Bisoprolol

Bisoprolol is generally well-tolerated, and side effects are mild and transient. Side effects include:

• abdominal cramps,
• diarrhea,
• dizziness,
• fatigue,
• depression,
• headache,
• nausea,
• impotence,
• slow heart rate,
• low blood pressure,
• numbness,
• tingling,
• cold extremities,
• sore throat, and
• shortness of breath or
• wheezing.

Patients with asthma may have symptoms increase.

: Rifampin may increase the metabolism (destruction) of bisoprolol, possibly making bisoprolol less effective. Certain calcium channel blockers (CCBs), especially verapamil (Calan, Isoptin) and diltiazem (Cardizem, Tiazac), may enhance the effect of bisoprolol on the heart. In some patients, this may cause excessive slowing of the heart rate or reduce the heart's ability to beat. The use of digoxin (Lanoxin) with bisoprolol also may cause an excessive reduction in heart rate.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Anaprox, Aleve), can reduce the blood pressure lowering effects of beta- blockers.

Bisoprolol is a prescription medication used to treat high blood pressure. Bisoprolol belongs to a group of drugs called beta blockers. It works to decrease blood pressure and heart rate by blocking beta receptors in the body.

This medication comes in tablet form. It is usually taken once daily, with or without food.

Common side effects include diarrhea, fatigue and dizziness. Do not drive or operate heavy machinery until you know how it affects you.

Bisoprolol may be found in some form under the following brand names:

• Zebeta

• Ziac

Bisoprolol is part of the drug class:

• Beta blocking agents, selective

It is not known if bisoprolol crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using bisoprolol.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Feeling tired or weak.
• Signs of a common cold.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
• Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about bisoprolol, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about bisoprolol. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using bisoprolol.

Review Date: October 4, 2017

Bisoprolol FUMARATE is indicated in the management of hypertension. It may be used alone or in combination with other antihypertensive agents.

Hepatitis or cirrhosis: Initial: 2.5 mg daily; increase cautiously.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience loss of strength and energy or common cold symptoms. Have patient report immediately to prescriber severe dizziness, passing out, shortness of breath, excessive weight gain, swelling of arms or legs, bradycardia, or abnormal heartbeat (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

CrCl less than 40 mL/min:
-Initial dose: 2.5 mg orally once a day; use caution with dose-titration

CrCl less than 40 mL/min:
-Initial dose: 2.5 mg orally once a day; use caution with dose-titration

No adjustment recommended

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• A headache, dizziness, diarrhea, dizziness, rhinitis, and fatigue are the most common side effects reported.
• Generally not recommended for people with bronchospastic disease; however, may be used in certain circumstances.
• Can mask symptoms of hypoglycemia or hyperthyroidism, so should be used with caution in people with diabetes or thyroid disease.
• May aggravate peripheral circulatory disorders (conditions that cause reduced blood flow to the hands or feet).
• May cause a number of unwanted heart-related effects and may affect breathing, so response must be monitored.
• Cardioselectivity of bisoprolol is not absolute, and at dosages higher than 20mg/day bisoprolol also inhibits beta2 receptors, mostly located in the bronchial and vascular musculature. The lowest effective dose should be used to maintain cardioselectivity.
• The clearance of bisoprolol from the body may be delayed in renal or liver disease.
• May not be suitable for some people including those with heart failure, a significantly slow heartbeat, or reduced peripheral circulation.
• May interact with some medications including other medications used for the treatment of arrhythmias or angina.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

• May be taken with or without food.
• Sudden discontinuation has been associated with an exacerbation of angina, and sometimes myocardial infarction (heart attack) or ventricular arrhythmias. If you need to discontinue bisoprolol, your doctor will advise how to do this slowly over at least a week.
• If you have diabetes, bisoprolol may mask some of the symptoms of hypoglycemia (low blood sugar).
• Should always be used as part of a comprehensive cardiovascular risk reduction program which includes diabetes management, smoking cessation, exercise, and other drug therapies. May be used in addition to other blood pressure lowering medicines.
• Seek medical advice immediately if shortness of breath develops.
• Seek medical advice if any new numbness, pain, skin color changes or reduced sensitivity occurs in fingers or toes.