Bisoprolol

Bisoprolol belongs to a group of medicines called beta-blockers. It is used to treat high blood pressure (hypertension), angina (heart-related chest pain), irregular heart rhythms (arrhythmia). It also helps to prevent future heart attacks and stroke and to prevent migraine. Bisoprolol is also used to relieve the symptoms caused by an overactive thyroid gland. It may be prescribed alone or together with other medications. The dose and frequency depend on what you are taking it for and the severity of your condition. It may be taken empty stomach or with a meal, but take it regularly at the same time each day to get the most benefit. It may take several weeks before you get the full benefit of this medicine and you may need to take it for the rest of your life. However, it is important to continue taking it even if you feel well. Most people with high blood pressure do not feel ill and if you stop taking it, your condition may worsen. The main side effects of this medicine are fatigue, headache, slow heart rate, feeling dizzy, and nausea. These are usually mild and short-lived. It may also cause shortness of breath or low blood pressure in some people. To reduce the risk of side effects your doctor will probably start the medicine at a low dose and gradually increase it. Consult your doctor if the side effects bother you or do not go away. Before taking it, let your doctor know if you have any liver problems. It may also not be suitable for people who have a slow heart rate, severe circulation problems, severe heart failure, or low blood pressure. Pregnant or breastfeeding mothers should also consult their doctor before taking it. You must talk to your doctor to find out whether this medicine is suitable for you to use. You should have your blood pressure checked regularly to make sure that this medicine is working properly. Avoid drinking alcohol as it may increase certain side effects. Bisoprolol is a beta blocker that works specifically on the heart. It works by slowing down the heart rate and makes the heart more efficient at pumping blood around the body.

• Hypertension (high blood pressure) • Angina (heart-related chest pain) • Heart failure

Bisoprolol selectively and competitively blocks beta1-receptors but has little or no effect on beta2-receptors except at high doses.

Adult Dose: The usual starting dose is 5 mg once daily. In some patients, 2.5 mg may be an appropriate starting dose. If the antihypertensive effect of 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily. For heart failure: Initially 1.25 mg once daily (in the morning) for 1 week then, if well tolerated, increased to 2.5 mg once daily for 1 week, then 3.75 mg once daily for 1 week, then 5 mg once daily for 4 weeks, then 7.5 mg once daily for 4 weeks, then 10 mg once daily; max. 10 mg daily. Hepatic impairment: Severe: Initially, 2.5 mg/day. Max: 10 mg/day. Elderly: Hypertension 2.5-20 mg PO qDay Heart Failure 1.25 mg PO qDay; not to exceed 10 mg/day Renal Dose: Renal impairment: CrCl (ml/min) <40 Initial: 2.5 mg/day.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Bisoprolol may be taken with or without food, but it is better to take it at a fixed time.

Common: • Nausea • Headache • Fatigue • Constipation • Diarrhea • Dizziness • Cold extremities

[UNSAFE] Bisoprolol may cause side effects which could affect your ability to drive. It may cause dizziness. If this happens to you, get up slowly when rising from a sitting or lying position. It can hide symptoms of low blood sugar if you are diabetic. Monitor your blood sugar levels regularly. Do not stop taking Bisoprolol suddenly as it can cause your blood pressure to rise suddenly, thereby increasing the risk of heart attack and stroke.

Patients with cardiogenic shock, overt cardiac failure, second or third degree AV block and marked sinus bradycardia.

May potentiate AV conduction time and may increase negative inotropic effect w/ class I antiarrhythmic drugs (e.g. quinidine, disopyramide, propafenone). Concomitant catecholamine-depleting drugs (e.g. reserpine, guanethidine) may produce excessive sympathetic activity. May exacerbate rebound HTN upon discontinuance of clonidine treatment. Increased risk of bradycardia w/ digitalis glycosides. Reduced hypotensive effect w/ NSAIDs.

[UNSAFE] Bisoprolol may cause excessive drowsiness with alcohol.

[CONSULT YOUR DOCTOR] Information regarding the use of Bisoprolol during pregnancy is not available. Please consult your doctor.

[CONSULT YOUR DOCTOR] Bisoprolol is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[CAUTION] Bisoprolol should be used with caution in patients with kidney disease. Dose adjustment of Bisoprolol may be needed. Please consult your doctor. Regular blood pressure monitoring is advisable for dose adjustment. [CAUTION] Bisoprolol should be used with caution in patients with liver disease. Dose adjustment of Bisoprolol may be needed. Please consult your doctor. Bisoprolol is started at a lower dose in these patients and further increased slowly with careful monitoring.

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