Bisoprolol

Betablocking Agent · Beta-blocker

Indications

Angina. Hypertension.

Dosage

Angina/Hypertension: Adults: Usually 10 mg once daily; max 20 mg daily. Children: Not recommended.

Adverse Effects

Cardiovascular effects including bradycardia, postural hypotension. Rarely, heart failure, increased AV block, cardiac arrhythmias. Raynaud's phenomenon, cold extremities, sexual dysfunction. GI, sleep and CNS disturbances. Dyspnoea rarely, bronchospasm. Skin reactions, withdraw if unexplained dry eyes or rash. Fatigue, paraesthesia, peripheral neuropathy, arthralgia, myopathy, altered blood sugar, haematology and lipid levels.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: 2nd or 3rd degree AV block (without pacemaker), severe bradycardia, sick sinus syndrome, uncontrolled heart failure, cardiogenic shock, severe peripheral arterial disease, hypotension, metabolic acidosis, untreated pheochromocytoma, severe asthma or COPD. Precautions: 1st degree AV block. Heart failure (avoid if uncontrolled). Peripheral arterial circulatory disorders (avoid if severe), Prinzmetal's angina, Myasthaenia gravis. Ischaemic heart disease, withdraw gradually. History of bronchospasm. Diabetes, hyperthyroidism, renal or hepatic impairment, psoriasis. Elderly. Consider withdrawal before elective surgery. Anaphylaxis risk due to increased sensitivity to allergens. Always withdraw gradually over period of 1-2 weeks.

Interactions

Ca++ antagonists. Antihypertensives including centrally acting agent (e.g. clonidine), antiarrhythmics, antipsychotics. TCADs, MAOIs, fluvoxamine, barbiturates, cardiac glycosides, sympathomimetics, cimetidine, hydralazine, rifampicin, insulin/oral hypoglycaemics, NSAIDs, ergot derivatives, erythromycin, anaesthetics, diuretics.

Advice to Patient

Take with or without meals. Do not take with antacids. Contact prescriber if there is unrelieved swelling of extremities, difficulty in respiration, fatigue, unusual weight gain, unrelieved constipation or muscle weakness. Check blood pressure and pulse regularly before taking medication. If you have diabetes, regularly check blood glucose level. Change position slowly.

Pharmacokinetics

Onset of action: 1-2 hrs. Absorption: Rapid and almost complete. Metabolism: Extensively hepatic; significant first-pass effect (approx. 20%). Bioavailability: Approx. 80%. Half-life elimination: Normal renal function: 9-12 hrs. CrCl <40mL/min: 27-36 hrs. Hepatic cirrhosis: 8-22 hrs. Time to peak: 2-4 hrs. Excretion: Urine (>50%). Faeces (<2%).

Brands with this active ingredient

• Actim
• Atbeta
• Barilol
• Bis-apt
• Biscot
• Bisolol
• Bison
• Bisoprolol
• Bispa
• Bisprol
• Blicor
• Boscor
• Byso
• Concor
• Corbis

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.