Bisoprolol

What is Bisoprolol?

Bisoprolol is a beta blocker and it’s used to treat high blood pressure and heart failure. It regulates the way nerve impulses are dealt with in the body and slows the heart rate to allow it to pump blood around your body with ease. The medicine also treats angina and other heart conditions associated with an irregular heartbeat.

When will Bisoprolol start to work?

Bisoprolol will start to work two hours after you start to take it but it usually takes a few weeks to have full effect.  

What happens if you don’t treat high blood pressure?

If left untreated, high blood pressure can lead to stroke, heart attack and kidney problems. Bisoprolol helps lower blood pressure by making the heart beat slower and with less force.

How long does Bisoprolol take to work?

It can take a few weeks for Bisoprolol to take effect so it’s important to persevere with it. For high blood pressure, Bisoprolol will usually start to work in the first couple of hours but you probably won’t feel different. This doesn’t mean that the medicine isn’t working. For angina, the chest pain should start to improve after a couple of weeks and if you’re taking it for heart failure it may take months to see an improvement. 

Is Bisoprolol safe for long term use?

Yes, Bisoprolol is safe for long term use and is most beneficial when taken over a long period of time. The medicine will regulate your blood pressure and prevent a heart attack or stroke.

Will I need to keep taking Bisoprolol after my blood pressure is lower?

You should keep taking Bisoprolol even if your blood pressure has lowered. If you stop taking it, your blood pressure may rise again and you’ll be at risk of experiencing a heart attack or stroke in the future. 

Active ingredients

Bisoprolol fumarate is the active ingredient within the medicine.

Inactive ingredients

Other ingredients in Bisoprolol are: lactose monohydrate, cellulose microcrystalline [E460], magnesium stearate and [E572] and crospovidone [E1202]. The 5mg tablets are a yellow colour and contain lactose and iron oxide [E172], with the 10mg tablets containing the same ingredients to make a beige colour.

Bisoprolol dosage

You’ll usually start with a low dose of 5 or 10mg. This may be increased to 20mg if your blood pressure is still high. 

How to take Bisoprolol

Bisoprolol is taken once a day with or without food. It’s best to stick to the same time each day and if you forget, take the tablet as soon as you remember, skipping a dose if you don’t remember until the next day. 

Can Bisoprolol pills be split in half or crushed?

You should check the individual instructions. Some brands produce Bisoprolol that can be split in half easily but unless otherwise stated you should swallow the tablet whole. Tablets that are not designed to be split can cause issues if you do break them apart - they may not work properly or could cause harm to you. You should avoid crushing Bisoprolol as it can increase the likelihood of side effects affecting your throat and breathing. If you struggle to take tablets whole, you should speak to your doctor, who can help you find a medication that works well for you.

How to cope with Bisoprolol side effects

You may experience dizziness when you first take Bisoprolol. If this happens, sit or lie down until it passes and don’t drive or use heavy machinery until you feel better. For headaches, stay hydrated and take a painkiller like paracetamol if needed. If you feel sick, avoid anything too spicy or rich and take your tablet after eating. If you experience constipation, eat food high in fibre and exercise regularly. Drinking plenty of water is important too and helps you to stay hydrated if you get diarrhea.  

Bisoprolol and breastfeeding

It’s not known if Bisoprolol is safe to take while breastfeeding. You should speak to your doctor to find a suitable treatment.

Will Bisoprolol affect my fertility?

Bisoprolol hasn’t been shown to affect fertility in women or men. In rare cases it can have an effect on sexual function and cause erectile dysfunction in men.

Does Bisoprolol cause constipation?

Constipation is a common side effect of Bisoprolol. It’s more likely to affect older adults over the age of 60 but this side effect should pass within a couple of weeks.

Bisoprolol and alcohol

During the first few days of taking Bisoprolol you should avoid drinking alcohol as it can exacerbate the effects of the medicine, causing you to feel dizzy or lightheaded. If these effects continue, it’s best to avoid alcohol during your treatment.

Can I drive when taking Bisoprolol?

If Bisoprolol makes you dizzy, you should avoid driving.

Will Bisoprolol affect my contraception?

Taking Bisoprolol won’t have an impact on your contraception. The combined pill is not usually suitable for women with high blood pressure, as it can cause your blood pressure to raise. This is something that you should discuss with your doctor if you are on the combined pill and are experiencing high blood pressure. 

Drug interactions

It’s important to inform your doctor about any other medications you are taking in case they interfere with each other. In particular the following medicines may stop Bisoprolol from working properly:

• Additional medicine for high blood pressure
• Certain types of antidepressants 
• Nitrates- a chest pain treatment 
• Baclofen- muscle relaxants 
• Treatment for enlarged prostate 
• Treatment for Parkinson’s disease 
• Anti-inflammatories like ibuprofen 
• Steroids 
• pseudoephedrine or xylometazoline in cough medicine
• Diabetes treatment 
• Allergy medication 
• Rifampicin 

Caution should be taken in mixing Bisoprolol with herbal remedies as it’s not known how they could interact with the medication.   

Bisoprolol and pregnancy

Bisoprolol is not recommended during pregnancy. You should inform your doctor if you are pregnant or planning to start a family before starting your treatment. Labetalol may be prescribed instead to avoid causing harm to the baby.

Contraindications

Bisoprolol can be taken by adults over the age of 18 but there are people who may not be able to take it. Inform your doctor if:

• You are allergic to Bisoprolol or other medicines 
• Have low blood pressure 
• You are experiencing a slow heart rate 
• You’ve had a recent heart attack
• You have heart disease or heart failure which is getting worse 
• Circulation problems like Raynaud's phenomenon
•  Metabolic acidosis 
• Severe asthma or a lung condition   

Bisoprolol side effects

Common side effects from Bisoprolol include:

• Feeling tired, weak or dizzy
• Headache
• Cold hands and feet 
• Low blood pressure
• Stomach problems

Less common side effects are:

• Problems sleeping
• Depression
• Triggering asthma symptoms in those with the condition 
• A feeling of weakness in the muscles or cramps

There are rare side effects which occur in less than 1 in 1000 people:

• Problems hearing 
• Dry eyes 
• Runny nose
• Yellowed skin and eyes due to an inflammation in the liver
• A rash or flushed, itchy skin 
• Sexual problems 
• Nightmares 
• Feeling faint 

Serious side effects cause the heartbeat to slow, difficulty breathing and heart failure to get worse. If you experience any of these issues, seek medical help right away.   

Alternatives to Bisoprolol

There are other types of medication which can be given to treat high blood pressure and heart problems. These include ACE inhibitors and Angiotensin-2 receptor blockers which relax the blood vessels, or calcium-channel blockers which widen the blood vessels. 

Lifestyle changes to reduce your blood pressure

There are changes you can make yourself to improve your lifestyle and overall health and benefit your blood pressure at the same time. Cutting down on salt and fatty foods, eating plenty of vegetables, stopping smoking and exercising regularly are all positive steps you can take to reduce your blood pressure. 

Bisoprolol vs other beta blockers

Some beta blockers treat heart conditions but are not effective for treating high blood pressure. Different types are suited to different purposes so it will depend on your condition and symptoms as to which one is best.  

What else can I do to lower my blood pressure?

Aside from medication, your diet and lifestyle have an impact on your blood pressure. Eating a healthy diet, cutting down on salt and saturated fats and exercising regularly are all things that will help to lower your blood pressure. 

What type of antihypertensive is Bisoprolol?

Antihypertensives are medicines which reduce high blood pressure. Bisoprolol is a beta blocker, which is one type of antihypertensive. Beta blockers work by blocking adrenaline from binding to the receptors in the muscles and organs, in particular the ones surrounding the blood vessels. This causes the blood vessels to dilate so that blood can flow more freely.

Can I eat grapefruit whilst taking Bisoprolol?

You don’t need to avoid any types of food or drink while you are taking Bisoprolol. Grapefruit should only be avoided if you are taking calcium-channel blockers. 

Do I need to avoid sports when taking Bisoprolol?

You can still participate in sports or physical activities while taking Bisoprolol. Take care not to overexert yourself and rest where necessary. If you are participating in competitions or athletic performance, taking medicines such as Bisoprolol may prohibit you from taking part.  

Will Bisoprolol affect my sex life?

A less common side effect of Bisoprolol is a decreased sex drive and for some men they have trouble getting an erection. This is not overly common however so you are not likely to experience problems with your sex life. 

Can I take Bisoprolol for migraines?

Bisoprolol can be helpful in preventing migraines. It’s likely that your doctor will try you with medication specifically designed for migraines first. Beta blockers can be a good preventative measure but they won’t ease the pain once it has began.

Can I take Bisoprolol for anxiety?

Beta blockers like Bisoprolol can sometimes be prescribed for anxiety. During periods of anxiety, the body goes into fight or flight mode which causes adrenaline to spike. Beta blockers work to block these hormones and regulate the heart which can help to treat the physical symptoms of anxiety.

Can I take Bisoprolol before surgery?

You’ll need to tell your doctor that you are taking Bisoprolol if you are scheduled to have surgery. You might need to stop taking it in the 48 hours before surgery as Bisoprolol could interact with certain general anaesthetics and cause your blood pressure to drop too low.

Sources

• Patient Information Leaflet
• NHS > Bisoprolol
• NHS > Beta Blockers
• Blood Pressure UK > Your Lifestyle
• Migraine.com > Beta Blockers
• Mayo Clinic > Beta Blockers