Bisoprolol

Bisoprolol is a type of antihypertensive drug called a beta-adrenergic receptor blocking agent (beta-blocker) used to treat hypertension (high blood pressure).

Bisoprolol is available under the following different brand names: Monocor, and Zebeta.

Dosages of Bisoprolol:

Dosage Forms and Strengths

Tablets

• 5 mg
• 10 mg

Dosage Considerations – Should be Given as Follows:

Pediatric:

• Safety and efficacy not established

Hypertension

• 2.5-5 mg orally once/day; may increase to 10 mg and if necessary to 20 mg orally once/day

Heart Failure

• 1.25 mg orally once/day; increase gradually if necessary not to exceed 10 mg/day

Renal Impairment

• Greater than 40 mL/min: Dose adjustment not necessary
• Less than 40 mL/min: 2.5 mg/day initially; titrate slowly and monitor

Common side effects of bisoprolol include:

Serious side effects of bisoprolol include:

• Dizziness
• Insomnia
• Slow, irregular heartbeats
• Upper respiratory infection
• Diarrhea
• Runny or stuffy nose
• Joint pain
• Cough
• Shortness of breath
• Nausea
• Sore throat
• Sinus infection (sinusitis)
• Vomiting
• Tiredness
• Drowsiness
• Lightheadedness upon standing
• Spinning sensation (vertigo)
• Dry mouth
• Stomach pain
• Constipation
• Increased urination
• Ringing in your ears
• Weakness
• Sleep problems (insomnia)
• Anxiety
• Restless feeling
• Muscle pain
• Itching or skin rash
• Loss of interest in sex

Less common side effects of bisoprolol include:

• Cold extremities
• Low blood pressure (hypotension)
• Depression
• Indigestion
• Bronchospasm

Rare but serious side effects of bisoprolol include:

• Very slow heartbeat
• Severe dizziness
• Fainting
• Blue fingers/toes
• Trouble breathing
• Mental/mood changes (such as confusion, mood swings, depression)

Other side effects of bisoprolol include:

• Aggravate congestive heart failure (CHF)
• Decrease HDL
• Hypertriglyceridemia
• Mask symptoms of low blood sugar (hypoglycemia)
• Decreased exercise tolerance
• Raynaud's phenomenon
• May increase triglyceride levels and insulin resistance

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Bisoprolol has no known severe interactions with other drugs.

Serious interactions of bisoprolol include:

• acebutolol
• atenolol
• betaxolol
• carvedilol
• celiprolol
• clonidine
• digoxin
• diltiazem
• esmolol
• labetalol
• metoprolol
• nadolol
• nebivolol
• penbutolol
• pindolol
• propranolol
• rivastigmine
• sotalol
• timolol
• verapamil

Bisoprolol has moderate interactions with at least 173 different drugs.

Bisoprolol has mild interactions with at least 32 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

This medication contains bisoprolol. Do not take Monocor or Zebeta if you are allergic to bisoprolol or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without a permanent pacemaker

Effects of Drug Abuse

• Avoid chronic use; may cause laxative dependence

Short-Term Effects

• See "What Are Side Effects Associated with Using Bisoprolol?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Bisoprolol?"

Cautions

• Use caution in anesthesia/surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, congestive heart failure (CHF), cardiomegaly, diabetes mellitus, hyperthyroidism/thyrotoxicosis, myasthenia gravis, liver disease, renal impairment, peripheral vascular disease, use in pheochromocytoma, insulin-dependent diabetes mellitus (IDDM), history of psychiatric disease, pre-existing sick sinus syndrome or similar cardiac conditions.
• Chronically administered beta-blocking therapy should not be routinely withdrawn before major surgery; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.
• Exacerbation of psoriasis reported with use.
• Less effective than thiazide diuretics in black and geriatric patients.
• Shown to decrease mortality in hypertension and post-heart attack (myocardial infarction).

Pregnancy and Lactation

• Use bisoprolol with caution during pregnancy if the benefits outweigh the risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.