What exactly is the chemical difference between Metoprolol and Bisoprolol?

[DKBX]

Aren’t they both beta blockers, so what makes them different if at all?

[Peony4575]

They are both lipophilic and both cardiac selective , bisoprolol may be more so , otherwise I don’t know. You could download the product summaries off the net and go through them . Sorry can’t be more help

[jeanjeannie50]

I asked my AF nurse this question and she said Metoprolol's effect starts gradually over 12 hours, reaching it's peak of effectiveness after 6 hours and then dying down slowly again, so needs two doses daily. Bisoprolol gives an even dose, think that was over 24hrs.

Jean

[DKBX in reply to jeanjeannie50]

Here in the US (“the colonies”), metoprolol comes as a tartrate (fast acting)or a succinate (slow release). Maybe bisoprolol is the succinate one? Like acetaminophen here is called paracetamol in the UK??

[jeanjeannie50 in reply to DKBX]

I think in the UK we may just have Metoprolol Tartrate, that's what mine is. I'm sure someone will let us know if not. Seems crazy that we have such different names for things when we are all part of the same closely related family.

[DERLIN in reply to jeanjeannie50]

Do you live in the UK? How do you have an AF nurse. Is he/she someone special you can make appointments to see?

[jeanjeannie50 in reply to DERLIN]

Yes, I live in Devon in the U.K. My AF nurse works for the local hospital's cardiology dept., along with two other AF nurses. As I've seen her this year, in the summer, I have another year from then when I can just call her up at any time if I'm worried about my heart rate. She will then give me a quick appointment to have an ECG and see her for the results right after. Because of covid she was doing the ECG's herself when I last went there. These nurses assist in cardioversions too and they've done several for me. My main hospital doesn't perform ablations and I had to travel about 30 miles to another hospital for the three I've had.

Initially I had a referral from my GP to the cardiologists dept at my local hospital and that's how I gained access to the AF nurses.

I have been told by my EP that I would not be suitable to have any more ablations and I don't see him for any checks now.

Jean

[Paulbounce]

Taken from medicines.org.uk

Bisoprolol

...The plasma elimination half-life (10-12 hours) provides 24 hours efficacy following a once daily dosage. Bisoprolol is excreted from the body by two routes, 50 % is metabolised by the liver to inactive metabolites which are then excreted by the kidneys..

Metoprolol

...Generally, 95% of an oral dose is found in the urine. Only 5% of the dose is excreted unmodified via the kidneys; in isolated cases, this figure can reach as high as 30%. The elimination half-life of metoprolol averages 3.5 hours (with extremes of 1 and 9 hours)...

I'm not sure if that really answers your question. For me though the 'half life' of a med is important. It's also worth checking (a blood test should tell) if your kidneys and liver are functioning well. That of course should help decide which is a better bet for you - consulting with your doctor of course.

Sorry I can't help further. It's not easy to do at the moment but maybe a blood test is good idea to check everything. Perhaps you could arrange an appointment with the GP's nurse who will be able to check by taking a blood sample ?

It's something I ought to do. I shouldn't worry to much but worth a thought.

Paul

[Polski]

Where are all the chemists around here? The pharmacist would know, but may not be able to explain easily!

[Tonyseafearer]

I don't know much about the chemical difference between bisoprolol and metoprolol. However, taking B blockers can produce an asthma attack in people that suffer asthma. Bisoprolol is the less like Bblocker to produce an asthma attack as it was created as an alternative to the rest of bblockers for people that suffer with asthma.