Bisoprolol

What is bisoprolol?

Bisoprolol is usually used with other medicines to treat heart failure, high blood pressure (hypertension) or to prevent chest pain (angina). It belongs to a group of medicines called beta-blockers. Beta-blockers work by blocking some natural chemicals in the body, to slow the heart rate and lower blood pressure. Read more about heart failure, high blood pressure and chest pain. In New Zealand bisoprolol comes as tablets. 

Dose

• The usual dose of bisoprolol is 10 milligrams once a day. 
• If you are taking bisoprolol for heart failure, your doctor will usually start you on a low dose and increase this over a few weeks. This allows your body to get used to the medicine and reduces side effects. 
• For example: you will be started on 1.25 mg once daily for 1 week, then 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.
• Bisoprolol comes in different strengths of tablets: 2.5 mg, 5 mg, and 10 mg. Check to make sure you receive the strength you are expecting.
• Always take your bisoprolol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much bisoprolol to take, how often to take it, and any special instructions.

My dose is:

How to take bisoprolol

• Take bisoprolol once a day, in the morning.
• Swallow your tablet with a glass of water.
• You can take bisoprolol either with or without food.
• Limit or avoid drinking alcohol while you are taking bisoprolol. 
• If you forget your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
• Do not stop taking bisoprolol suddenly; speak to your doctor or nurse before stopping.

Precautions – before taking bisoprolol

• Do you have asthma?
• Do you have diabetes?
• Do you have problems with your kidneys?
• Do you play a professional sport?
• Are you pregnant or breastfeeding?
• Have you ever had an allergic reaction to a medicine?
• Are you are taking or using any other medicines? This includes any medicines you are using which are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking bisoprolol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Like all medicines, bisoprolol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Diabetes

If you have diabetes you need to take extra care to measure your blood glucose levels regularly.

• Beta-blockers can cause an increase in blood glucose levels, especially when you first start taking them. This effect usually settles with time.
• Beta-blockers may reduce the warning signs of a low blood sugar level (hypoglycaemia – often called a hypo). For example, you may not have the feeling of fast, irregular or strong heartbeats (palpitations) or tremor, which can occur when your blood glucose is going too low. If you are worried about this, talk to your doctor. Do not stop taking your beta-blocker without checking with your doctor first. Read more about hypoglycaemia.

Asthma

If you have asthma, taking a beta blocker may trigger your asthma symptoms or make them worse. Not everybody with asthma is sensitive to these medicines and this is rare with bisoprolol. If you are worried about this, talk to your doctor. They may be able to prescribe a different medicine or increase the dose of your asthma preventer medication. Do not suddenly stop taking your beta-blocker without talking to your doctor first. This can be dangerous and make you feel unwell. Read more about medicines that may trigger asthma symptoms.

Other side effects

Interactions

• Check with a pharmacist before taking over the counter medicines such as:
  • Cold or flu tablets containing phenylephrine (e.g. Sudafed PE), or diphenhydramine (e.g. Benadryl Original)
  • Anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), mefenamic acid (e.g. Ponstan), naproxen (e.g. Naprogesic)
• Bisoprolol may interact with other medications and herbal supplements, so check with your doctor or pharmacist before starting bisoprolol or before starting any new medicines.

Learn more

The following links provide further information on bisoprolol:

Medsafe Consumer Information Sheet: Bosvate 
New Zealand Formulary Patient Information: bisoprolol

References

1. Bisoprolol fumarate New Zealand Formulary