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Bisoprolol, Oral Tablet

Highlights for bisoprolol

  1. Bisoprolol oral tablet is only available as a generic drug. It’s no longer available as the brand-name drug Zebeta.
  2. Bisoprolol only comes as a tablet you take by mouth.
  3. This drug is used to treat high blood pressure. It can be used alone or in combination with other blood pressure medications.
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Important warnings

Important warnings

  • 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 or blood pressure, worsened chest pain, and heart attack. If you’re stopping this drug, your doctor will slowly lower your dosage 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 your treatment with bisoprolol. If you have heart failure that’s treated with other medications, you may still be able to take bisoprolol.

About

What is bisoprolol?

Bisoprolol oral tablet is a prescription drug that’s only available in a generic form. Generic drugs usually cost less than the brand-name version. Bisoprolol is no longer available as the brand-name drug Zebeta.

Bisoprolol only comes as an oral tablet.

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.

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

How it works

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

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Side effects

Bisoprolol side effects

Bisoprolol oral tablet can cause several types of side effects, including drowsiness. Don’t drive, use machinery, or perform any activities that require alertness until you know how it affects you.

More common side effects

The more common side effects of bisoprolol oral tablet include:

  • slower heart rate
  • diarrhea
  • weakness
  • tiredness
  • dizziness
  • anxiety
  • changes in sex drive or performance
  • nausea
  • dry or burning eyes
  • headache
  • cold or flu symptoms
  • swelling in any part of your body

If these effects are mild, they 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.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • 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

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.

Interactions

Bisoprolol may interact with other medications

Bisoprolol oral tablet 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.

Examples of drugs that can cause interactions with bisoprolol are listed below.

Heart rhythm drugs

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

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

Beta-blockers

Bisoprolol should not be used with another beta-blocker because your heart rate can be lowered too much. Examples of these drugs include:

  • acebutolol
  • atenolol
  • carvedilol
  • metoprolol
  • propranolol

Calcium channel blockers

  • Dihydropyridine calcium channel blockers: Using these drugs with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This raises your risk of falls. Examples of these drugs include:
    • amlodipine
    • felodipine
    • nifedipine
  • Non-dihydropyridine calcium channel blockers: Using verapamil with bisoprolol can cause severe heart block, low heart rate, changes in how your heart works, heart failure, and low blood pressure. If you have poor function of your heart ventricles, you should not use these drugs together.
  • Bisoprolol and diltiazem have similar action on the heart. Using one of these drugs with bisoprolol can cause heart failure, a heart rate that’s lower than normal, 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 and guanethidine: Using these drugs with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This can increase your risk of falls.

Anti-infective drug

Using rifampin with bisoprolol can speed up the rate at which bisoprolol leaves your body. This can prevent bisoprolol from working as well as it should.

Alpha-blockers

Using these drugs with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This raises your risk of falls. Examples of these drugs include:

  • doxazosin
  • prazosin
  • terazosin

Anesthetic

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 drugs together.

Malaria drug

Using mefloquine with bisoprolol can cause heart rhythm abnormalities and your heart may stop working.

Stimulants

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

  • norepinephrine
  • phenylephrine

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

Don’t take these drugs without talking to your doctor or pharmacist. Some over-the-counter drugs contain ingredients that can increase your blood pressure. Other drugs may cancel out the action of bisoprolol. Examples of these drugs include:

  • products containing phenylephrine, such as:
    • Sudafed PE
    • Mucinex Sinus-Max
    • Advil Congestion Relief
    • Tylenol Cold Multi-Symptom
  • products containing pseudoephedrine, such as:
    • Sudafed Congestion
    • Sudafed 12 Hour
    • Sudafed 24 Hours

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs may decrease the blood pressure-lowering effects of bisoprolol. If you take them with bisoprolol, your doctor will likely monitor your blood pressure and change your bisoprolol dosage if needed. Examples of these drugs include:

  • indomethacin
  • naproxen
  • piroxicam
  • sulindac
  • nabumetone

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.

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Other warnings

Bisoprolol warnings

This drug comes with several warnings.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

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

Call 911 or go to the nearest emergency room if you develop these symptoms. Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction

Alcohol lowers your blood pressure. Drinking alcohol while taking bisoprolol may lower your blood pressure to dangerously low levels.

Warnings for people with certain health conditions

For 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 slow heart rate (bradycardia). If you have one of these conditions, your heart is already having trouble 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 medication (compensated heart failure), this drug could worsen your heart failure.

For people with peripheral vascular disease: This drug could worsen the symptoms of your condition.

For 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 medications that treat high blood pressure. Your doctor will give you the lowest possible dosage of bisoprolol. You should have a beta-agonist inhaler, such as albuterol, available.

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

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

For people with a cough, cold, allergies, or pain: Talk to your doctor or pharmacist. They can help you find medication that you can use safely when you’re taking bisoprolol.

Warnings for other groups

For 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.

Call your doctor right away if you become pregnant while taking this drug.

For women who are breastfeeding: It isn’t known if bisoprolol passes into breast milk. If it does, it may cause serious effects in a breastfeeding child. You and your doctor should decide if you’ll take bisoprolol or breastfeed.

For children: It has not been established that bisoprolol is safe and effective for use in people under the age of 18 years.

For people having surgery: 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.

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Dosage

How to take bisoprolol

This dosage information is for bisoprolol 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

Forms and strengths

Generic: Bisoprolol

  • Form: oral tablet
  • Strengths: 5 mg and 10 mg

Dosage for high blood pressure (hypertension)

Adult dosage (ages 18–64 years)

  • The usual starting dosage is 5 mg taken once per day.
  • If you don’t respond to that dosage, your doctor may increase your dose to 10 mg taken once per day.
  • The maximum dosage is 20 mg per day.

Child dosage (ages 0–17 years)

A safe and effective dosage 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 dosage.

Special considerations

  • For people with asthma or respiratory disease: Your doctor will likely start you on 2.5 mg of bisoprolol per day and increase your dosage slowly. If your dosage is too high, bisoprolol can act on your lungs in addition to your heart.
  • For people with kidney problems: Your doctor may start you on 2.5 mg of bisoprolol per day. Your doctor will take care when increasing your dosage.
  • For people with liver problems: Your doctor may start you on 2.5 mg of bisoprolol per day. Your doctor will take care when increasing your dosage.

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.

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Take as directed

Take as directed

Bisoprolol oral tablet is used for long-term treatment. It 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:

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

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

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.

Important considerations

Important considerations for taking bisoprolol

Keep these considerations in mind if your doctor prescribes bisoprolol oral tablet for you.

General

  • You don’t need to take bisoprolol with food.
  • You can cut or crush the bisoprolol tablet.

Storage

  • Store at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is not refillable. If you need this medication refilled, you or your pharmacy will have to contact your doctor for a new prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

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

  • your blood pressure
  • your heart rate
  • your weight

Your doctor may periodically check your:

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

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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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