Bisoprolol is also used to prevent chest pain caused by angina.
It's also used to treat atrial fibrillation and other conditions that cause an irregular heartbeat.
It works by slowing down your heart rate and making it easier for your heart to pump blood around your body.
Bisoprolol is only available on prescription. It comes as tablets.
Who can take bisoprolol
Most adults aged 18 and over can take bisoprolol.
Bisoprolol is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting to take bisoprolol if you have:
- ever had an allergic reaction to bisoprolol or any other medicine
- low blood pressure (hypotension) or a slow heart rate
- heart failure that's getting worse, heart disease, or you have recently had a heart attack
- severe blood circulation problems in your limbs (such as Raynaud's), which may make your fingers and toes tingle or turn paler than usual or blue (this may be less obvious on brown or black skin)
- metabolic acidosis – when there's too much acid in your blood
- a lung disease or severe asthma
Your dose of bisoprolol depends on why you need the medicine.
For high blood pressure or angina, you'll usually start on 5mg to 10mg once a day. If this dose is not working well enough to reduce your blood pressure or control your angina, your doctor may increase it to 20mg.
For heart failure, you'll usually start at a low dose of 1.25mg a day and increase gradually up to 10mg a day. The dose is usually increased slowly over a few months.
You'll usually take bisoprolol once a day in the morning.
Your doctor may advise you to take your very first dose before bedtime as it can make you feel dizzy. If you do not feel dizzy after having your first dose, take bisoprolol in the morning.
Bisoprolol does not usually upset your stomach, so you can take it with or without food.
Swallow the tablets with a drink of water. Some brands have a score line to help you break the tablet to make it easier to swallow. Check the information leaflet for your brand to see if you can do this.
How long to take it for
Usually, treatment with bisoprolol is long term, even for the rest of your life.
Talk to your doctor if you want to stop taking it. Stopping can make your blood pressure rise, increasing your risk of heart attack and stroke.
Take bisoprolol even if you feel well, as you'll still be getting the benefits of the medicine.
If you miss a dose of bisoprolol, take it as soon as you remember that day. If you do not remember until the next day, skip the missed dose and take your next dose at the usual time.
Never take a double dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
An overdose of bisoprolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.
The amount of bisoprolol that can lead to an overdose varies from person to person.
- you take more than your prescribed dose of bisoprolol
If you need to go to A&E, do not drive yourself. Get someone else to drive you, or call for an ambulance.
Take the bisoprolol packet or leaflet inside it, plus any remaining medicine, with you.
you take more than your prescribed dose of bisoprolol and you:
- have a slow heart rate
- have breathing problems
- feel dizzy or shaky
Common side effects
These common side effects of bisoprolol happen in more than 1 in 100 people. They're usually mild and shortlived. There are things you can do to help cope with them:
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.
It happens rarely, but some people have serious side effects when taking bisoprolol.
Call a doctor or contact 111 straight away if:
- you have shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
- the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – these can be signs of liver problems
- you have chest pain – this can be a sign of heart problems
- you have shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
In rare cases, bisoprolol may cause a serious allergic reaction (anaphylaxis).
These are not all the side effects of bisoprolol. For a full list, see the leaflet inside your medicine packet.
Bisoprolol and pregnancy
Bisoprolol can be taken during pregnancy.
If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking bisoprolol. Sometimes bisoprolol can affect your baby's growth. You'll need to have extra ultrasound scans to monitor this.
If your doctor or health visitor says that your baby is healthy, it's OK to take bisoprolol while breastfeeding.
There is not very much information about whether bisoprolol passes into breast milk, but it may pass into breast milk in slightly higher amounts compared to other beta blockers. If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist as other medicines might be better while breastfeeding.
If you notice that your baby is not feeding as well as usual, seems unusually sleepy, or seems much paler than usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.
Bisoprolol and fertility
There's no clear evidence to suggest that taking bisoprolol reduces fertility in either men or women.
Speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.
Cautions with other medicines
There are some medicines that may affect the way bisoprolol works.
Tell your doctor if you're taking any of these:
- other medicines for high blood pressure – the combination with bisoprolol can sometimes lower your blood pressure too much, which may make you feel dizzy or faint. If this keeps happening to you, tell your doctor as they may change your dose
- other medicines that can lower your blood pressure, such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson's disease medicines, such as co-careldopa and levodopa
- non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen – they can stop bisoprolol working as well as it should
- steroids, like prednisolone
- cough medicines that contain pseudoephedrine or xylometazoline
- medicines for diabetes – bisoprolol may make it more difficult to recognise the warning signs of low blood sugar
- medicines for allergies, such as ephedrine, noradrenaline or adrenaline
- medicines for asthma or chronic obstructive pulmonary disease (COPD)
- rifampicin, an antibiotic
There's very little information about taking herbal remedies and supplements with bisoprolol. It's not possible to say whether they are safe to take together. They're not tested in the same way as pharmacy and prescription medicines.
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