Generic Name: bisoprolol, Oral tablet

Zebeta

All Brands

  • Zebeta
SECTION 1 of 5

Highlights for bisoprolol

Oral tablet
1

Bisoprolol is an oral drug used to treat high blood pressure. It can be used alone or in combination with other blood pressure medicines.

2

The standard starting dose is 5 mg per day. If that dose doesn’t lower your blood pressure enough, your dose can be increased to 10 mg per day. The maximum dose per day is 20 mg.

3

Common side effects include slower heart rate, diarrhea, weakness, tiredness, anxiety, changes in sex drive or performance, depression, and nausea.

4

Don’t stop taking this medicine without speaking to your doctor first. Stopping the drug suddenly can cause changes in heart rhythm, blood pressure, worse chest pain, or a heart attack. Your doctor will slowly lower your dose to help prevent these side effects.

5

Don’t take over-the-counter (OTC) cough, cold, allergy, or pain medications without speaking to your doctor or pharmacist first. Some medications have ingredients that can increase your blood pressure.

IMPORTANT INFORMATION

Stopping bisoprolol warning

Bisoprolol lowers your heart rate and blood pressure. Suddenly stopping bisoprolol can worsen your heart condition, especially if you have coronary artery disease. It may also cause changes in heart rhythm, blood pressure, worse chest pain, and heart attack. Your doctor will slowly lower your dose over at least 1 week to help prevent these side effects.

Diabetes warning

Bisoprolol can mask the signs of low blood sugar (hypoglycemia). Use it with caution if you have diabetes, especially if you take insulin or other diabetes drugs that can cause low blood sugar.

Heart failure risk

Bisoprolol decreases some heart actions. This can cause or worsen heart failure. If you develop heart failure, your doctor may slowly stop bisoprolol. If you have heart failure that’s treated with other medicines, you may still be able to take bisoprolol.

Drug Features

Bisoprolol is a prescription drug. It’s available as an oral tablet.

Bisoprolol is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used alone or as part of a combination therapy. That means you may need to take it with other drugs.

Why It's Used

Bisoprolol is used to treat high blood pressure. It can be used alone or in combination with other high blood pressure medicines.

How It Works

Bisoprolol belongs to a class of drugs called beta blockers.

More Details

How It Works

Bisoprolol belongs to a class of drugs called beta blockers. It works by decreasing how hard your heart works and slows how fast it beats. This helps to treat high blood pressure and heart rate problems.

In our body, we have beta receptors in the heart and in the lungs. Some beta blockers are “cardioselective,” which means they mostly act on the beta receptors in the heart. When beta blockers act on the beta-receptors in the heart, they decrease the force of contraction of the heart and slow how fast the heart beats.

Bisoprolol works primarily on the heart, especially at lower doses. In doses of 20 mg or more, bisoprolol becomes less heart selective and can cause spasms or tightening of the airways in your lungs.

SECTION 2 of 5

bisoprolol Side Effects

Oral tablet

Most Common Side Effects

The most common side effects of bisoprolol include:

  • slower heart rate

  • diarrhea

  • weakness

  • tiredness

  • anxiety

  • changes in sex drive or performance

  • depression

  • nausea

  • dry or burning eyes

  • headache

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • allergic reactions. Symptoms may include:

    • skin rash
    • itching
    • hives
    • swelling of your face, lips, or tongue
  • changes to your heart rate. Symptoms may include:

    • irregular or slow heart rate
    • feeling dizzy
    • fainting
  • heart problems. Symptoms may include:

    • breathing problems
    • swollen legs or ankles
    • chest pain
  • cold, tingling, or numbness in your hands or feet

  • confusion

  • muscle aches and pains

  • sweating

  • tremors

  • vomiting

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Bisoprolol can cause drowsiness. Don’t drive, operate machinery, or perform any activities that require alertness until you know how it affects you.

This medication also has predictable side effects after you take it. It may make your heart rate slower than normal.

Mild side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

bisoprolol May Interact with Other Medications

Oral tablet

Bisoprolol can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol Interaction

Alcohol lowers your blood pressure. Combining alcohol and bisoprolol may lower your blood pressure to dangerously low levels.

Medications That Might Interact with This Drug

Heart drugs

Heart rhythm drugs:

  • sotalol
  • amiodarone
  • bretylium
  • quinidine
  • disopyramide
  • encainide
  • moricizine
  • flecainide
  • propafenone
  • procainamide
  • digoxin

These heart rhythm drugs may cause a lower heart rate or more side effects. If you take these medicines with bisoprolol, you’ll be monitored closely. Your doctor might change the dose of your heart rhythm drugs.

Beta-blockers:, including

  • acebutolol (Sectral)
  • atenolol (Tenormin)
  • carvedilol (Coreg, Coreg CR)
  • metoprolol (Lopressor, Toprol XL)
  • propranolol (Inderal)

Bisoprolol should not be used with another beta blocker because your heart rate can be lowered too much.

Calcium channel blockers, including:

  • dihydropyridine CCB:
    • amlodipine
    • felodipine
    • nifedipine
  • non-dihydropyridine CCB:
    • verapamil
    • diltiazem
  • diltiazem

Using dihydropyridine calcium channel blockers with bisoprolol may cause a drop in blood pressure when you change position from sitting to standing or from lying down to sitting. This can increase your risk of falls.

Using verapamil with bisoprolol can cause severe heart block, low heart rate, changes in how the heart works, heart failure, and low blood pressure. If you have poor function of your heart ventricles, you should not use these medicines together.

Bisoprolol and diltiazem have similar action on the heart. Using them together can cause heart failure, lower than normal heart rate, low blood pressure, problems with how the heart works, and heart block.

Blood pressure drugs
  • clonidine. If you’re starting bisoprolol and stopping clonidine, your blood pressure can severely increase. If you’re on both medications and are going to stop taking clonidine, your doctor should stop bisoprolol several days before stopping clonidine.
  • reserpine. Using this drug with bisoprolol may cause a drop in blood pressure when you change position from sitting to standing or from lying down to sitting. This can increase your risk of falls.

Alpha-blockers
  • doxazosin
  • prazosin
  • terazosin

Using these medicines with bisoprolol may cause a drop in blood pressure when you change position from sitting to standing or from lying down to sitting. This can increase your risk of falls.

Anesthetic
  • lidocaine

Bisoprolol might affect how lidocaine is cleared from your body. This can cause lidocaine toxicity. Your doctor may check your blood levels if you use these medicines together.

Malaria drug
  • mefloquine

Using these medicines together can cause heart rhythm abnormalities and your heart may stop working.

Stimulants

Examples are:

  • norepinephrine
  • phenylephrine

Don’t use these medicines with bisoprolol. If you take them together, they will cancel out the action of each other and won’t work.

Over-the-counter cough, cold, allergy, and pain drugs

Examples are:

  • products containing phenylephrine. Examples are:
    • Sudafed PE
    • Mucinex Sinus-Max
    • Advil Congestion Relief
    • Tylenol Cold Multi-Symptom
  • products containing pseudoephedrine. Examples are:
    • Sudafed Congestion
    • Sudafed 12 Hour
    • Sudafed 24 Hours

Don’t take these drugs without speaking to your doctor or pharmacist. Some OTC medicines have ingredients that can increase your blood pressure. Other medicines may cancel out the action of bisoprolol.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Examples are:

  • indomethacin
  • naproxen
  • piroxicam
  • sulindac
  • nabumetone

These medicines may decrease the blood pressure lowering effects of bisoprolol. Your doctor will monitor your blood pressure and change your bisoprolol dose if needed.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with heart problems

Don’t take this drug if you have problems with pumping blood to your body, active heart failure, second or third degree heart block, or slower than normal heart rate (bradycardia). If you have one of these conditions, your heart is already having a hard time working properly. Taking bisoprolol could make your condition worse by making it harder for your heart to pump blood effectively.

If you have heart failure that’s being treated with medicine (compensated heart failure), be careful when taking bisoprolol. This drug may make your heart failure worse.

People with peripheral vascular disease

Use caution if you have peripheral vascular disease and take bisoprolol. This drug can make your symptoms worse.

People with lung diseases

In general, you shouldn’t take bisoprolol if you have asthma or other breathing problems. However, your doctor may allow you to take it if you can’t tolerate other medicines to treat high blood pressure. Your doctor will give you the lowest possible dose of bisoprolol. You should have a beta-agonist inhaler, like albuterol, available.

People with diabetes

Bisoprolol can mask the symptoms of low blood sugar (hypoglycemia). Bisoprolol may also slow how long it takes for blood sugar to rise to normal levels. Bisoprolol should be used with caution if you have diabetes, especially if you’re taking insulin or other medicines for diabetes that cause low blood sugar.

People with hyperactive thyroid

Bisoprolol can mask the symptoms of a hyperactive thyroid (hyperthyroidism). If you suddenly stop taking bisoprolol, your hyperthyroidism symptoms can get worse or you may get a condition called thyroid storm.

Pregnant women

Bisoprolol is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Bisoprolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are nursing

It isn’t known if bisoprolol passes into breast milk. If it does, it may cause serious effects in a nursing child.

You and your doctor should decide if you’ll take bisoprolol or breastfeed.

For Children

The safety and effectiveness of bisoprolol haven’t been established in people under the age of 18 years.

When to call the doctor

Tell your doctor if you have a cough, cold, allergies, or pain. Your doctor or pharmacist will help you find medicine that you can use safely when you’re taking bisoprolol

Tell your doctor if you’re going to have surgery. They’ll need to monitor your heart and blood pressure and watch for drug interactions.

Allergies

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

Symptoms of an allergic reaction include:

  • rash or hives
  • itching
  • blistering or peeling skin
  • fever
  • problems breathing or chest tightness
  • swelling of your mouth, face, lips, tongue or throat
SECTION 4 of 5

How to Take bisoprolol (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

High blood pressure (hypertension)
Form: Oral tablet
Strengths: 5 mg and 10 mg
Adult Dosage (ages 18–64 years)
  • The usual starting dose is 5 mg taken once per day.
  • If you don’t respond to that dose, your doctor may increase your dose to 10 mg taken once per day.
  • The maximum dose is 20 mg per day.
Child Dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for this age group

Senior Dosage (ages 65 years and older)

As you age, your organs (such as kidneys or liver) may not work as well as they once did. This causes more of the drug to stay in your body. Your doctor may start you at a lower dose.

Special Considerations

Asthma or respiratory disease: If you have asthma or other breathing problems, your doctor will start you on 2.5 mg of bisoprolol per day and increase your dose slowly. At high doses, bisoprolol acts on the lungs in addition to the heart.

Kidney problems: If you have kidney problems, your doctor may start you on 2.5 mg of bisoprolol per day. Be careful when increasing your dose.

Liver problems: If you have liver problems, your doctor may start you on 2.5 mg of bisoprolol per day. Be careful when increasing your dose.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Bisoprolol comes with serious risks if you don’t take it as prescribed.

If You Miss a Dose

If you miss a dose, take it as soon as you can. If it’s close to the time of your next dose, only take the coming dose.

Don’t double the dose to try to make up for missed doses.

If You Take Too Much

The most common signs of overdose include:

  • slower than normal heart rate
  • lower than normal blood pressure
  • heart failure
  • lower than normal blood sugar
  • tightening of the airways in your lungs making it harder to breathe (bronchospasm)

If you think you’ve taken too much, go to the emergency room or contact your local poison control center.

How to Tell the Drug Is Working

You may be able to tell this drug is working if your blood pressure and heart rate are lower.

Bisoprolol is used for long-term treatment.

Important Considerations for Taking Bisoprolol

Store at room temperature: 68–77°F (20–25°C)

Keep drugs away from areas where they could get wet, such as bathrooms. Store them away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription label with you when traveling.

Clinical Monitoring

While you’re taking bisoprolol, your doctor will check the following regularly to see how well the medicine is working:

  • blood pressure
  • heart rate
  • weight

Your doctor may periodically check the following:

  • kidney function
  • liver function
  • blood sugar levels
  • cholesterol levels
  • complete blood count

The generic bisoprolol is usually stocked at pharmacies

The brand name, Zebeta, might not be stocked at pharmacies, so call ahead.

Are There Any Alternatives?

There are several other medicines that can be used to treat high blood pressure. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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SECTION 5 of 5

How Much Does bisoprolol Cost?

Oral tablet
We've partnered with GoodRX so you can compare prices and save money on your next prescription. Check out the lowest cash prices below and enter your zip code to find the best deal near you.

Compare prices and save money on your next refill!

Lowest price for bisoprolol

Walgreens $10.00
Sams Club $10.00
CVS Pharmacy $20.85
These represent the lowest cash prices for bisoprolol and may be lower than your insurance.

Find the lowest prices of bisoprolol near you

These represent the lowest cash prices for bisoprolol and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on June 12, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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