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Bisoprolol: Side Effects and Usage of this Beta-Blocker

In this article, we answer some of the most frequently asked questions about bisoprolol, its usage, and side effects.

Bisoprolol belongs to the group of medications called beta-blockers. Beta-blockers help reduce blood pressure by preventing certain hormones from binding to beta receptors. This in turn reduces the number of heartbeats per minute and the heart’s oxygen requirement, thereby increasing the heart’s efficiency. Beta-blockers also relieve the heart muscles and are therefore mainly used to combat coronary heart disease or high blood pressure. You can read more about heart conditions over on our blog: Cardiac Dysrhythmia: Signs, Symptoms, and Treatment and How Exercise Can Lower Your Cholesterol & Keep Your Heart Healthy. Here we answer the 14 most commonly asked questions about bisoprolol.

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.

What is bisoprolol?

Bisoprolol is a beta-1 receptor blocker. This means that it prevents hormones such as adrenaline and norepinephrine from binding to beta-1 receptors, thereby reducing blood pressure. Furthermore, bisoprolol reduces the number of heartbeats per minute as well as the heart’s oxygen requirement which in turn increases the heart’s efficiency.

As such, bisoprolol is mainly used to treat coronary heart diseases such as angina and chronic heart failure, and/or to treat hypertension by relieving the heart muscles.

In which forms is bisoprolol available?

Bisoprolol most commonly comes in the form of tablets, available in doses of 1.25mg, 2.5 mg, 3.75mg, 5mg, 7.5 mg, or 10mg. The packs usually contain 20, 30, 50, or 100 tablets. It is marketed under the brand name Zebeta in the United States but is also available in generic form. Both generic bisoprolol and generic Zebeta are only available with a prescription.

What do I need to consider before taking bisoprolol?

Before you begin taking bisoprolol you should speak with your doctor about the risks and side effects in order to ensure that bisoprolol is the best choice for you.

If you are already experiencing any of the following symptoms or conditions before taking bisoprolol, you should speak with your doctor about finding an alternative medicine that’s more suitable for you.

Bisoprolol may not be suitable for you if you suffer from any of the following symptoms:

  • Allergies to beta blockers
  • Hypersensitivity or allergies to the active ingredient
  • Acute heart failure
  • Low blood pressure
  • Untreated pheochromocytoma
  • Sick sinus syndrome (arrhythmia)
  • Raynaud’s syndrome, peripheral arterial disease
  • Asthma or COPD
  • Ongoing desensitization due to increased sensitivity to allergens
  • Metabolic acidosis
  • Hypothyroidism
  • Lactose intolerance
  • Psoriasis, only after careful consideration of the risks and benefits
  • Type 2 diabetes mellitus with strongly fluctuating values; Bisoprolol can disguise hypoglycemia
  • Type 1 diabetes mellitus- no success with therapy

The use of bisoprolol can lead to positive results in doping controls. If you are having a scheduled surgical procedure, be sure your healthcare provider knows you are taking bisoprolol. You may or may not need to stop you bisoprolol according to your provider’s instructions.

You should also talk to your doctor before taking bisoprolol about any additional medications you are taking or have taken until recently, as bisoprolol can interact with several medications. See below.

Does bisoprolol interact with other drugs?

Bisoprolol has been known to interact with several other medications. For this reason, it is essential that you inform your doctor of all the medications that you are taking or have taken until recently before starting the therapy. Your doctor can then advise you on the best course of action, whether that be going ahead with bisoprolol therapy, or prescribing a suitable alternative.

If you are already taking medication from one of the following groups, your healthcare provider may recommend switching to a medication that doesn’t interact with bisoprolol or taking a different blood pressure or coronary heart disease medication:

  • Monoamine oxidase inhibitors (MAOIs) (e.g. specific medication prescribed for depression)
  • Mefloquine (used to treat malaria)
  • Ergotamine derivatives, cholinergic
  • Rifampicin, also known as rifampin
  • Calcium channel blockers (antihypertensives), such as verapamil or diltiazem
  • Other beta-blockers (e.g. those which are found in eye drops) See Your Most Common Questions About Beta-Blockers Answered
  • Insulin and oral hypoglycaemic agents
  • Certain painkillers and anti-inflammatory medicines such as ibuprofen and COX2-Inhibitor
  • Amiodarone, dronedarone, fingolimod, flecainide, propafenone (Rythmol), crizotinib, pasireotide (Signifor)

Your doctor or pharmacist can inform you about any other medications that bisoprolol may interact with.

How do I take bisoprolol?

Bisoprolol should be taken in the morning, either on its own or with breakfast and a glass of water. The tablets can easily be broken into two halves, making them adaptable to each individual’s dosage.

In general, a total daily dose of 5-10mg is recommended for adults. Under medical instruction, the maximum dose can be increased to 20mg per day. Given that the recommended dosage of bisoprolol varies from person to person and depends on certain factors, you must allow your doctor to determine what your dose should be before you begin taking the medication.

Should I make up for a missed dose of bisoprolol?

If you forget to take bisoprolol on one occasion, you should not take a double dose to compensate for this. Instead, simply take the dose set by your doctor at the next scheduled time.

How long can I take bisoprolol for?

The duration of your bisoprolol usage depends on the type of problem you have and is accordingly also determined by your doctor depending on your condition. However, generally there is nothing to prevent long-term use of the drug.

How do I come off bisoprolol?

You should not stop taking bisoprolol before first discussing this with your doctor; abrupt withdrawal from the medicine can lead to an acute deterioration in your general state of health. In principle, there is no time limit to the use of the drug since it can be used long-term.

If you want to stop taking bisoprolol, discuss with your doctor how you can slowly withdraw from the medicine.

What side effects can bisoprolol have?

Taking bisoprolol can cause several side effects. The most common are listed below:

  • Nausea, vomiting, constipation, diarrhea, abdominal cramps
  • Headache, dizziness, fatigue
  • Insomnia, depression
  • Low blood pressure, bradycardia
  • Muscle weakness, muscle cramps, general weakness
  • Shortness of breath, especially in those with lung conditions such as asthma
  • Cold feeling in the arms and legs
  • Hair loss
  • Psoriasis
  • Further side effects with less frequent occurrence

If you experience side effects when first starting bisoprolol, know that with consistent use, many of them will go away after 2-4 weeks. If you experience severe side effects, contact your doctor who may prescribe you an alternative beta-blocker that is more suitable for you.

What should I do if I overdose on bisoprolol?

If you think that you have taken an overdose of bisoprolol, contact your doctor. They will be able to properly assess the situation and, if necessary, take appropriate countermeasures.

In case of an overdose of bisoprolol, the treatment must be stopped at short notice. It is possible to experience a variety of overdose symptoms such as vomiting, breathing difficulties, a drop in blood pressure, weakened heart muscles and cardiac arrest.

An overdose of bisoprolol is therefore very serious and a doctor must be contacted immediately, should this occur.

Can I take bisoprolol whilst pregnant or breastfeeding?

If you are breastfeeding or pregnant, think that you are pregnant, or are trying to get pregnant, you should speak with your doctor before beginning to take bisoprolol.

The effects of taking bisoprolol whilst breastfeeding are not fully known. As a general rule, bisoprolol is not recommended during pregnancy or whilst breastfeeding, unless your doctor has previously weighed up the possible risks to you and your child.

Special beta 1 selective beta-blockers are available for use during pregnancy.

Can I drive whilst taking bisoprolol?

In an examination of patients with coronary heart disease, it was found that the ability to drive was not impaired by bisoprolol. Nevertheless, due to individual side effects and different reactions to the drug, driving ability can be restricted. As such, frequent driving should be avoided, particularly when you first begin taking the drug.

However, if you do not experience any side effects or impairments after the start of the treatment and the treatment is well-adjusted, there is nothing to prevent you from resuming your normal driving activities.

Can I drink alcohol whilst taking bisoprolol?

It is generally recommended to refrain from drinking alcohol while taking any sort of medication. As regards bisoprolol, alcohol can influence the effect of the drug in an unpredictable way or increase the mode of action. Alcohol consumption in combination with bisoprolol is therefore not recommended.

If you have further questions about drinking alcohol whilst taking medication, contact your doctor. As the person most familiar with your condition, they will be able to give you the best advice for your situation.

Can I give bisoprolol to my child?

Due to the lack of therapeutic experience of bisoprolol in children under 18 years of age, it is not recommended for children and adolescents under 18 years of age.

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.