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Updated 11 February 2013

Bisoprolol

Bisoprolol is indicated for the treatment of high blood pressure, fast or irregular heart rhythms and to prevent chest pain (angina pectoris).

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Bisoprolol is the active ingredient of Concor, Cardicor, Bisohexal, Bilocor and Adco-Bisocor.

Bisoprolol is also one of multiple active ingredients found in Ziak (bisoprolol + hydrochlorothiazide).

General information

Bisoprolol is indicated for the treatment of high blood pressure, fast or irregular heart rhythms and to prevent chest pain (angina pectoris). It does not cure any of these conditions, but keeps them under control, and is therefore prescribed to be taken long term.

For bisoprolol to be effective it has to be taken regularly, even if you do not notice an immediate effect. Blood pressure declines gradually and it may take a few weeks before you get the full benefit.

Bisoprolol may provoke breathing difficulties due to its effect on receptors in the lungs. If you suffer from asthma or other respiratory conditions, bisoprolol should be taken with caution. You may also find strenuous activities more difficult, partly because of the drug's effect on the lungs, and partly because it reduces heart rate.

Beta blocking drugs may also reduce blood supply to the limbs and extremities, and may therefore cause cold hand and feet. For the same reason, some men may also experience temporary impotence when taking bisoprolol.

Bisoprolol can be used on its own, or in combination with other medications for high blood pressure such as diuretics, etc.

How does bisoprolol work?

Bisoprolol reduces the stimulating effect of noradrenalin. As a result is lowers the force and speed at which the heart is beating. This assists in stabilising fast and abnormal heart rhythms, reduces blood pressure and decreases the heart's oxygen requirement, which prevents angina.

Fast facts

Drug schedule: Schedule 3

Available as: Tablets

What does it do? Bisoprolol lowers blood pressure and reduce the heart's workload

Overdose risk: Medium

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Within 4 hours.

Duration of action: Up to 24 hours.

Dietary advice: Bisoprolol can be taken with or without food.

Stopping this medicine: Bisoprolol should never be stopped suddenly after prolonged use. This may markedly increase blood pressure, cause chest pain and may cause fast or irregular heart rhythms. A heart attack may even be provoked. When treatment with this medication needs to be stopped, the dosage should be gradually reduced under medical supervision.

Prolonged use: No problems expected. Your doctor may request periodic tests if you use this medication for extended periods of time.

Special precautions

Alert your doctor before using this drug if:

  • you suffer from asthma or any other respiratory condition,
  • you have or have had severe congestive heart failure in the past,
  • you have known liver or kidney disease,
  • you have diabetes. Bisoprolol may mask some of the warning signs of low blood sugar such as a fast heart rate,
  • you have an overactive thyroid .Bisoprolol may mask symptoms of this condition,
  • you have a medical emergency, or
  • before you have any surgery.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: This medication is safe to use.

Infants and children : Safety and efficacy of this medication has not been established for children

Elderly: Caution is advised in the elderly, as adverse effects may be more likely. A reduced dose may be needed.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol : Avoid concomitant use of alcohol with this medication as it may cause a dangerous drop in blood pressure.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Diarrhoea

x

x

Dizziness/ tiredness/ weakness

x

x

Headache

x

x

Nausea/indigestion

x

x

Rash/itching

x

x

Chest pain or tightness

x

x

Difficulty breathing/ shortness of breath

x

x

Swelling of ankles

x

x

Interactions

Non-steroidal anti-inflammatory drugs (NSAID's) like ibuprofen

May reduce the drug's antihypertensive effect

Certain blood pressure medications, eg reserpine

Severe low blood pressure or slow heart rate may occur

Certain drugs for malaria/malaria prevention

Risk of serious heart problems may be increased

Cimetidine

Increase potential for bisoprolol toxicity

Certain over-the-counter cold and flu remedies

Risk of severe high blood pressure

Corticosteroids

May decrease bisoprolol 's effectiveness

Clonidine

Severe high blood pressure may occur

Rifampicin

Reduced efficacy of bisoprolol

Overdose action

An overdose can be fatal. Seek immediate emergency medical attention. Symptoms of overdose may include swelling of the legs, feet and ankles; shortness of breath; difficult breathing and a slow heartbeat.

Recommended dosage

Adults: 5-10mg once daily

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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