How does this medication work? What will it do for me?

Bisoprolol belongs to the class of medications called beta-blockers. Beta-blockers reduce the workload of the heart and help it to beat more regularly by blocking the effects of certain hormones. Bisoprolol is used for the control of mild to moderate high blood pressure but does not cure the condition.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Bisoprolol by Sorres Pharma Inc. is no longer being manufactured for sale in Canada. For brands that may still be available, search under bisoprolol. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The usual starting dose of bisoprolol is 5 mg once daily at the same time each day, with or without food. If your blood pressure does not respond well enough to the 5 mg dose, your doctor may decide to increase the dose to 10 mg, and then if necessary to 20 mg once daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take bisoprolol if you:

  • are allergic to bisoprolol or any ingredients of the medication
  • have a very low heart rate
  • have cardiogenic shock or heart failure
  • have right ventricular failure due to pulmonary hypertension
  • have second or third degree AV (atrioventricular) block

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • cough
  • diarrhea
  • fatigue
  • headache
  • insomnia
  • joint pain
  • nausea
  • sore throat

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur.

  • dizziness
  • peripheral edema (swelling of the ankles)
  • rhinitis or sinusitis (inflammation in the nose)
  • urinary tract infection (painful urination, frequent urination, or cloudy urine)
  • very slow heart rate (less than 50 beats per minute)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a serious allergic reaction (e.g., hives, swelling of face or throat, difficulty breathing, rash, or itching)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Angina: People with coronary artery disease may experience worsening of angina (chest pain) if they stop taking bisoprolol suddenly. If you want to stop taking the medication, talk to your doctor about how to do this safely by gradually reducing the dose over time.

Lung, heart, or circulation problems: If you have circulation problems, asthma, bronchitis, any other lung disease, or a history of heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hyperthyroidism: Bisprolol may mask the signs of thyroid overactivity. If it is stopped suddenly, it may cause a worsening of the symptoms of hyperthyroidism (overactive thyroid). Do not stop the medication on your own. Instead, talk to your doctor about how to safely stop the medication by gradually reducing the dose over time.

Diabetes: Bisoprolol may mask some symptoms of low blood sugar. If you have diabetes, your doctor should closely monitor your condition while you are taking bisoprolol.

Impaired kidney or liver function: Your doctor may recommend laboratory tests to check your kidney and liver function while you are on this medication.

Occupational hazards: Bisoprolol may cause drowsiness and lightheadedness. Avoid anything that requires you to be awake and alert until you know how the medication affects you.

Stopping the medication: Do not stop taking bisoprolol suddenly - check with your doctor first. Your doctor can advise you on how to stop the medication safely.

Surgery: Before surgery (including dental surgery), tell the doctor or dentist that you are taking bisoprolol.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if bisoprolol passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

What other drugs could interact with this medication?

There may be an interaction between bisoprolol and any of the following:

  • aminophylline
  • asthma medications (e.g., theophylline)
  • diabetes medications (e.g., glyburide)
  • caffeine
  • calcium channel blocker medicines (e.g., diltiazem, felodipine, nifedipine, verapamil)
  • clonidine
  • cocaine
  • diltiazem
  • disopyramide
  • guanethidine
  • medications for abnormal heart rhythms (e.g., disopyramide)
  • methacholine
  • monoamine oxidase (MAO) inhibitors (e.g., phenelzine, selegiline, tranylcypromine)
  • other beta-blockers (e.g., propranolol, metoprolol)
  • oxtriphylline
  • reserpine
  • rifampin
  • verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.