Bisoprolol
A once-daily beta blocker that selectively slows the heart and lowers its workload, used for heart failure, angina, high blood pressure and to control the rate in atrial fibrillation.
- Generic name
- Bisoprolol
- Active ingredient
- Bisoprolol (variants: bisoprolol fumarate)
- Product type
- Small-molecule medicine
- Drug class
- Beta blockers
- Brand names
- UK Cardicor, Congescor · US Zebeta
- Routes
- Oral (Oral (tablets))
- Dosage forms
- Tablet
- Forms
- Tablets 1.25 to 10 mg once daily, started low and increased slowly in heart failure
- Onset and duration
- Heart rate and blood pressure fall within hours; the benefit in heart failure builds over months. Not stopped suddenly: the dose is reduced gradually.
- Terminology
- RxNorm RxCUI 19484 · ATC C07AB07 · FDA EPC beta-Adrenergic Blocker [EPC]
- Monitoring
- Heart rate and blood pressure at each dose change; symptoms of heart failure and fluid retention during titration; blood glucose awareness in diabetes.
Availability by country
| Country | Status | Note | Source |
|---|---|---|---|
| UK | Prescription only | UK |
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
- Heart failure with reduced ejection fraction, where it improves survival
- Angina
- High blood pressure, usually when other classes are unsuitable or as an add-on
- Rate control in atrial fibrillation and other fast rhythms
How it works in the body
Bisoprolol blocks beta-1 adrenoceptors on heart muscle and the conducting system, so adrenaline and noradrenaline can no longer speed the heart or make it contract as forcefully. The heart beats more slowly, needs less oxygen and, in heart failure, is protected from the long-term damage of sustained sympathetic drive. It has little effect on the beta-2 receptors of the airways at usual doses, though it is still used with caution in asthma.
Common side effects
- Tiredness, cold hands and feet, a slow pulse
- Headache, dizziness, feeling sick
- Sleep disturbance
Serious: seek help
- Breathlessness or wheeze, particularly in asthma
- Fainting or a very slow heartbeat
- Worsening fluid retention early in heart failure treatment
- Signs of an allergic reaction
Cautions and interactions
- Avoided in asthma unless a specialist judges the benefit greater; used cautiously in COPD
- Not started during decompensated heart failure; introduced once the person is stable
- Combined with verapamil or diltiazem it can slow the heart dangerously
- Masks the warning signs of low blood sugar in diabetes
- Never stopped abruptly: the dose is tapered
Interactions
Check interactions
Taking Bisoprolol with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
No pair records for this medicine are in the sources currently represented by Anatomy Nexus. Absence from this list does not mean no interaction exists.
Same-class and related medicines
Same class: Beta blockers
Medicines that share the class of Bisoprolol. They are separate medicines with their own licences, doses and interactions, not alternative names for Bisoprolol.
Related medicines
Medicines often discussed alongside Bisoprolol: used together, compared with it, or acting on the same problem by a different route.