Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464
Information last reviewed 04/09/2021
Bisoprolol is a beta-blocker used to treat high blood pressure, heart failure, angina and some heart rhythm disorders. 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. Beta-blockers are also sometimes prescribed to treat symptoms of anxiety, hyperthyroidism and migraine.
Bisoprolol starts to take effect within just a few hours of taking it, but to have an optimal effect on your blood pressure it may take a few weeks. High blood pressure often doesn’t have any symptoms, so you’re not likely to feel any different, but this doesn’t mean that the medicine isn’t working. If you’re taking a beta-blocker 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.
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.
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.
Bisoprolol will start to work two hours after you start to take it but it usually takes a few weeks to have full effect.
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.
Bisoprolol fumarate is the active ingredient in this medication.
Other ingredients in bisoprolol are cellulose microcrystalline, sodium starch glycolate, povidone K-30, silica colloidal anhydrous, magnesium stearate (E470b), hypromellose E-15 (E464), macrogol 400 (E553), titanium dioxide (E171) and talc.
Please note: inactive ingredients can vary between different doses and brands.
You’ll usually start with a low dose of 5 mg or 10 mg. This may be increased to 20 mg if your blood pressure is still high.
Bisoprolol is usually taken once a day, in the morning, 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 the dose if you don’t remember until the next day.
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 unless specifically advised, 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 an alternative solution.
Common side effects from bisoprolol include:
Uncommon side effects are:
Rare or very rare side effects that occur in less than 1 in 1,000 people:
Serious side effects include difficulty breathing and worsening of heart failure symptoms. If you experience any of these issues, seek medical help right away.
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:
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:
Caution should be taken in mixing bisoprolol with herbal remedies as it’s not known how they could interact with the medication.
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.
It’s not known if bisoprolol is safe to take while breastfeeding. You should speak to your doctor to find a suitable treatment.
If bisoprolol makes you dizzy, you should avoid driving.
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.
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 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.
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 rise. If you have high blood pressure and you are taking the combined pill, you should speak to your doctor to discuss your contraceptive options.
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 diarrhoea.
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.
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.
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.
There are other types of medication that can be given to treat high blood pressure and heart problems. These include ACE inhibitors, angiotensin receptor blockers and calcium-channel blockers which help widen the blood vessels.
Antihypertensives are medicines that reduce 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. Beta-blockers also act on the heart, slowing the heart rate.
You don’t need to avoid any types of food or drink while you are taking bisoprolol. Grapefruit should be avoided if you are also taking certain types of calcium channel blocker.
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.
A less common side effect of bisoprolol is trouble getting an erection. If this becomes a problem, speak to your healthcare practitioner.
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 for migraines, but should only be used for this purpose if specifically prescribed for it.
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. Only take bisoprolol for anxiety under supervision from your doctor.
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 before surgery as it may interact with certain general anaesthetics and cause your blood pressure to drop too low.
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