Dosing & Uses
Dosage Forms & Strengths
tablet
- 5mg
- 10mg
Hypertension
2.5-5 mg PO qDay; may increase to 10 mg and if necessary to 20 mg PO qDay
Heart Failure
1.25 mg PO qDay; increase gradually if necessary not to exceed 10 mg/day
Renal Impairment
>40 mL/min: Dose adjustment not necessary
<40 mL/min: 2.5 mg/day initially; titrate slowly and monitor
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (23)
- acebutolol
acebutolol and bisoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- atenolol
atenolol and bisoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- betaxolol
betaxolol and bisoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- carvedilol
bisoprolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- celiprolol
bisoprolol and celiprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- clonidine
clonidine, bisoprolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- digoxin
digoxin, bisoprolol. Either decreases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- diltiazem
diltiazem, bisoprolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- esmolol
bisoprolol and esmolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to induce bradycardia. .
- labetalol
bisoprolol and labetalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- lofexidine
lofexidine, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- mavacamten
bisoprolol, mavacamten. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility.
- metoprolol
bisoprolol and metoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nadolol
bisoprolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nebivolol
bisoprolol and nebivolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- penbutolol
bisoprolol and penbutolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- pindolol
bisoprolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- propranolol
bisoprolol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- rivastigmine
bisoprolol increases toxicity of rivastigmine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive bradycardia effect may result in syncope.
- sotalol
bisoprolol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- timolol
bisoprolol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- verapamil
verapamil, bisoprolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
Monitor Closely (172)
- acebutolol
acebutolol and bisoprolol both increase serum potassium. Use Caution/Monitor.
- aceclofenac
bisoprolol and aceclofenac both increase serum potassium. Use Caution/Monitor.
aceclofenac decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - acemetacin
bisoprolol and acemetacin both increase serum potassium. Use Caution/Monitor.
acemetacin decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - albuterol
bisoprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - aldesleukin
aldesleukin increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfuzosin
alfuzosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aluminum hydroxide
aluminum hydroxide decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amifostine
amifostine, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
bisoprolol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.
- amiodarone
amiodarone, bisoprolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia.
- amlodipine
bisoprolol, amlodipine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- amobarbital
amobarbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- arformoterol
bisoprolol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor. - asenapine
asenapine and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aspirin
bisoprolol and aspirin both increase serum potassium. Use Caution/Monitor.
aspirin decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin rectal
bisoprolol and aspirin rectal both increase serum potassium. Use Caution/Monitor.
aspirin rectal decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
bisoprolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - atazanavir
atazanavir increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.
- atenolol
atenolol and bisoprolol both increase serum potassium. Use Caution/Monitor.
- avanafil
avanafil increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bendroflumethiazide
bisoprolol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- betaxolol
betaxolol and bisoprolol both increase serum potassium. Use Caution/Monitor.
- bismuth subsalicylate
bismuth subsalicylate, bisoprolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.
- bretylium
bisoprolol, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
bisoprolol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butabarbital
butabarbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- butalbital
butalbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- calcium acetate
calcium acetate decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
calcium carbonate decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours. - calcium chloride
calcium chloride decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium citrate
calcium citrate decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium gluconate
calcium gluconate decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- candesartan
candesartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - carbenoxolone
bisoprolol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
bisoprolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- celecoxib
bisoprolol and celecoxib both increase serum potassium. Use Caution/Monitor.
celecoxib decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celiprolol
bisoprolol and celiprolol both increase serum potassium. Use Caution/Monitor.
- chlorothiazide
bisoprolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorthalidone
bisoprolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
bisoprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
choline magnesium trisalicylate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - clevidipine
bisoprolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- clonidine
bisoprolol, clonidine. Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- cyclopenthiazide
bisoprolol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dasiglucagon
bisoprolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- desflurane
desflurane, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- dichlorphenamide
dichlorphenamide and bisoprolol both decrease serum potassium. Use Caution/Monitor.
- diclofenac
bisoprolol and diclofenac both increase serum potassium. Use Caution/Monitor.
diclofenac decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - diflunisal
bisoprolol and diflunisal both increase serum potassium. Use Caution/Monitor.
diflunisal decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - digoxin
bisoprolol and digoxin both increase serum potassium. Use Caution/Monitor.
bisoprolol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia. - diltiazem
bisoprolol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- dobutamine
bisoprolol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor. - dopexamine
bisoprolol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor. - doxazosin
doxazosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- drospirenone
bisoprolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.
- ephedrine
bisoprolol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine
bisoprolol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine racemic
bisoprolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. - eprosartan
eprosartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - esmolol
bisoprolol and esmolol both increase serum potassium. Use Caution/Monitor.
- ethacrynic acid
bisoprolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ether
bisoprolol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.
- etodolac
bisoprolol and etodolac both increase serum potassium. Use Caution/Monitor.
etodolac decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - etomidate
etomidate, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- felodipine
bisoprolol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- fenbufen
bisoprolol and fenbufen both increase serum potassium. Use Caution/Monitor.
- fenoprofen
bisoprolol and fenoprofen both increase serum potassium. Use Caution/Monitor.
fenoprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - fingolimod
bisoprolol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.
- flurbiprofen
bisoprolol and flurbiprofen both increase serum potassium. Use Caution/Monitor.
flurbiprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - formoterol
bisoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - furosemide
bisoprolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gentamicin
bisoprolol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glucagon
glucagon decreases toxicity of bisoprolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- glucagon intranasal
glucagon intranasal decreases toxicity of bisoprolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- hydralazine
hydralazine increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.
- hydrochlorothiazide
bisoprolol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen
bisoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.
ibuprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ibuprofen IV
ibuprofen IV decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
bisoprolol and ibuprofen IV both increase serum potassium. Use Caution/Monitor. - indacaterol, inhaled
indacaterol, inhaled, bisoprolol. Other (see comment). Use Caution/Monitor. Comment: Beta-blockers and indacaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- indapamide
bisoprolol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
bisoprolol and indomethacin both increase serum potassium. Use Caution/Monitor.
indomethacin decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - insulin degludec
bisoprolol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin degludec/insulin aspart
bisoprolol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin inhaled
bisoprolol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- iodixanol
bisoprolol increases toxicity of iodixanol by unspecified interaction mechanism. Use Caution/Monitor. Use of beta-blockers lowers the threshold for and increases the severity of contrast reactions, and reduces the responsiveness of treatment of hypersensitivity reactions with epinephrine. .
- irbesartan
irbesartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - isoproterenol
bisoprolol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - isradipine
bisoprolol, isradipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- ivabradine
ivabradine, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.
- ketamine
ketamine, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- ketoprofen
bisoprolol and ketoprofen both increase serum potassium. Use Caution/Monitor.
ketoprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac
bisoprolol and ketorolac both increase serum potassium. Use Caution/Monitor.
ketorolac decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac intranasal
bisoprolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - labetalol
bisoprolol and labetalol both increase serum potassium. Use Caution/Monitor.
- lasmiditan
bisoprolol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.
- levalbuterol
bisoprolol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - levodopa
levodopa increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lornoxicam
bisoprolol and lornoxicam both increase serum potassium. Use Caution/Monitor.
lornoxicam decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - losartan
losartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - lurasidone
lurasidone increases effects of bisoprolol by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maraviroc
maraviroc, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- meclofenamate
meclofenamate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
bisoprolol and meclofenamate both increase serum potassium. Use Caution/Monitor. - mefenamic acid
bisoprolol and mefenamic acid both increase serum potassium. Use Caution/Monitor.
mefenamic acid decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - mefloquine
mefloquine increases levels of bisoprolol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.
- meloxicam
bisoprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - metaproterenol
bisoprolol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - methyclothiazide
bisoprolol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- metolazone
bisoprolol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
bisoprolol and metoprolol both increase serum potassium. Use Caution/Monitor.
- moxisylyte
moxisylyte and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nabumetone
bisoprolol and nabumetone both increase serum potassium. Use Caution/Monitor.
nabumetone decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nadolol
bisoprolol and nadolol both increase serum potassium. Use Caution/Monitor.
- naproxen
bisoprolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nebivolol
bisoprolol and nebivolol both increase serum potassium. Use Caution/Monitor.
- nicardipine
bisoprolol, nicardipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- nifedipine
bisoprolol, nifedipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- nimodipine
bisoprolol, nimodipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- nisoldipine
bisoprolol, nisoldipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- nitroglycerin rectal
nitroglycerin rectal, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.
- norepinephrine
bisoprolol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - olmesartan
olmesartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - oxaprozin
bisoprolol and oxaprozin both increase serum potassium. Use Caution/Monitor.
oxaprozin decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - oxymetazoline topical
oxymetazoline topical increases and bisoprolol decreases sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
bisoprolol and parecoxib both increase serum potassium. Use Caution/Monitor.
parecoxib decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - patiromer
patiromer will decrease the level or effect of bisoprolol by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- penbutolol
bisoprolol and penbutolol both increase serum potassium. Use Caution/Monitor.
- pentobarbital
pentobarbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of pentobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenobarbital
phenobarbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenoxybenzamine
phenoxybenzamine and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phentolamine
phentolamine and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- pindolol
bisoprolol and pindolol both increase serum potassium. Use Caution/Monitor.
- pirbuterol
bisoprolol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - piroxicam
bisoprolol and piroxicam both increase serum potassium. Use Caution/Monitor.
piroxicam decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ponesimod
ponesimod and bisoprolol both increase pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.
- potassium acid phosphate
bisoprolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
bisoprolol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
bisoprolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- prazosin
prazosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- primidone
primidone decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of primidone. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- propofol
propofol, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- propranolol
bisoprolol and propranolol both increase serum potassium. Use Caution/Monitor.
- sacubitril/valsartan
sacubitril/valsartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - salicylates (non-asa)
bisoprolol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.
salicylates (non-asa) decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - salmeterol
bisoprolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. - salsalate
bisoprolol and salsalate both increase serum potassium. Use Caution/Monitor.
salsalate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - saquinavir
saquinavir, bisoprolol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of PR prolongation and cardiac arrhythmias.
- secobarbital
secobarbital decreases levels of bisoprolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- sevoflurane
sevoflurane, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- sildenafil
bisoprolol increases effects of sildenafil by additive vasodilation. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy.
- silodosin
silodosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- siponimod
siponimod, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.
- sodium bicarbonate
sodium bicarbonate decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium citrate/citric acid
sodium citrate/citric acid decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sotalol
bisoprolol and sotalol both increase serum potassium. Use Caution/Monitor.
- spironolactone
bisoprolol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.
- succinylcholine
bisoprolol and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
bisoprolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.
sulfasalazine decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sulindac
bisoprolol and sulindac both increase serum potassium. Use Caution/Monitor.
sulindac decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tadalafil
tadalafil increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - terazosin
terazosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- terbutaline
bisoprolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor. - theophylline
bisoprolol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.
- timolol
bisoprolol and timolol both increase serum potassium. Use Caution/Monitor.
- tolfenamic acid
bisoprolol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.
tolfenamic acid decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolmetin
bisoprolol and tolmetin both increase serum potassium. Use Caution/Monitor.
tolmetin decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolvaptan
bisoprolol and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
bisoprolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triamterene
bisoprolol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.
- valsartan
valsartan and bisoprolol both increase serum potassium. Use Caution/Monitor.
bisoprolol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - verapamil
bisoprolol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- xipamide
xipamide increases effects of bisoprolol by pharmacodynamic synergism. Use Caution/Monitor.
Minor (29)
- adenosine
bisoprolol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.
- agrimony
agrimony increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- cevimeline
cevimeline increases effects of bisoprolol by unspecified interaction mechanism. Minor/Significance Unknown.
- cocaine topical
bisoprolol increases effects of cocaine topical by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.
- cornsilk
cornsilk increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- dihydroergotamine
dihydroergotamine, bisoprolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dihydroergotamine intranasal
dihydroergotamine intranasal, bisoprolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dipyridamole
dipyridamole, bisoprolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.
- escitalopram
escitalopram increases levels of bisoprolol by decreasing metabolism. Minor/Significance Unknown.
- fenoldopam
fenoldopam increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- forskolin
forskolin increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- guanfacine
bisoprolol, guanfacine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- imaging agents (gadolinium)
bisoprolol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.
- levobetaxolol
levobetaxolol increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- maitake
maitake increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- melatonin
melatonin decreases toxicity of bisoprolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.
- metipranolol ophthalmic
metipranolol ophthalmic increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- neostigmine
bisoprolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- noni juice
bisoprolol and noni juice both increase serum potassium. Minor/Significance Unknown.
- octacosanol
octacosanol increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- physostigmine
bisoprolol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pilocarpine
pilocarpine increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- reishi
reishi increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- rifampin
rifampin decreases levels of bisoprolol by increasing metabolism. Minor/Significance Unknown.
- shepherd's purse
shepherd's purse, bisoprolol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- tizanidine
tizanidine increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- treprostinil
treprostinil increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- yohimbe
bisoprolol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
1-10%
Dizziness (10%)
Insomnia (8%-10%)
Bradyarrhythmia (9%)
Upper respiratory infection (5%)
Diarrhea (4%)
Rhinitis (4%)
Arthralgia (3%)
Cough (3%)
Dyspnea (2%)
Nausea (2%)
Pharyngitis (2%)
Sinusitis (2%)
Vomiting (2%)
<1%
Cold extremities
Hypotension
Depression
Dyspepsia
Bronchospasm
Frequency Not Defined
Aggravate CHF
Decrease HDL
Hypertriglyceridemia
Mask symptoms of hypoglycemia
Decreased exercise tolerance
Raynaud's phenomenon
May increase triglyceride levels and insulin resistance
Warnings
Contraindications
Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without permanent pacemaker
Cautions
Use caution in anesthesia/surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, CHF, cardiomegaly, DM, hyperthyroidism/thyrotoxicosis, myasthenia gravis, liver disease, renal impairment, peripheral vascular disease, use in pheochromocytoma, IDDM, history of psychiatric disease, pre-existing sick sinus syndrome or similar cardiac conditions
Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures
Exacerbation of psoriasis reported with use
Less effective than thiazide diuretics in black and geriatric patients
Shown to decrease mortality in hypertension and post-myocardial infarction
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Blocks response to beta-adrenergic stimulation; cardioselective for beta-1 at low doses with little or no effect on beta-2 receptors at doses ≤ 20 mg
Pharmacikinetics
Half-Life: 9-12 hr (normal renal function); 27-36hr (<40 mL/min); 8-22 hr (hepatic cirrhosis)
Peak Plasma Time: 2-4 hr
Bioavailability: 80%
Onset of action: 1-2 hr
Metabolism: Hepatic
Protein Bound: 30%
Excretion: Renal (50%); feces (<2%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| bisoprolol fumarate oral - | 10 mg tablet |  | |
| bisoprolol fumarate oral - | 10 mg tablet |  | |
| bisoprolol fumarate oral - | 5 mg tablet |  | |
| bisoprolol fumarate oral - | 10 mg tablet |  | |
| bisoprolol fumarate oral - | 5 mg tablet |  | |
| bisoprolol fumarate oral - | 10 mg tablet |  | |
| bisoprolol fumarate oral - | 5 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
bisoprolol fumarate oral
BISOPROLOL - ORAL
(BIS-oh-PROE-lol)
COMMON BRAND NAME(S): Zebeta
WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.
USES: Bisoprolol is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body such as epinephrine on the heart and blood vessels. This effect lowers the heart rate, blood pressure, and strain on the heart.
HOW TO USE: See also Warning section.Take this medication by mouth with or without food as directed by your doctor, usually once a day. The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase).
SIDE EFFECTS: See also Warning and Precautions sections.Tiredness, slow heartbeat, diarrhea, and dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: very slow heartbeat, fainting, blue fingers/toes, mental/mood changes (such as confusion, mood swings, depression).Although this medication may be used to treat heart failure, some people may rarely develop new or worsening symptoms of heart failure. Tell your doctor right away if you experience any of these serious side effects: shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking bisoprolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block), breathing problems (such as asthma, chronic bronchitis, emphysema), kidney disease, liver disease, overactive thyroid disease (hyperthyroidism), serious allergic reactions including those needing treatment with epinephrine, blood circulation problems (such as Raynaud's disease, peripheral vascular disease), mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist that you are taking this medication.If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia), especially if they are vomiting or not eating regularly. To help prevent low blood sugar, feed children on a regular schedule. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, seizures), stop this medication and tell the doctor right away.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk or if it may harm a nursing infant. Discuss the risks and benefits with your doctor before breast-feeding.
DRUG INTERACTIONS: See also Precautions section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: fingolimod.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness, severe weakness, fainting, trouble breathing.
NOTES: Do not share this medication with others.Talk with your doctor about making changes to your lifestyle that may help this medication work better (such as stress reduction programs, exercise, and dietary changes).Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to check your own blood pressure and pulse at home, and share the results with your doctor.Lab and/or medical tests should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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