Background pattern

Ramipril+bisoprolol fumarate Sandoz

About the medicine

How to use Ramipril+bisoprolol fumarate Sandoz

Leaflet attached to the packaging: patient information

Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 1.25 mg, hard capsules
Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 2.5 mg, hard capsules

Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 2.5 mg, hard capsules

Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 5 mg, hard capsules

Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 5 mg, hard capsules

Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 10 mg, hard capsules

Ramipril+Bisoprolol fumarate:
:

You should carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

You should keep this leaflet, so that you can read it again if you need to.
In case of any doubts, you should consult a doctor, pharmacist, or nurse.
This medicine has been prescribed specifically for one person. Do not pass it on to others.
The medicine may harm another person, even if the symptoms of their illness are the same.
If the patient experiences any side effects, including any possible side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet:

  • 1. What is Ramipril+Bisoprolol fumarate Sandoz and what is it used for
  • 2. Important information before taking Ramipril+Bisoprolol fumarate Sandoz
  • 3. How to take Ramipril+Bisoprolol fumarate Sandoz
  • 4. Possible side effects
  • 5. How to store Ramipril+Bisoprolol fumarate Sandoz
  • 6. Contents of the packaging and other information

1. What is Ramipril+Bisoprolol fumarate Sandoz and what is it used for

Ramipril+Bisoprolol fumarate Sandoz contains two active substances, bisoprolol fumarate and ramipril, in one capsule:
Ramipril is an angiotensin-converting enzyme inhibitor (ACEI). It works by dilating blood vessels, making 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 make the heart pump blood more efficiently.
Ramipril+Bisoprolol fumarate Sandoz is used to treat high blood pressure (hypertension) and/or chronic heart failure with left ventricular dysfunction (a condition in which the heart is not able to pump enough blood to meet the body's needs, resulting in shortness of breath and swelling) and/or to reduce the risk of heart events, such as heart attack, in patients with chronic coronary artery disease (a condition in which the blood supply to the heart is reduced or blocked) who have had a heart attack and/or have undergone surgery to improve blood flow to the heart by widening the blood vessels that supply it, or with diabetes with at least one other cardiovascular risk factor.
Instead of taking bisoprolol fumarate and ramipril in separate capsules, the patient takes only one capsule of Ramipril+Bisoprolol fumarate Sandoz, which contains both active substances in the same amounts.
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2. Important information before taking Ramipril+Bisoprolol fumarate Sandoz

When not to take Ramipril+Bisoprolol fumarate Sandoz

Warnings and precautions

Before starting treatment with Ramipril+Bisoprolol fumarate Sandoz, the patient should discuss it with their doctor or pharmacist if:

  • the patient has diabetes;
  • the patient has kidney problems (including patients who have had a kidney transplant) or is undergoing dialysis;
  • the patient has liver disease;
  • the patient has aortic stenosis and/or mitral stenosis (narrowing of the main blood vessel leading out of the heart), hypertrophic cardiomyopathy (a heart muscle disease), or renal artery stenosis (narrowing of the blood vessels supplying the kidneys);
  • the patient has high levels of a hormone called aldosterone in the blood (primary aldosteronism);
  • the patient has heart failure or any other heart condition, such as arrhythmias or severe chest pain at rest (Prinzmetal's angina);
  • the patient has collagenosis (a 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 levels of potassium in the blood can cause changes in heart rhythm);
  • the patient has recently had diarrhea or vomiting, or is dehydrated (Ramipril+Bisoprolol fumarate Sandoz may cause a drop in blood pressure);
  • the patient is undergoing LDL apheresis (removal of cholesterol from the blood using a special device);

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the patient is undergoing desensitization treatment to reduce allergic reactions to bee or wasp stings;

  • the patient is fasting or on a diet;
  • the patient is undergoing anesthesia and/or surgery;
  • the patient has circulatory disorders in the limbs;
  • the patient has asthma or chronic obstructive pulmonary disease;
  • the patient has (or has had) psoriasis;
  • the patient has an adrenal gland tumor (pheochromocytoma);
  • the patient has thyroid disorders (Ramipril+Bisoprolol fumarate Sandoz may mask symptoms of hyperthyroidism);
  • angioedema (a severe allergic reaction characterized by swelling of the face, lips, tongue, or throat, difficulty swallowing or breathing). This reaction can occur at any time during treatment. If the patient experiences such symptoms, they should stop taking Ramipril+Bisoprolol fumarate Sandoz and contact their doctor immediately.
  • the patient is black, as there is a higher risk of angioedema, and this medicine may be less effective in lowering blood pressure than in patients of other races.
  • the patient is taking any of the following medicines used to treat high blood pressure:
  • angiotensin receptor blockers (ARBs) (also known as sartans - e.g., valsartan, telmisartan, irbesartan), especially if the patient has diabetic kidney problems;
  • aliskiren. The doctor may monitor kidney function, blood pressure, and electrolyte levels (e.g., potassium) in the blood at regular intervals. See also the information in the "When not to take Ramipril+Bisoprolol fumarate Sandoz" section.
  • the patient is taking any of the following medicines, which increase the risk of angioedema:
  • racecadotril (used to treat diarrhea);
  • sirolimus, everolimus, temsirolimus, and other medicines belonging to the group of medicines called mTOR inhibitors (used to prevent rejection of transplanted organs);
  • sacubitril (available in a combination medicine containing sacubitril and valsartan), used to treat chronic heart failure.

Do not stop taking Ramipril+Bisoprolol fumarate Sandoz suddenly, as this may cause severe worsening of heart function. Treatment should not be stopped abruptly, especially in patients with coronary artery disease.
The patient should tell their doctor if they think they are (or may be) pregnant. Ramipril+Bisoprolol fumarate Sandoz is not recommended in early pregnancy and should not be taken if the patient is pregnant for more than 3 months, as the medicine may cause serious harm to the baby if taken during this period (see "Pregnancy").

Children and adolescents

Ramipril+Bisoprolol fumarate Sandoz is not recommended for use in children and adolescents under 18 years of age.

Ramipril+Bisoprolol fumarate Sandoz with other medicines

The patient should tell their doctor or pharmacist about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take. Other medicines may affect the action of Ramipril+Bisoprolol fumarate Sandoz, or Ramipril+Bisoprolol fumarate Sandoz may affect the action of other medicines. This type of interaction may cause one or both medicines to be less effective or may increase the risk or severity of side effects.
The patient should tell their doctor if they are taking any of the following medicines:

  • medicines used to regulate blood pressure or treat 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 receptor blockers (ARBs), aliskiren (see also the information in the "When not to take Ramipril+Bisoprolol fumarate Sandoz" section 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, other medicines that may increase potassium levels in the body (such as heparin and cotrimoxazole, also known as a combination medicine containing trimethoprim and sulfamethoxazole);
  • potassium-sparing medicines used to treat heart failure: eplerenone and spironolactone in 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 used to treat diarrhea or to prevent rejection of transplanted organs (sirolimus, everolimus, temsirolimus, and other medicines belonging to the group of medicines called mTOR inhibitors). See the "Warnings and precautions" section.
  • a combination medicine containing sacubitril and valsartan (used to treat chronic heart failure). See the "When not to take Ramipril+Bisoprolol fumarate Sandoz" and "Warnings and precautions" sections.
  • lithium used to treat mania or depression;
  • certain medicines used to treat depression, such as imipramine, amitriptyline, monoamine oxidase inhibitors (MAOIs; except for MAO-B inhibitors);
  • certain medicines used to treat schizophrenia (antipsychotic medicines);
  • certain medicines used to treat epilepsy (phenytoin, barbiturates, such as phenobarbital);
  • anesthetics used in surgical procedures;
  • vasodilators, including nitrates (medicines that cause blood vessels to dilate);
  • trimethoprim used to treat infections;
  • immunosuppressive medicines (medicines that reduce the body's immune response), such as cyclosporine, tacrolimus, used to treat autoimmune disorders or after organ transplantation;
  • allopurinol used to treat gout;
  • parasympathomimetic medicines used to treat conditions such as Alzheimer's disease or glaucoma;
  • topically applied beta-blockers used to treat glaucoma (increased pressure in the eye);
  • mefloquine used to prevent or treat malaria;
  • baclofen used to treat muscle stiffness in conditions such as multiple sclerosis;
  • gold salts, especially when given 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 medicines (NSAIDs), such as ibuprofen, diclofenac, or high doses of acetylsalicylic acid, used to treat arthritis, headache, pain, or inflammation.

Ramipril+Bisoprolol fumarate Sandoz with food, drink, and alcohol

Ramipril+Bisoprolol fumarate Sandoz should be taken before a meal.

Pregnancy and breastfeeding

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If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor or pharmacist before taking this medicine.
Pregnancy
The patient should tell their doctor if they think they are (or may be) pregnant. The doctor will usually recommend stopping Ramipril+Bisoprolol fumarate Sandoz before pregnancy or as soon as the patient finds out they are pregnant, and will recommend taking a different medicine instead of Ramipril+Bisoprolol fumarate Sandoz. Ramipril+Bisoprolol fumarate Sandoz is not recommended in early pregnancy and should not be taken if the patient is pregnant for more than 3 months, as the medicine may cause serious harm to the baby if taken during this period.
Breastfeeding
The patient should tell their doctor if they are breastfeeding or plan to breastfeed. Ramipril+Bisoprolol fumarate Sandoz is not recommended for breastfeeding women. The doctor may choose a different treatment if the patient wants to breastfeed, especially if the baby is a newborn or was born prematurely.

Driving and using machines

Ramipril+Bisoprolol fumarate Sandoz usually does not affect alertness, but some patients may experience dizziness or weakness due to low blood pressure, especially at the beginning of treatment or when changing the medicine or in combination with alcohol. In such cases, the ability to drive or operate machines may be impaired.
Lactose
Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 1.25 mg, contains 40.97 mg of lactose (20.49 mg of glucose and 20.49 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 2.5 mg, contains 40.97 mg of lactose (20.49 mg of glucose and 20.49 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 2.5 mg, contains 81.94 mg of lactose (40.97 mg of glucose and 40.97 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 5 mg, contains 81.94 mg of lactose (40.97 mg of glucose and 40.97 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 5 mg, contains 163.88 mg of lactose (81.94 mg of glucose and 81.94 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 10 mg, contains 163.88 mg of lactose (81.94 mg of glucose and 81.94 mg of galactose) per dose. This should be taken into account in patients with diabetes.
Sodium
Ramipril+Bisoprolol fumarate Sandoz contains less than 1 mmol of sodium (23 mg) per capsule, which means the medicine is "sodium-free",

3. How to take Ramipril+Bisoprolol fumarate Sandoz

This medicine should always be taken exactly as prescribed by the doctor or pharmacist. In case of doubts, the patient should consult their doctor or pharmacist.
The recommended dose is one capsule per day. 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 Ramipril+Bisoprolol fumarate Sandoz. Ramipril+Bisoprolol fumarate Sandoz 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 Ramipril+Bisoprolol fumarate Sandoz.

Use in children and adolescents

Ramipril+Bisoprolol fumarate Sandoz is not recommended for use in children and adolescents.

Taking a higher dose of Ramipril+Bisoprolol fumarate Sandoz than recommended

In case of taking too many capsules, the patient should contact their doctor or pharmacist immediately.
The most likely symptom of overdose is low blood pressure, which may cause dizziness or fainting (if this happens, it may help to lay the patient down with their legs elevated), severe breathing difficulties, tremors (due to low blood sugar), and slow heart rate.

Missing a dose of Ramipril+Bisoprolol fumarate Sandoz

It is important to take the medicine regularly, every day, for it to work better. If a dose of Ramipril+Bisoprolol fumarate Sandoz is missed, the next dose should be taken at the usual time. A double dose should not be taken to make up for a missed dose.

Stopping treatment with Ramipril+Bisoprolol fumarate Sandoz

The patient should not stop taking Ramipril+Bisoprolol fumarate Sandoz suddenly or change the dose without consulting their doctor, as this may cause significant worsening of heart function. The patient should not stop treatment abruptly, especially if they have coronary artery disease.
In case of any further doubts about taking this medicine, the patient should consult their doctor, pharmacist, or nurse.

4. Possible side effects

Like all medicines, Ramipril+Bisoprolol fumarate Sandoz can cause side effects, although not everybody gets them.

The patient should stop taking this medicine and contact their doctor immediately if they experience any of the following side effects:

  • severe dizziness or fainting due to low blood pressure (common - occurs in less than 1 in 10 people);
  • worsening of heart failure causing severe shortness of breath and/or fluid retention (common - occurs in less than 1 in 10 people);
  • swelling of the face, lips, mouth, tongue, or throat, difficulty breathing (angioedema; uncommon - occurs in less than 1 in 100 people);
  • sudden onset of wheezing, chest pain, shortness of breath, or difficulty breathing (bronchospasm; uncommon - occurs in less than 1 in 100 people);
  • very fast or irregular heartbeat, chest pain (angina pectoris), or heart attack (very rare - occurs in less than 1 in 10,000 people);
  • weakness of the arms or legs, or difficulty speaking, which may be a sign of a stroke (very rare - occurs in less 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 less than 1 in 10,000 people);
  • jaundice (yellowing of the skin or eyes), which may be a sign of liver inflammation (very rare - occurs in less than 1 in 10,000 people);
  • a rash often starting with red, itchy patches on the face, arms, or legs (erythema multiforme; very rare - occurs in less than 1 in 10,000 people).

Ramipril+Bisoprolol fumarate Sandoz is usually well tolerated, but like other medicines, it can cause side effects, especially at the beginning of treatment.
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The patient should tell their doctor or pharmacist immediately if they experience any of the following side effects:

very common (occurs in more than 1 in 10 people):

  • slow heart rate;

common (occurs in less than 1 in 10 people):

  • headache;
  • central dizziness;
  • fainting, abnormally low blood pressure, especially when standing up or changing position quickly;
  • numbness of the hands or feet;
  • feeling of cold hands or feet;
  • cough;
  • shortness of breath;
  • sinusitis or bronchitis;
  • chest pain;
  • gastrointestinal disorders, such as nausea, vomiting, abdominal pain, indigestion, or difficulty digesting food, diarrhea, constipation;
  • allergic reactions, such as rash, itching;
  • muscle cramps, muscle pain;
  • feeling of fatigue;
  • weakness;
  • higher than normal potassium levels in blood test results.

uncommon (occurs in less than 1 in 100 people):

  • peripheral dizziness;
  • taste disorders;
  • tingling sensation (paresthesia);
  • vision disorders;
  • tinnitus (feeling of noise in the ears);
  • nasal congestion, difficulty breathing, or worsening of asthma;
  • rhinitis, nasal congestion;
  • hot flashes;
  • mood changes;
  • sleep disorders;
  • depression;
  • dry mouth;
  • sweating;
  • kidney problems;
  • increased urine production during the day;
  • impotence;
  • increased eosinophil count (a type of white blood cell);
  • drowsiness;
  • palpitations;
  • tachycardia;
  • irregular heart rhythm (atrioventricular conduction disorders);
  • muscle weakness;
  • joint pain;
  • peripheral edema;
  • fever;
  • loss of appetite (anorexia);
  • changes in laboratory test results: increased eosinophil count, increased urea levels in the blood, increased creatinine levels in the blood, increased liver enzyme activity, high bilirubin levels in the blood;
  • increased protein levels in the urine;

rare (occurs in less than 1 in 1,000 people):

  • nightmares, hallucinations;
  • decreased tear production (dry eyes);
  • redness, itching, or tearing of the eyes;
  • hearing disorders;
  • liver inflammation, which may cause yellowing of the skin or eyes;
  • vasculitis;
  • changes in laboratory test results: changes in lipid levels, increased red blood cell count, white blood cell count, or platelet count, or changes in hemoglobin levels.

very rare (occurs in less than 1 in 10,000 people):

  • disorientation;
  • pancreatitis (which may cause severe abdominal pain radiating to the back);
  • hair loss;
  • onset or worsening of psoriasis, psoriasis-like rash;
  • increased sensitivity of the skin to sunlight (phototoxic reactions)

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

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

Concentrated urine (dark urine), nausea, or vomiting, muscle cramps, disorientation, and seizures, which may be caused by inappropriate secretion of antidiuretic hormone, may occur with the use of angiotensin-converting enzyme inhibitors. If such symptoms occur, the patient should contact their doctor as soon as possible.

Reporting side effects

If the patient experiences any side effects, including any possible side effects not listed in the leaflet, they should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Drug Safety Monitoring of 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
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help to gather more information on the safety of the medicine.

5. How to store Ramipril+Bisoprolol fumarate Sandoz

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the blister and carton after 'EXP'.
The expiry date refers to the last day of the month stated.
Do not store the medicine at temperatures above 30°C. Do not store in the refrigerator or freeze.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
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6. Contents of the packaging and other information

What Ramipril+Bisoprolol fumarate Sandoz contains

The active substances of the medicine are ramipril and bisoprolol fumarate.
The other ingredients are:
capsule contents: lactose monohydrate, polyvinyl alcohol, sodium croscarmellose, sodium stearyl fumarate, microcrystalline cellulose, calcium hydrogen phosphate anhydrous, crospovidone type A, colloidal anhydrous silica, magnesium stearate.
AquaPolish P yellow coating: hypromellose, hydroxypropyl cellulose, 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 with a strength of 10 mg+10 mg, 10 mg+5 mg, 5 mg+5 mg, 5 mg+2.5 mg], yellow iron oxide (E 172) - [capsules with a strength of 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 with a strength of 5 mg+2.5 mg, 2.5 mg + 2.5 mg, 2.5 mg + 1.25 mg].
ink:shellac, black iron oxide (E 172), propylene glycol, concentrated ammonia solution, potassium hydroxide.

What Ramipril+Bisoprolol fumarate Sandoz looks like and contents of the pack

Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 1.25 mg, hard capsules
A capsule with a yellow cap with black printing "2.5 mg" and a white body with black printing "1.25 mg".
Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of one yellow, biconvex, film-coated, round tablet.
Ramipril+Bisoprolol fumarate Sandoz, 2.5 mg + 2.5 mg, hard capsules
A capsule with a yellow cap with black printing "2.5 mg" and a yellow body with black printing "2.5 mg".
Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of one yellow, biconvex, film-coated, round tablet.
Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 2.5 mg, hard capsules
A capsule with an orange cap with black printing "5 mg" and a yellow body with black printing "2.5 mg".
Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of one yellow, biconvex, film-coated, round tablet.
Ramipril+Bisoprolol fumarate Sandoz, 5 mg + 5 mg, hard capsules
A capsule with an orange cap with black printing "5 mg" and an orange body with black printing "5 mg".
Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of one yellow, biconvex, film-coated, round tablet.
Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 5 mg, hard capsules
A capsule with a reddish-brown cap with black printing "10 mg" and an orange body with black printing "5 mg".
Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of one yellow, biconvex, film-coated, round tablet.
Ramipril+Bisoprolol fumarate Sandoz, 10 mg + 10 mg, hard capsules
A capsule with a reddish-brown cap with black printing "10 mg" and a reddish-brown body with black printing "10 mg".
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Contents of the capsule: ramipril in the form of a white or almost white powder and bisoprolol fumarate in the form of two yellow, biconvex, film-coated, round tablets.
Blisters of BOPA/Aluminum/PVC/Aluminum
The blisters and leaflet are placed in a carton.
The capsules are available in packs of 10, 30, 60, or 100 capsules.
Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder
Sandoz GmbH
Biochemiestrasse 10
A-6250 Kundl, Austria
Manufacturer:
Adamed Pharma S.A.
Marszałka Józefa Piłsudskiego 5
95-200 Pabianice, Poland
Lek Pharmaceuticals d.d.
Verovškova 57
1526 Ljubljana, Slovenia

This medicine is authorized in the Member States of the European Economic Area under the following names:

Croatia
Byol Combi 1.25 mg/2.5 mg hard capsules
Byol Combi 2.5 mg/2.5 mg hard capsules
Byol Combi 2.5 mg/5 mg hard capsules
Byol Combi 5 mg/5 mg hard capsules
Byol Combi 5 mg/10 mg hard capsules
Byol Combi 10 mg/10 mg hard capsules
Poland
Ramipril+Bisoprolol fumarate Sandoz

For further information on this medicine, please contact the local representative of the marketing authorization holder:

Sandoz Polska Sp. z o.o.
ul. Domaniewska 50 C
02-672 Warsaw
tel. 22 209 70 00
Date of last revision of the leaflet:11/2023
Sandoz logo
PL/H/0755/001-006/IB/003

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Ekaterina Agapova

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Dr. Ekaterina Agapova is a neurologist specialising in the diagnosis and treatment of neurological conditions and chronic pain. She provides online consultations for adults, combining evidence-based medicine with a personalised approach.

She offers expert care for:

  • Headaches and migraines, including tension-type and cluster headaches.
  • Neck and back pain, both acute and chronic.
  • Chronic pain syndromes – fibromyalgia, neuropathic pain, post-traumatic pain.
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  • Polyneuropathies – diabetic, toxic, and other types.
  • Multiple sclerosis – diagnosis, monitoring, long-term support.
  • Dizziness and coordination disorders.
  • Sleep disturbances – insomnia, daytime sleepiness, fragmented sleep.
  • Anxiety, depression, and stress-related conditions.

Dr. Agapova helps patients manage complex neurological symptoms like pain, numbness, weakness, poor sleep, and emotional distress. Her consultations focus on accurate diagnosis, clear explanation of findings, and tailored treatment plans.

If you’re struggling with chronic pain, migraines, nerve disorders, or sleep problems, Dr. Agapova offers professional guidance to restore your well-being.

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Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
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  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
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  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Doctor

Salome Akhvlediani

Pediatrics11 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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