Bisoprolol

Bisoprolol is a type of medication called a beta-blocker. Beta-blockers slow your heart rate down and make it easier for your heart to pump blood around your body, which lowers your blood pressure.

Your doctor may prescribe this medication long-term if you have high blood pressure, heart failure, or chest pain caused by angina. If you have high blood pressure, bisoprolol can reduce your risk of having a heart attack or stroke in the future. It is also used to treat some conditions that cause an irregular heartbeat like atrial fibrillation.

In the UK, bisoprolol is also sold under the brand names Cardicor and Congescor.

Beta-blockers (beta-adrenergic blocking agents) work by blocking the release of the stress hormones adrenaline and noradrenaline. This slows your heart rate and makes it easier for your heart to pump blood around your body.

• Take your tablet at the same time every day
• Your doctor may advise you to take your first tablet before bed as bisoprolol can make you feel sleepy. If you do not feel sleepy after taking bisoprolol, you can continue to take your tablet at any time of the day.
• Swallow your tablets whole with water (do not crush or chew).
• You can take bisoprolol with or without food

For high blood pressure or angina, the normal starting dose of bisoprolol is 5mg to 10mg once a day. Your doctor will monitor your condition and may increase your dose to 20mg once a day if needed.

For heart failure, the usual starting dose is 1.25mg once a day. This is gradually increased over the next few months to a maximum of 10mg once a day.

Always take any medication exactly as your doctor tells you to. Before taking any medicine for the first time, read the patient information leaflet carefully and ask your doctor or pharmacist if you have any questions.

Bisoprolol tablets are normally taken once a day. The dose you need to take will depend on why you are taking it.

Bisoprolol starts to lower blood pressure after about 2 hours of taking it, but it may take between 2 and 6 weeks for it to have a full effect.

If you are taking bisoprolol for angina, it normally takes a couple of weeks for your chest pain to get better.

If you’re taking bisoprolol for heart failure it may be several weeks or even months before you start to feel better.

Bisoprolol is an effective treatment that works just as well as other types of beta blockers in treating high blood pressure but has fewer side effects.

There are many different medications for high blood pressure, and beta blockers aren’t usually the first choice of treatment. They are usually used when other medications haven’t worked or in combination with other treatments.

Your doctor will decide on the best treatment for you based on your:

• symptoms
• past medical history
• age
• ethnicity

What if it doesn’t work?

If bisoprolol doesn’t work for you, there are many other treatment options available. Talk to your GP about other available treatments.

What if I forget to take bisoprolol?

If you miss a dose of bisoprolol, and it’s still the same day, take it as soon as you remember. If it’s already the next day, skip your missed dose and continue with your next dose at the usual time.

What if I take too much bisoprolol?

Taking too much bisoprolol can cause symptoms such as:

• dizziness
• trembling
• slow heart rate
• difficulty breathing

If you have taken too much bisoprolol, call your doctor or 111 immediately for advice.

If you need to go to hospital, do not drive yourself. Take the medication packet and any remaining medication with you.

Bisoprolol may not be suitable for you if you have:

• ever had an allergic reaction to bisoprolol, any other beta blocker, or any of its ingredients
• low blood pressure
• a slow heart rate
• heart failure that is getting worse
• heart disease
• recently had a heart attack
• a severe circulation problem such as Raynaud’s disease, a disease that causes your fingers and toes to tingle and become pale or blue
• severe asthma
• lung disease

Most people over 18 years of age can take bisoprolol, but this medication may not be suitable for everyone. Always tell your doctor about any medical conditions or allergies you have as well as any other medications you are taking.

Like all medications, bisoprolol can cause side effects in some people. Most side effects are mild and go away without treatment. Many people taking bisoprolol don’t have any side effects at all.

Common side effects include:

• dizziness
• weakness
• headaches
• nausea (feeling sick)
• vomiting (being sick)
• constipation
• diarrhoea
• cold hands and feet

If your side effects are bothering you, getting worse, or not going away, talk to your GP.

Rarely, bisoprolol can cause serious side effects. Call your doctor or 111 immediately if you experience:

• shortness of breath, cough that gets worse on exertion, swelling of the legs or ankles —could be signs of heart problems
• yellowing of the skin or the whites of the eyes —could indicate liver problems

Call an ambulance immediately if you experience:

• chest pain
• difficulty breathing, noisy breathing, and chest tightness
• symptoms of a severe allergic reaction (anaphylaxis) including swelling of the face, throat, and tongue, difficulty breathing or talking, chest tightness, itchy rash, blisters, swollen or peeling skin

For a full list of possible side effects of bisoprolol, read the patient information leaflet.

Are there any long-term side effects?

Bisoprolol is usually a long-term treatment, making it safe to take for a long time without negative side effects. Most people who are prescribed this medication take it for the rest of their lives.

Medications that may interact with bisoprolol include:

• other medications for high blood pressure
• medications that can lower blood pressure including, some antidepressants, nitrates, muscle relaxants, and medications for enlarged prostate and Parkinson’s disease
• non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• steroids like prednisolone
• cough medicines that contain pseudoephedrine or xylometazoline
• some diabetes medications
• some allergy medications
• some medications for asthma or chronic obstructive pulmonary disease (COPD)
• rifampicin (an antibiotic)

Bisoprolol and alcohol

Alcohol can lower your blood pressure and increase some of the side effects of bisoprolol such as dizziness. It’s better to avoid alcohol for a few days after you start taking bisoprolol while you get used to the medication and how it affects you. If you experience dizziness while taking bisoprolol, it's safer for you not to drink alcohol.

Bisoprolol and bananas

You can usually follow your normal diet while taking bisoprolol unless advised otherwise by a doctor. Beta-blockers like bisoprolol can increase the level of potassium in your blood, so it may be best to avoid too many potassium-rich foods like bananas while taking this medication.

Bisoprolol and ibuprofen

Ibuprofen may reduce the effectiveness of bisoprolol in lowering blood pressure, especially if taken regularly. Talk to your doctor or pharmacist about an alternative to ibuprofen if you are taking bisoprolol.

Bisoprolol and Viagra

Viagra (sildenafil) can increase the effect of bisoprolol on lowering blood pressure. If you experience faintness, dizziness, headache, or a fast heartbeat when taking Viagra, talk to your doctor.

Bisoprolol and antihistamines

Most antihistamines are fine to take with bisoprolol, however, medications to treat severe allergic reactions like adrenaline (epinephrine) can cause serious side effects in some people. If you suffer from severe allergies and may need to take adrenaline, talk to your GP before starting bisoprolol.

Alternative high blood pressure treatment

If bisoprolol isn’t right for you, there are many alternative treatments available including:

• other types of beta-blockers such as atenolol or propranolol
• angiotensin-converting enzyme (ACE) inhibitors like lisinopril or ramipril
• calcium channel blockers like amlodipine
• diuretics (medications that make you pee more) such as furosemide

Your doctor will decide which medication or combination of medications is best for you.