Lodoz
Lodoz is a fixed-dose combination of bisoprolol 2.5 mg + hydrochlorothiazide 6.25 mg in one daily tablet from Merck — beta-blocker plus thiazide diuretic for hypertension. Complementary mechanisms; improves adherence vs two separate pills. Take in the morning. Monitor potassium and uric acid.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Lodoz?
Lodoz is een fixed-dose combination of bisoprolol + hydrochlorothiazide (HCTZ) from Merck — a beta-blocker plus a thiazide diuretic in a single daily tablet. The combination attacks hypertension at two complementary mechanisms: bisoprolol reduces cardiac output and renin release, while HCTZ causes renal sodium-water loss and a direct vasodilator effect. Typical dose: one tablet once daily in the morning. Beta-blocker contraindications apply (asthma, severe bradycardia, heart block, acute heart failure) + HCTZ-specific cautions (gout, severe renal / hepatic impairment, hypokalaemia, hyponatraemia, sulfonamide allergy). Monitor for hypokalaemia and hyperuricaemia (gout flare) during the first months. Do not stop abruptly — taper the bisoprolol component to avoid rebound.
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What Is Lodoz?
Lodoz is a fixed-dose combination oral tablet from Merck containing:
- Bisoprolol — a highly beta-1-cardioselective beta-blocker (the same molecule in Concor)
- Hydrochlorothiazide (HCTZ) — a thiazide diuretic (the same molecule in Aquazide, Hydrocl)
Combining a beta-blocker with a thiazide was one of the first “fixed-dose combination” antihypertensive strategies, dating to the 1970s. It is still commonly used because the two mechanisms complement each other (RAAS suppression + sodium diuresis) and adherence is better with one tablet per day than two.
How Lodoz Works
Bisoprolol + HCTZ lowers blood pressure via four complementary mechanisms:
- Bisoprolol — reduces heart rate and cardiac output (beta-1 blockade in SA node + ventricle)
- Bisoprolol — suppresses renin release (beta-1 blockade in juxtaglomerular cells), lowering angiotensin II and aldosterone over weeks
- HCTZ — inhibits the Na-Cl cotransporter in the distal convoluted tubule, causing natriuresis and modest plasma volume reduction
- HCTZ — direct vascular effect (not fully characterised) that maintains BP-lowering after plasma volume restores to baseline
Uses & Dosing
- Essential hypertension (primary indication) — typically as step-up when a single agent is insufficient
- Usually one tablet once daily in the morning (HCTZ causes diuresis; morning dosing avoids nocturia)
- Target BP: <140/90 in uncomplicated hypertension; <130/80 in diabetes, CKD, or cardiovascular disease
Monitoring:
- Baseline + at 4 weeks + periodically: electrolytes (sodium, potassium, calcium, magnesium), urea + creatinine (eGFR), uric acid, glucose, lipids
- Pulse and BP at 2, 4, 8 weeks
- Beta-blocker requires taper if discontinued — do not stop abruptly
Bijwerkingen
Bisoprolol-related: fatigue, cold extremities, bradycardia, exercise intolerance, erectile dysfunction, mild depression.
HCTZ-related:
- Hypokalaemia (low potassium) — particularly with >25 mg/day HCTZ; check at 4 weeks
- Hyponatraemia — particularly in elderly; can cause confusion, falls
- Hyperuricaemia / gout flare
- Hyperglycaemia / worsening insulin sensitivity — bisoprolol contributes modestly; HCTZ is the bigger driver. Monitor in diabetes.
- Hyperlipidaemia (mild)
- Photosensitivity rash
- Erectiestoornissen
- Mild volume depletion, dizziness
Contra-indicaties
- Asthma, severe COPD (bisoprolol component — highly selective but still avoid in severe disease)
- Second/third-degree heart block, sinus bradycardia <50, sick sinus syndrome
- Decompensated heart failure
- Severe hepatic or renal impairment (eGFR <30 — HCTZ ineffective below this)
- Anuria
- Refractory hypokalaemia, hyponatraemia, hypercalcaemia
- Gout (relative)
- Sulfonamide allergy (cross-reactivity with HCTZ rare but possible)
- Phaeochromocytoma without prior alpha-blockade
- Hypersensitivity to either component
Pregnancy: avoid. HCTZ reduces plasma volume which can impair placental perfusion; beta-blockers have the neonatal bradycardia / IUGR considerations. Switch to labetalol and/or methyldopa in pregnancy.
Storage & Frequently Asked Questions
Store below 25°C; keep dry. Keep out of reach of children.
Why both drugs in one tablet?
Adherence. Two BP drugs in one tablet is substantially more likely to be taken reliably than two separate pills. For patients who need dual therapy and tolerate both components, FDC is the rational choice.
Can I take Lodoz if I have gout?
Relative contraindication. HCTZ raises uric acid and can precipitate gout flares. If gout is well-controlled on allopurinol or febuxostat, low-dose HCTZ (like the 6.25 mg in Lodoz) is often tolerated, but flares can still occur. Alternative combinations (bisoprolol + amlodipine, or ACE-inhibitor + amlodipine) avoid the uric acid issue.
Do I need to take Lodoz in the morning?
Yes, recommended. HCTZ causes diuresis for 6-12 hours after a dose — if taken in the evening, it disrupts sleep with nocturia. Morning dosing lets the diuretic effect wear off by night.
Where can I buy Lodoz online?
You can buy Lodoz (bisoprolol + HCTZ 2.5 mg + 6.25 mg, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.
Related Beta-Blockers & Antihypertensives
- Ciplar LA — Propranolol 20/40 mg long-acting (Cipla)
- Lobet — Labetalol 100 mg
- Metolar — Metoprolol Tartrate 25/50/100 mg
- Nebicard — Nebivolol 2.5/5 mg
- Nilol — Atenolol + Nifedipine combo
- P-Nolol — Propranolol 20/40 mg
- Browse all High Blood Pressure Medications
Veelgestelde vragen
How does Lodoz work?
Lodoz contains a clinically-validated active ingredient that targets the specific pathway involved in the condition it treats. Once absorbed, the medicine reaches its site of action and produces its effect over the dosing interval. Your prescriber or specialist can explain the exact mechanism for your indication.
How long does Lodoz take to start working?
Onset varies by indication and formulation. Some effects (for example pain or symptom relief) begin within 30–60 minutes; for chronic-condition therapies the full clinical benefit may take several days to a few weeks of consistent dosing. Continue the prescribed course even if you feel better quickly — stopping early can let symptoms return.
What are the most common side effects of Lodoz?
Most patients tolerate Lodoz well. Mild, self-limiting effects can include gastrointestinal upset, headache, or transient changes in sleep or appetite. Stop the medication and seek medical advice if you develop a rash, swelling, breathing difficulty, severe abdominal pain, jaundice, or any symptom that feels rapidly worsening.
Can I take Lodoz with food or alcohol?
Most formulations can be taken with or without food unless your prescriber tells you otherwise — taking with a small meal often reduces stomach upset. Alcohol should generally be limited or avoided during a course of medication, particularly for antibiotics, sedating agents, and anything metabolised by the liver. Read the patient leaflet supplied with your pack for the exact food/alcohol guidance.
What should I do if I miss a dose of Lodoz?
Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed one and resume the regular schedule — never double up to catch up. If you miss several doses or your symptoms worsen, contact your healthcare professional for advice on restarting.
Where can I buy Lodoz online?
MedsBase ships Lodoz worldwide from a WHO-GMP certified manufacturer in discreet plain packaging. Every order is backed by our Reshipment Assurance Policy: if your parcel does not arrive within the published window we will reship at our expense, subject to the policy terms. Add Lodoz to your cart and pay by card (the statement descriptor is the crypto-payment processor — never “MedsBase” or any medication name), SEPA, or crypto.
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| Sterkte | 5 mg |
|---|---|
| Hoeveelheid | 30 Tabletten, 60 Tabletten, 90 Tabletten, 180 Tabletten |
Lodoz
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