Bisoprolol at a glance
Medicine class
Selective beta-1 blocker.
Main licensed uses
High blood pressure, chronic stable angina and stable chronic heart failure with reduced systolic function; licences differ between products.
Food
The selected formulations may be taken with food.
What is Bisoprolol used for?
Licensed indications vary between UK products and include:
Hypertension (high blood pressure).
Chronic stable angina pectoris.
Stable chronic heart failure with reduced systolic left-ventricular function, alongside other appropriate heart-failure medicines.
How does Bisoprolol work?
Bisoprolol preferentially blocks beta-1 receptors in the heart. This reduces adrenaline-like effects, slowing the heart and reducing contraction force, oxygen demand and cardiac workload.
Bisoprolol preparations and strengths
Dispersible tablet
Route: Oral
Strengths: 1.25 mg, 2.5 mg, 5 mg
Oral solution
Route: Oral
Strengths: 0.5 mg/mL, 1 mg/mL
How to take Bisoprolol
Administration depends on the supplied formulation.
Film-coated tablets are swallowed with liquid and not chewed.
Orodispersible tablets are placed on the tongue, allowed to break down and then swallowed with or without water. They are not chewed.
Oral solution is measured with the supplied oral syringe rather than a household spoon.
The selected formulations can be taken with food.
Bisoprolol side effects
Common or expected effects
- Tiredness or weakness
- Dizziness or headache
- Cold or numb hands and feet
- Low blood pressure
- Nausea, vomiting, diarrhoea or constipation
- Slow heart rate, particularly in people treated for chronic heart failure
Get urgent medical advice
- Swelling of the face, tongue or throat, widespread itchy rash or breathing difficulty
- New or worsening wheeze or breathing difficulty
- Fainting, pronounced slowing of the heartbeat or an unusual rhythm
- Worsening breathlessness, swelling or other heart-failure symptoms
- Yellow skin or eyes, dark urine or significant abdominal pain suggesting liver inflammation
Bisoprolol in pregnancy
Bisoprolol can be used during pregnancy following an individual risk–benefit review. Fetal growth monitoring may be offered. Exposure near delivery can occasionally cause temporary slow heart rate or low blood glucose in the newborn.
Bisoprolol while breastfeeding
Evidence during breastfeeding is very limited. UK specialist advice says bisoprolol may be used cautiously when clinically appropriate, although labetalol, metoprolol or propranolol are generally preferred if suitable. Observe the infant for unusual sleepiness, poor feeding, inadequate weight gain, jitteriness or signs of a slow heartbeat. Specialist advice is particularly important for premature or unwell infants.
Bisoprolol interactions
Bisoprolol can interact with medicines that affect heart rate, blood pressure or glucose responses.
Verapamil or diltiazem
May excessively reduce cardiac contractility and conduction, causing marked hypotension or heart block.
Antiarrhythmics such as flecainide, disopyramide or amiodarone
May further slow cardiac conduction or reduce contraction strength.
Clonidine and other centrally acting antihypertensives
Can worsen bradycardia or heart failure; abrupt clonidine withdrawal can cause rebound hypertension.
Common questions about Bisoprolol
Answers are fully visible for fast scanning and source review.
Does bisoprolol fumarate lower the heart rate?
Yes. Slowing the heart is part of its intended action, but an unusually slow pulse with faintness, severe weakness or breathlessness needs clinical assessment.
Can bisoprolol fumarate be used with asthma?
Severe asthma is contraindicated in the selected product information. Other asthma or obstructive airways disease requires careful assessment and monitoring because bronchospasm can occur despite beta-1 selectivity.
How does bisoprolol fumarate affect diabetes?
It can mask some warning symptoms of low blood glucose and may increase hypoglycaemia risk with certain glucose-lowering medicines.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.