Generic
Bisoprolol
87 brands available in the market
At a glance
Bisoprolol is a beta-blocker medicine used in the treatment of high blood pressure (hypertension), angina (heart-related chest pain), irregular heart rhythms (arrhythmia), and heart failure. It also helps prevent future heart attacks and stroke. It works by slowing down the heart rate and making the heart more efficient at pumping blood.
Description
Bisoprolol belongs to a group of medicines called beta-blockers. It is used to treat high blood pressure, angina, irregular heart rhythms, and heart failure. It also helps prevent future heart attacks and stroke.
Bisoprolol selectively and competitively blocks β1-receptors but has little or no effect on β2-receptors except at high doses. It slows down the heart rate and makes the heart more efficient at pumping blood, thereby reducing blood pressure and decreasing the heart's workload. It may be prescribed alone or together with other medications.
Indications
- Hypertension (high blood pressure)
- Angina (heart-related chest pain)
- Heart failure
- Irregular heart rhythms (arrhythmia)
- Prevention of heart attack and stroke
Therapeutic class
Beta-blocker
Pharmacological class
Cardioselective Beta-blocker
Pharmacology
Bisoprolol is a cardioselective beta-blocker that selectively blocks β1-adrenergic receptors. It slows the heart rate, reduces myocardial contractility, and dilates blood vessels, leading to reduced blood pressure and decreased myocardial oxygen demand. At high doses, it may also affect β2-receptors.
Mechanism of action
Bisoprolol selectively and competitively blocks β1-receptors, reducing heart rate and myocardial contractility, which lowers blood pressure and decreases cardiac workload. It reduces myocardial oxygen demand, relieving angina, and improves cardiac function in heart failure.
Dosage
Hypertension:
Initial dose: 5 mg once daily (2.5 mg in some patients). May be increased to 10 mg and up to 20 mg once daily if needed.
Heart Failure:
Week 1: 1.25 mg once daily (morning)
Week 2: 2.5 mg once daily
Week 3: 3.75 mg once daily
Weeks 4-7: 5 mg once daily
Weeks 8-11: 7.5 mg once daily
Thereafter: 10 mg once daily (maximum)
Renal impairment (CrCl <40 mL/min): 2.5 mg/day
Severe hepatic impairment: 2.5 mg/day (max 10 mg/day)
Elderly: Hypertension 2.5-20 mg/day; Heart failure 1.25 mg/day (max 10 mg/day)
Administration
Take in the dose and duration as advised by your doctor. Swallow the tablet whole. Do not chew, crush or break it. May be taken with or without food, preferably at a fixed time every day.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose. Do not stop the medication suddenly.
Side effects
Common side effects:
Nausea, headache, fatigue, constipation, diarrhea, dizziness, cold extremities, slow heart rate.
Other:
Shortness of breath, low blood pressure, insomnia, depression, abdominal pain.
These side effects are usually mild and short-lived.
Precautions & warnings
- May cause dizziness; get up slowly from a sitting or lying position.
- Diabetic patients should monitor blood glucose regularly (may mask symptoms of low blood sugar).
- Do not stop suddenly (may cause sudden rise in blood pressure, increasing risk of heart attack and stroke).
- May affect ability to drive; be cautious.
- Avoid alcohol consumption (may increase drowsiness).
- Regular blood pressure monitoring is recommended.
- Use with caution in patients with liver and kidney disease.
Contraindications
- Cardiogenic shock
- Overt cardiac failure (obstructive)
- Second or third degree AV block
- Marked sinus bradycardia
- Hypersensitivity
Drug interactions
- Class I antiarrhythmic drugs (quinidine, disopyramide, propafenone) may potentiate AV conduction time and increase negative inotropic effect.
- Catecholamine-depleting drugs (reserpine, guanethidine) may produce excessive sympathetic activity.
- May exacerbate rebound hypertension upon discontinuation of clonidine.
- Increased risk of bradycardia with digitalis glycosides.
- Reduced hypotensive effect with NSAIDs.
Food interactions
Excessive drowsiness may occur with alcohol. Avoid alcohol consumption.
Use in pregnancy
Information regarding the use of Bisoprolol during pregnancy is not available. Please consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Probably unsafe during breastfeeding. Limited human data suggests the drug may pass into breast milk and harm the baby. Please consult your doctor.
Pediatric use
Safety and effectiveness in pediatric patients have not been established.
Geriatric use
Renal / hepatic impairment
Hepatic impairment: Use with caution in liver disease. Severe hepatic impairment: Initial dose 2.5 mg/day (max 10 mg/day). Titrate slowly with careful monitoring.
Overdose effects
Overdose may cause severe bradycardia, hypotension, dyspnea, and heart failure. Seek immediate medical attention if overdose is suspected.
Storage conditions
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Chemical structure
Bisoprolol (Cardioselective Beta-blocker)