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Bisoprolol

Bisoprolol is a beta blocker medicine used to treat high blood pressure (hypertension) and heart failure.

If you have high blood pressure, taking bisoprolol helps prevent future heart disease, heart attacks and strokes.

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.

Who may not be able to 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

Dosage

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.

How to take it

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

Go to 111.nhs.uk or call 111

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.

Serious side effects

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

Go to 111.nhs.uk or call 111

  • 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.

Bisoprolol and breastfeeding

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

Mixing bisoprolol with herbal remedies and supplements

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.

Related links

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5,252 public posts

Bisoprolol

I thank everyone for your constructive comments on Bisoprolol, I have started talking therapy as of yesterday and I think I will decide what to do when I have completed my therapy course, having a very honest and constructive conversation with the therapist yesterday a lot of my morning tiredness and
I thank everyone for your constructive comments on Bisoprolol, I have started talking therapy as of yesterday and I think I will decide what to do when I have completed my therapy course, having a very honest and constructive conversation with the therapist yesterday a lot of my morning tiredness and
E16Pat profile image
E16Pat
in British Heart Foundation
6 days ago

Bisoprolol

Hi all, has anyone changed there Bisoprolol for something else, I really getting fed up with the fatigue this medication gives me, thinking of trying to see my GP mind you that not going to be easy. Take care everyone Pat🙏
Hi all, has anyone changed there Bisoprolol for something else, I really getting fed up with the fatigue this medication gives me, thinking of trying to see my GP mind you that not going to be easy. Take care everyone Pat🙏
E16Pat profile image
E16Pat
in British Heart Foundation
8 days ago

Bisoprolol?

On 2nd month of Bisoprolol and the tiredness is getting me down. I can hardly get out of bed, even for food! I've gone from a busy bee to a lazy bones. Has anyone else felt like this taking this med & if so were you changed to another med? Will give it another week than I'll make appt with Dr.
On 2nd month of Bisoprolol and the tiredness is getting me down. I can hardly get out of bed, even for food! I've gone from a busy bee to a lazy bones. Has anyone else felt like this taking this med & if so were you changed to another med? Will give it another week than I'll make appt with Dr.
PteW43 profile image
PteW43
in British Heart Foundation
20 days ago
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bisoprolol

how long does it take to get Bisoprolol out of your system
how long does it take to get Bisoprolol out of your system
Garden3slids profile image
Garden3slids
in AF Association
2 months ago

Bisoprolol

Good morning Just wondering if any of you have leg cramps whilst taking bisoprolol? I'm struggling to get more than 4 hours sleep as can't get comfortable due to DCM and now having been prescribed bisoprolol for ectopics I've got leg cramps. Feeling exhausted 😩 Thank you L x
Good morning Just wondering if any of you have leg cramps whilst taking bisoprolol? I'm struggling to get more than 4 hours sleep as can't get comfortable due to DCM and now having been prescribed bisoprolol for ectopics I've got leg cramps. Feeling exhausted 😩 Thank you L x
Familyk profile image
Familyk
in British Heart Foundation
3 months ago

Bisoprolol

can I drop down from 5 mg Bisoprolol to 2.5 mg Bisoprolol
can I drop down from 5 mg Bisoprolol to 2.5 mg Bisoprolol
Garden3slids profile image
Garden3slids
in British Heart Foundation
3 months ago

bisoprolol

would 3/4 of a 1.25mg bisoprolol do anything. 1 tablet makes me lightheaded. I’ve been taking 3/4 at night but my cardiologist doesn’t think that’s doing anything so said take 1/2 twice a day. He said it wouldn’t make me lightheaded but it has.
would 3/4 of a 1.25mg bisoprolol do anything. 1 tablet makes me lightheaded. I’ve been taking 3/4 at night but my cardiologist doesn’t think that’s doing anything so said take 1/2 twice a day. He said it wouldn’t make me lightheaded but it has.
Numberonedog profile image
Numberonedog
in British Heart Foundation
3 months ago

Bisoprolol level

Thankfully I have a cardiac nurse appointment next week. I am fed up of being a zombie. I am on 10mg now double what I was on. My average testing BP is 102/66. My doctor told me they know best but my quality of life is rock bottom. Lost my license and more or less house bound taking 14 medications a
Thankfully I have a cardiac nurse appointment next week. I am fed up of being a zombie. I am on 10mg now double what I was on. My average testing BP is 102/66. My doctor told me they know best but my quality of life is rock bottom. Lost my license and more or less house bound taking 14 medications a
Doublef profile image
Doublef
in British Heart Foundation
2 months ago

Bisoprolol, leg pain

like varicose vein pain which I was not getting before taking bisoprolol.
like varicose vein pain which I was not getting before taking bisoprolol.
TravellerSue profile image
TravellerSue
in British Heart Foundation
6 days ago

Bisoprolol

Hi All Many thanks for replying to me re the above meds! I haven’t tolerated this since I went on it in June 21, I will therefore look into taking it in the evening. Take care x
Hi All Many thanks for replying to me re the above meds! I haven’t tolerated this since I went on it in June 21, I will therefore look into taking it in the evening. Take care x
Platypus6 profile image
Platypus6
in British Heart Foundation
5 months ago

Bisoprolol

Hi Does anyone take their medication in the evening?
Hi Does anyone take their medication in the evening?
Platypus6 profile image
Platypus6
in British Heart Foundation
5 months ago

Blood pressure higher in the evening

I am on medication , I take ramipril a diuretic and bisoprolol (2.5) at night and another bisoprolol in the morning at 11. I have discovered that my BP is normal at 11am (120/80) but sharply increased in the evening at 19:00 (160/110) Anybody know why this should be?
I am on medication , I take ramipril a diuretic and bisoprolol (2.5) at night and another bisoprolol in the morning at 11. I have discovered that my BP is normal at 11am (120/80) but sharply increased in the evening at 19:00 (160/110) Anybody know why this should be?
Pindarus profile image
Pindarus
in AF Association
24 days ago

switch from sotalol (80 mg x2) to bisoprolol and flecanide 50 mg x2

I was on Bisoprolol and Fleca for years then my cardio decided to put me on sotalol, I’m in afib everyday for 24 hours with just 2 days off. Sotalol bothers my stomach and I want to go back to bisoprolol and Fleca now as PIP. With bisoprolol the main drug keeping things under control.
I was on Bisoprolol and Fleca for years then my cardio decided to put me on sotalol, I’m in afib everyday for 24 hours with just 2 days off. Sotalol bothers my stomach and I want to go back to bisoprolol and Fleca now as PIP. With bisoprolol the main drug keeping things under control.
Anonymouskd profile image
Anonymouskd
in AF Association
2 months ago

Bisoprolol

hi I’ve been on Bisoprolol fumerate 1.25mg for a few months for a slight irregularity that was seen on a 24 hour heart monitor. My blood pressure is on the low side but since my valve replacement I have symptoms. The beta is making those symptoms a little worse.
hi I’ve been on Bisoprolol fumerate 1.25mg for a few months for a slight irregularity that was seen on a 24 hour heart monitor. My blood pressure is on the low side but since my valve replacement I have symptoms. The beta is making those symptoms a little worse.
Numberonedog profile image
Numberonedog
in British Heart Foundation
5 months ago

Medication

What experience have people had on Bisoprolol,Spirolactone and Dapagliflozin. Many Thanks
What experience have people had on Bisoprolol,Spirolactone and Dapagliflozin. Many Thanks
Twinkletoes64 profile image
Twinkletoes64
in British Heart Foundation
3 days ago

Ibruprofen and Bisoprolol

Could someone advise me as to whether I can take 400mg of ibruprofen daily for osteoarthritis when I am currently taking 1.25mg of Bisoprolol and 50mg of Losartan plus 125 micro grams of levothyroxine for an underactive thyroid..
Could someone advise me as to whether I can take 400mg of ibruprofen daily for osteoarthritis when I am currently taking 1.25mg of Bisoprolol and 50mg of Losartan plus 125 micro grams of levothyroxine for an underactive thyroid..
theminiaturist profile image
theminiaturist
in British Heart Foundation
19 days ago

Bisoprolol to Sotalol

I’ve been on 10 mgs of Bisoprolol for a year, having had the dose gradually increased since my diagnosis in 2017. This drug has served me well in lowering my heart rate when it has gone into Tachycardia territory.
I’ve been on 10 mgs of Bisoprolol for a year, having had the dose gradually increased since my diagnosis in 2017. This drug has served me well in lowering my heart rate when it has gone into Tachycardia territory.
Tellingfibs profile image
Tellingfibs
in AF Association
21 days ago

New meds.

Hi,can I please ask if a medicine called Bisoprolol can exacerbate RLS.
Hi,can I please ask if a medicine called Bisoprolol can exacerbate RLS.
Whymelord profile image
Whymelord
in Restless Legs Syndrome
21 days ago

Bisoprolol

Bisoprolol does anybody else get very very tired on this medication and have nightmares Cheers
Bisoprolol does anybody else get very very tired on this medication and have nightmares Cheers
E16Pat profile image
E16Pat
in British Heart Foundation
5 months ago

stopping bisoprolol

cardiologist said stop after 2 1/2 years now. 1.25mg. I’ve stopped but can I expect any side effects ?
cardiologist said stop after 2 1/2 years now. 1.25mg. I’ve stopped but can I expect any side effects ?
ampdolly profile image
ampdolly
in British Heart Foundation
4 months ago
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