil count (a type of white blood cell);
  • drowsiness;
  • palpitations;
  • tachycardia;
  • irregular heart rate (atrioventricular conduction disorders);
  • muscle weakness;
  • joint pain;
  • peripheral edema;
  • fever;
  • loss or decrease of appetite (anorexia);
  • altered laboratory test results: increased number of white blood cells (eosinophilia), increased blood urea levels, increased blood creatinine levels, increased liver enzyme activity, high serum bilirubin concentration;
  • increased protein in urine;
  • oral ulceration;
  • breast enlargement in men.

Rare (occurs in no more than 1 in 1,000 people):

  • nightmares, hallucinations;
  • decreased tear production (dry eyes);
  • redness, itching or watering of the eyes;
  • hearing disturbances;
  • hepatitis, which may cause yellowing of the skin or whites of the eyes;
  • vasculitis;
  • altered laboratory test results: changes in lipid levels, increased number of red blood cells, white blood cells or platelets, or changes in hemoglobin concentration.

Very rare (occurs in fewer than 1 in 10,000 people):

  • disorientation;
  • pancreatitis (which may cause severe upper abdominal pain radiating to the back);
  • hair loss;
  • occurrence or worsening of psoriasis, psoriasiform rash;
  • increased sensitivity of the skin to sunlight (photosensitivity reactions).

Frequency not known (frequency cannot be estimated from available data):

  • change in color, numbness and pain in fingers of hands and feet (Raynaud's phenomenon);
  • low sodium levels, very low blood sugar levels (hypoglycemia) in diabetic patients;
  • glossitis (inflammation of the tongue).

Concentrated urine (dark-colored urine), nausea or vomiting, muscle cramps, disorientation,
and seizures, which may be caused by inappropriate antidiuretic hormone secretion,
may occur during treatment with angiotensin-converting enzyme inhibitors. If such
symptoms occur, contact your doctor as soon as possible.
Reporting of adverse reactions
If any adverse effects occur, including any not listed in this leaflet, you should inform your doctor, pharmacist or nurse. Adverse reactions can be reported directly to the Department of Monitoring Adverse Reactions of Medicinal Products at the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products: Al. Jerozolimskie 181C, 02-222 Warsaw
Tel: +48 22 49 21 301, Fax: +48 22 49 21 309, Website: https://smz.ezdrowie.gov.pl
Adverse reactions can also be reported to the marketing authorization holder.
Reporting adverse reactions helps provide more information on the safety of the medicine.

5. How to store Piramil Biso

Keep this medicine out of sight and reach of children.
Do not use this medicine after the expiry date stated on the blister and the cardboard
pack after ‘EXP’.
The expiry date refers to the last day of the stated month.
Do not store the medicine above 30°C. Do not store in the refrigerator and do not freeze.
Medicines must not be disposed of via wastewater or household waste. Ask your
pharmacist how to dispose of medicines no longer required. This will help protect
the environment.

6. Contents of the pack and other information

What Piramil Biso contains
The active substances are ramipril and bisoprolol fumarate.
Other components:
Capsule contents: lactose monohydrate, polyvinyl alcohol, sodium croscarmellose, sodium stearyl fumarate, microcrystalline cellulose, anhydrous calcium hydrogen phosphate, crospovidone type A, colloidal anhydrous silica, magnesium stearate.
Coating AquaPolish P yellow: hypromellose, hydroxypropylcellulose, medium-chain triglycerides, talc, titanium dioxide (E 171), yellow iron oxide (E 172).
Capsule shell: titanium dioxide (E 171), gelatin, red iron oxide (E 172) – [capsules of strength 10 mg+10 mg, 10 mg+5 mg, 5 mg+5 mg, 5 mg+2.5 mg], yellow iron oxide (E 172) – [capsules of strength 10 mg+5 mg, 5 mg+5 mg, 5 mg+2.5 mg, 2.5 mg + 2.5 mg, 2.5 mg + 1.25 mg], quinoline yellow (E 104) – [capsules of strength 5 mg+2.5 mg, 2.5 mg + 2.5 mg, 2.5 mg + 1.25 mg].
Printing ink: shellac, black iron oxide (E 172), propylene glycol, concentrated ammonium hydroxide, potassium hydroxide.

What Piramil Biso looks like and contents of the pack
Piramil Biso, 2.5 mg + 1.25 mg, hard capsules
Yellow cap with black print "2.5 mg" and white body with black print "1.25 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as one yellow, biconvex, coated, round tablet.

Piramil Biso, 2.5 mg + 2.5 mg, hard capsules
Yellow cap with black print "2.5 mg" and yellow body with black print "2.5 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as one yellow, biconvex, coated, round tablet.

Piramil Biso, 5 mg + 2.5 mg, hard capsules
Orange cap with black print "5 mg" and yellow body with black print "2.5 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as one yellow, biconvex, coated, round tablet.

Piramil Biso, 5 mg + 5 mg, hard capsules
Orange cap with black print "5 mg" and orange body with black print "5 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as one yellow, biconvex, coated, round tablet.

Piramil Biso, 10 mg + 5 mg, hard capsules
Reddish-brown cap with black print "10 mg" and orange body with black print "5 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as one yellow, biconvex, coated, round tablet.

Piramil Biso, 10 mg + 10 mg, hard capsules
Reddish-brown cap with black print "10 mg" and reddish-brown body with black print "10 mg".
Capsule contents: ramipril as white or almost white powder and bisoprolol fumarate as two yellow, biconvex, coated, round tablets.

Blister packs made of BOPA/Aluminium/PVC/Aluminium
Blister and leaflet are contained in a cardboard box.
Capsules are available in packs of 10, 30, 60 or 100 capsules.
Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder
Sandoz GmbH
Biochemiestrasse 10
A-6250 Kundl, Austria

Manufacturers:
Adamed Pharma S.A.
Marszałka Józefa Piłsudskiego 5
95-200 Pabianice, Poland
Lek Pharmaceuticals d.d.
Verovškova 57
1526 Ljubljana, Slovenia

This medicinal product is authorised in the Member States of the European Economic Area under the following names:
Poland: Piramil Biso
Germany: Ramipril HEXAL plus Bisoprolol 2.5 mg/1.25 mg Hartkapseln
Ramipril HEXAL plus Bisoprolol 2.5 mg/2.5 mg Hartkapseln
Ramipril HEXAL plus Bisoprolol 5 mg/2.5 mg Hartkapseln
Ramipril HEXAL plus Bisoprolol 5 mg/5 mg Hartkapseln
Ramipril HEXAL plus Bisoprolol 10 mg/5 mg Hartkapseln
Ramipril HEXAL plus Bisoprolol 10 mg/10 mg Hartkapseln
Italy: Ramilolo

For more detailed information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
Sandoz Polska Sp. z o.o.
ul. Domaniewska 50 C
02-672 Warszawa
tel. 22 209 70 00