Know the basics
What is bisoprolol used for?
Bisoprolol is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
Bisoprolol belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body such as epinephrine on the heart and blood vessels. This effect lowers the heart rate, blood pressure, and strain on the heart.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
Bisoprolol may also be used to treat mild to moderate heart failure.
How should I take bisoprolol?
Take bisoprolol by mouth with or without food, usually once a day or as directed by your doctor.
Dosage is based on your medical condition and response to treatment.
Use bisoprolol regularly to get the most benefit from it. To help you remember, take it at the same time each day.
For the treatment of high blood pressure, it may take several weeks before you get the full benefit of bisoprolol. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase).
How do I store bisoprolol?
Bisoprolol is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store bisoprolol in the bathroom or the freezer. There may be different brands of bisoprolol that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush bisoprolol down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using bisoprolol?
Before taking bisoprolol:
- tell your doctor and pharmacist if you are allergic to bisoprolol or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiazac, others) and verapamil (Calan, Isoptin, Verelan); clonidine (Catapres); guanethidine (Ismelin); medications for irregular heartbeat such as disopyramide (Norpace); other beta blockers; reserpine (Serpalan, Serpasil, Serpatabs); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had asthma or other lung disease; a slow heart rate; heart failure; heart, liver, or kidney disease; diabetes; severe allergies; circulation problems; or an overactive thyroid gland (hyperthyroidism).
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking bisoprolol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking bisoprolol.
- you should know that bisoprolol may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- remember that alcohol can add to the drowsiness caused by this medication.
- you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using bisoprolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.
Is it safe to take bisoprolol during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk,
- B=No risk in some studies,
- C=There may be some risk,
- D=Positive evidence of risk,
Know the side effects
What are the side effects of bisoprolol?
The following is a comprehensive list of adverse experiences reported with bisoprolol fumarate in worldwide studies, or in postmarketing experience (in italics):
- Central Nervous System: Dizziness,unsteadiness, vertigo, syncope, headache, paresthesia, hypoesthesia, hyperesthesia, somnolence, sleep disturbances, anxiety/restlessness, decreased concentration/memory.
- Autonomic Nervous System: Dry mouth, Cardiovascular, Bradycardia,palpitations and other rhythm disturbances, cold extremities,claudication, hypotension, orthostatic hypotension, chest pain, congestive heart failure, dyspnea on exertion.
- Psychiatric: Vivid dreams, insomnia, depression,
- Gastrointestinal: Gastric/epigastric/abdominal pain,gastritis, dyspepsia, nausea, vomiting, diarrhea, constipation, peptic ulcer.
- Musculoskeletal: Muscle/joint pain,arthralgia, back/neck pain, muscle cramps, twitching/tremor.
- Skin: Rash,acne, eczema, psoriasis, skin irritation, pruritus, flushing, sweating,alopecia, dermatitis, angioedema, exfoliative dermatitis, cutaneous vasculitis.
- Special Senses: Visual disturbances, ocular pain/pressure, abnormal lacrimation,tinnitus,decreased hearing, earache, taste abnormalities.
- Metabolic: Gout.
- Respiratory: Asthma/bronchospasm,bronchitis, coughing, dyspnea, pharyngitis, rhinitis, sinusitis, URI.
- Genitourinary: Decreased libido/impotence,Peyronie’s disease, cystitis, renal colic, polyuria.
- Hematologic: Purpura.
- General: Fatigue, asthenia, chest pain,malaise, edema, weight gain, angioedema.
In addition, a variety of adverse effects have been reported with other beta-adrenergic blocking agents and should be considered potential adverse effects of ZEBETA (bisoprolol fumarate):
- Central Nervous System: Reversible mental depression progressing to catatonia, hallucinations, an acute reversible syndrome characterized by disorientation to time and place, emotional lability, slightly clouded sensorium.
- Allergic: Fever, combined with aching andsore throat, laryngospasm, respiratory distress.
- Hematologic: Agranulocytosis,thrombocytopenia, thrombocytopenic purpura.
- Gastrointestinal: Mesenteric arterial thrombosis, ischemiccolitis.
- Miscellaneous: The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with Zebeta (bisoprolol fumarate) during investigational use or extensive foreign marketing experience.
- Laboratory Abnormalities: In clinical trials, the most frequently reported laboratory change was an increase in serum triglycerides, but this was not a consistent finding.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with bisoprolol?
Bisoprolol may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Albuterol, Amiodarone, Arformoterol, Bambuterol, Clenbuterol, Clonidine, Colterol, Crizotinib, Diltiazem, Dronedarone, enoldopam, Fenoterol, Fingolimod, Formoterol, Hexoprenaline, Indacaterol, Isoetharine, Lacosamide, Levalbuterol, Metaproterenol, Olodaterol, Pirbuterol, Procaterol, Reproterol, Ritodrine, Salmeterol, Terbutaline, Tretoquinol, Tulobuterol, Verapamil, Vilanterol.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose, Aceclofenac, Acemetacin, Acetohexamide, Acetyldigoxin, Alfuzosin, Amlodipine, Amtolmetin Guacil, Arbutamine ,Aspirin, Benfluorex, Bromfenac, Bufexamac, Bunazosin, Celecoxib, Chlorpropamide, Choline Salicylate, Clonixin, Deslanoside, Dexibuprofen, Dexketoprofen, Diclofenac, Diflunisal, Digitoxin, Digoxin, Dipyrone ,Doxazosin, Etodolac, Etofenamate, Etoricoxib, Felbinac, Felodipine, Fenoprofen, Fepradinol, Feprazone, Floctafenine, Flufenamic Acid ,Flurbiprofen, Gliclazide, Glimepiride, Glipizide, Gliquidone, Glyburide, Guar Gum, Ibuprofen, Ibuprofen Lysine, Indomethacin, Insulin, Insulin Aspart, Recombinant, Insulin Glulisine, Insulin Lispro, Recombinant, Ketoprofen, Ketorolac, Lacidipine, Lercanidipine, Lornoxicam, Loxoprofen, Lumiracoxib, Manidipine, Meclofenamate, Mefenamic Acid, Meloxicam, Metformin ,Methyldopa, Metildigoxin, Mibefradil, Miglitol , Morniflumate, Moxisylyte, Nabumetone, Naproxen, Nepafenac, Nicardipine, Nifedipine, Niflumic Acid, Nilvadipine, Nimesulide, Nimodipine, Nisoldipine, Nitrendipine, Oxaprozin, Oxyphenbutazone, Parecoxib, Phenoxybenzamine, Phentolamine, Phenylbutazone, Piketoprofen, Piroxicam, Pranidipine, Pranoprofen, Prazosin, Proglumetacin, Propyphenazone, Proquazone, Repaglinide, Rifapentine, Rofecoxib, Salicylic Acid, Salsalate, Sodium Salicylate, St John’s Wort, Sulindac, Tamsulosin, Tenoxicam, Terazosin, Tiaprofenic Acid, Tolazamide, Tolbutamide, Tolfenamic Acid, Tolmetin, Trimazosin, Troglitazone, Urapidil, Valdecoxib.
Does food or alcohol interact with bisoprolol?
Bisoprolol may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with bisoprolol?
Bisoprolol may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:
- Angina (severe chest pain)—May provoke chest pain if stopped too quickly.
- Blood vessel disease—Use with caution. This medicine may make this condition worse.
- Bradycardia (slow heartbeat).
- Heart block.
- Heart failure—Should not use in patients with these conditions.
- Hyperthyroidism (overactive thyroid).
- Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat.
- Kidney disease.
- Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
- Lung disease (e.g., asthma, bronchitis, emphysema)—May cause difficulty with breathing in patients with this condition.
Understand the dosage
The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.
What is the dose of Bisoprolol for an adult?
Usual Adult Dose for Hypertension
Initial dose: 5 mg orally once a day.
Maintenance dose: 5 to 20 mg orally once a day.
Usual Adult Dose for Congestive Heart Failure
Initial dose: 1.25 mg orally once a day.
Maintenance dose: This dosage may be increased by 1.25 mg after 48 hours, then weekly as needed and tolerated to a maximum recommended daily dose of 5 mg.
Usual Adult Dose for Angina Pectoris Prophylaxis
Initial dose: 5 mg orally once a day.
Maintenance dose: This dosage may be increased as needed and tolerated to prevent this patient’s angina pectoris. If necessary, this dosage may be increased approximately every three days to 10 mg, then 20 mg once a day.
Usual Adult Dose for Premature Ventricular Depolarizations
Initial dose: 5 mg orally once a day.
Maintenance dose: This dosage may be increased as needed and tolerated to eradicate this patient’s premature ventricular depolarizations. If necessary, this dosage may be increased approximately every three days to 10 mg, then 20 mg once a day.
Usual Adult Dose for Supraventricular Tachycardia
Initial dose: 5 mg orally once a day.
Maintenance dose: This dosage may be increased as needed and tolerated to achieve control of this patient’s supraventricular tachycardia. If necessary, this dosage may be increased approximately every three days to 10 mg, then 20 mg once a day.
What is the dose of Bisoprolol for a child?
The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.
How is bisoprolol available?
Bisoprolol is available in the following dosage forms and strengths:
Tablet, Oral: 5 mg, 10 mg
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
What should I do if I miss a dose?
If you miss a dose of bisoprolol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
Bisoprolol https://www.drugs.com/bisoprolol.html. Accessed July 8, 2016.
Bisoprolol, Oral Tablet http://www.healthline.com/drugs/bisoprolol/oral-tablet#Highlights1. Accessed July 8, 2016.