Bisoprolol hctz side effects

hydrochlorothiazide and bisoprolol (Ziac)

Brand Names: Ziac

Generic Name: hydrochlorothiazide and bisoprolol

  • What is hydrochlorothiazide and bisoprolol (Ziac)?
  • What are the possible side effects of hydrochlorothiazide and bisoprolol (Ziac)?
  • What is the most important information I should know about hydrochlorothiazide and bisoprolol (Ziac)?
  • What should I discuss with my healthcare provider before taking hydrochlorothiazide and bisoprolol (Ziac)?
  • How should I take hydrochlorothiazide and bisoprolol (Ziac)?
  • What happens if I miss a dose (Ziac)?
  • What happens if I overdose (Ziac)?
  • What should I avoid while taking hydrochlorothiazide and bisoprolol (Ziac)?
  • What other drugs will affect hydrochlorothiazide and bisoprolol (Ziac)?
  • Where can I get more information (Ziac)?

What is hydrochlorothiazide and bisoprolol (Ziac)?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Bisoprolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Hydrochlorothiazide and bisoprolol is a combination medicine used to treat high blood pressure (hypertension).

Hydrochlorothiazide and bisoprolol may also be used for purposes not listed in this medication guide.

001850701_PB

round, peach, imprinted with E 701

001850704_PB

round, red, imprinted with E 704

001850707_PB

round, white, imprinted with E 707

003780501_PB

round, orange, imprinted with 501, M

003780503_PB

round, blue, imprinted with 503, M

003780505_PB

round, white, imprinted with 505, M

293000187_PB

round, yellow, imprinted with UL

293000188_PB

round, pink, imprinted with UL, ll

293000189_PB

round, white, imprinted with UL, lll

512850047_PB

round, yellow, imprinted with b, 47

Bisoprolol-HCT 10 mg-6.25 mg-PUR

oblong, white, imprinted with 652, R

Bisoprolol-HCT 10 mg-6.25 mg-WAT

round, white, imprinted with 843, WATSON

Bisoprolol-HCT 2.5 mg-6.25 mg-WAT

round, yellow, imprinted with 841, WATSON

Bisoprolol-HCT 5 mg-6.25 mg-WAT

round, pink, imprinted with 842, WATSON

Bisoprolol-HCTZ 10-6.25 mg-MYL

round, white, imprinted with 505, M

Bisoprolol-HCTZ 2.5-6.25 mg-MYL

round, orange, imprinted with 501, M

Bisoprolol-HCTZ 5-6.25 mg-MYL

round, blue, imprinted with 503, M

Ziac 10 mg

round, white, imprinted with LL, B 14

Ziac 10 mg-BAR

round, white, imprinted with b, 40

Ziac 2.5 mg

round, yellow, imprinted with LL, B 12

Ziac 2.5 mg-BAR

round, yellow, imprinted with b, 47

Ziac 5 mg

round, pink, imprinted with LL, B 13

Ziac 5 mg-BAR

round, pink, imprinted with b, 50

What are the possible side effects of hydrochlorothiazide and bisoprolol (Ziac)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • chest pain;
  • fast, slow, or uneven heartbeats;
  • a light-headed feeling, like you might pass out;
  • blurred vision, tunnel vision, eye pain, or seeing halos around lights;
  • shortness of breath (even with mild exertion), swelling, rapid weight gain;
  • low potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, extreme thirst, increased urination, numbness or tingling, muscle weakness or limp feeling;
  • liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • low blood sugar–headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or
  • severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about hydrochlorothiazide and bisoprolol (Ziac)?

You should not use this medicine if you are unable to urinate. You should not use hydrochlorothiazide and bisoprolol if you have a serious heart condition such as “sick sinus syndrome” or “AV block,” severe heart failure, or slow heartbeats that have caused you to faint.

Bisoprolol

Identification

Are you a new drug developer? Contact us to learn more about our customized products and solutions. Stay in the know! As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages. #DrugBankUpdates Name Bisoprolol Accession Number DB00612 (APRD00257) Type Small Molecule Groups Approved Description

Bisoprolol is a cardioselective β1-adrenergic blocking agent used to treat high blood pressure.4,16 It is considered a potent drug with a long-half life that can be used once daily to reduce the need for multiple doses of antihypertensive drugs.4 Bisoprolol is generally well tolerated, likely due to its β1-adrenergic receptor selectivity and is a useful alternative to non-selective β-blocker drugs in the treatment of hypertension such as Carvedilol and Labetalol. It may be used alone or in combination with other drugs to manage hypertension16 and can be useful in patients with chronic obstructive pulmonary disease (COPD) due to its receptor selectivity.13

Structure 3D Download Similar Structures

Structure for Bisoprolol (DB00612)

× Close Synonyms External IDs CL 297,939 / CL 297939 / EMD 33 512 / EMD 33512 Product Ingredients

Ingredient UNII CAS InChI Key
Bisoprolol fumarate UR59KN573L 104344-23-2 VMDFASMUILANOL-WXXKFALUSA-N

Product Images Prescription Products

Name Dosage Strength Route Labeller Marketing Start Marketing End
Unlock Additional Data
Bisoprolol Tablet 5 mg Oral Sivem Pharmaceuticals Ulc 2012-06-12 Not applicable Canada
Bisoprolol Tablet 10 mg Oral Sanis Health Inc 2012-10-01 Not applicable Canada
Bisoprolol Tablet 10 mg Oral Sorres Pharma Inc 2009-02-26 2014-06-20 Canada
Bisoprolol Tablet 5 mg Oral Sanis Health Inc 2012-10-01 Not applicable Canada
Bisoprolol Tablet 5 mg Oral Sorres Pharma Inc 2009-02-26 2014-06-20 Canada
Bisoprolol Tablet 10 mg Oral Sivem Pharmaceuticals Ulc 2012-06-12 Not applicable Canada
Monocor -(10mg) Tablet Oral Biovail Pharmaceuticals Canada Division Of Biovail Corporation 2000-06-22 2005-03-10 Canada
Monocor -(5mg) Tablet Oral Biovail Pharmaceuticals Canada Division Of Biovail Corporation 2000-06-22 2009-07-31 Canada
Zebeta Tablet, film coated 10 mg/1 Oral Teva Women’s Health 1993-10-29 2017-05-31 US
Zebeta Tablet, film coated 5 mg/1 Oral Teva Women’s Health 1993-10-20 2016-10-31 US

Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more

  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

    Learn more

Generic Prescription Products

Name Dosage Strength Route Labeller Marketing Start Marketing End
Unlock Additional Data
Apo-bisoprolol Tablet Oral Apotex Corporation 2004-08-10 Not applicable Canada
Apo-bisoprolol Tablet Oral Apotex Corporation 2004-08-10 Not applicable Canada
Ava-bisoprolol Tablet Oral Avanstra Inc 2011-08-22 2014-08-21 Canada
Ava-bisoprolol Tablet Oral Avanstra Inc 2011-08-22 2014-08-21 Canada
Bisoprolol Tablet, film coated 10 mg/1 Oral Trupharma, Llc 2019-06-20 Not applicable US
Bisoprolol Tablet, film coated 5 mg/1 Oral Nucare Pharmaceuticals,inc. 2019-06-20 Not applicable US
Bisoprolol Tablet, film coated 5 mg/1 Oral Trupharma, Llc 2019-06-20 Not applicable US
Bisoprolol Fumarate Tablet, film coated 10 mg/1 Oral Mylan Pharmaceuticals Inc. 2012-09-24 2020-11-30 US
Bisoprolol Fumarate Tablet, film coated 10 mg/1 Oral Teva Pharmaceuticals USA, Inc. 2004-06-01 Not applicable US
Bisoprolol Fumarate Tablet, film coated 5 mg/1 Oral Citron Pharma LLC 2006-12-27 Not applicable US

Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more

  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

    Learn more

Mixture Products

Name Ingredients Dosage Route Labeller Marketing Start Marketing End
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, film coated Oral Teva Pharmaceuticals USA, Inc. 2019-08-07 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, coated Oral bryant ranch prepack 2000-09-25 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, coated Oral Med Pharma Co., Ltd. 2011-07-19 2012-10-10 US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, coated Oral Eon Labs, Inc. 2000-09-25 2016-10-31 US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (10 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, coated Oral Physicians Total Care, Inc. 2003-08-01 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (10 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet, film coated Oral Mylan Pharmaceuticals Inc. 2000-09-25 2019-09-30 US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (10 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet Oral Nucare Pharmaceuticals, Inc. 2010-10-12 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (2.5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet Oral bryant ranch prepack 2010-10-12 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (5 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet Oral Blenheim Pharmacal, Inc. 2013-11-15 Not applicable US
Bisoprolol Fumarate and Hydrochlorothiazide Bisoprolol fumarate (10 mg/1) + Hydrochlorothiazide (6.25 mg/1) Tablet Oral Unichem Pharmaceuticals (USA), Inc. 2010-10-12 Not applicable US

International/Other Brands Bisocor / Cardicor (Bayer) / Concor (Merck) / Concore (Merck) / Detensiel (Merck Santé) / Emconcor (Merck) / Emcor (Merck) / Euradal (Lacer) / Isoten (Meda) / Monocor (Biovail Pharmaceuticals) / Soprol (Helsinn) Categories UNII Y41JS2NL6U CAS number 66722-44-9 Weight Average: 325.443
Monoisotopic: 325.225308485 Chemical Formula C18H31NO4 InChI Key VHYCDWMUTMEGQY-UHFFFAOYSA-N InChI InChI=1S/C18H31NO4/c1-14(2)19-11-17(20)13-23-18-7-5-16(6-8-18)12-21-9-10-22-15(3)4/h5-8,14-15,17,19-20H,9-13H2,1-4H3 IUPAC Name 1–3-(4-{methyl}phenoxy)propan-2-ol SMILES CC(C)NCC(O)COC1=CC=C(COCCOC(C)C)C=C1

Pharmacology

Indication

Bisoprolol is indicated for the treatment of mild to moderate hypertension.16 It may be used off-label to treat heart failure, atrial fibrillation, and angina pectoris.1,2

Associated Conditions

  • Atrial Fibrillation (AF)
  • Cardiovascular Events
  • Chronic Stable Angina Pectoris
  • Heart Failure
  • High Blood Pressure (Hypertension)
  • Mild Hypertension
  • Premature Ventricular Contractions
  • Supraventricular Arrhythmias
  • Moderate Hypertension
  • Perioperative arrhythmia

Pharmacodynamics

Bisoprolol decreases heart rate (chronotropy), decreases contractility (inotropy), and reduces blood pressure.14,16 The results of various clinical studies indicate that bisoprolol reduces cardiovascular mortality and all-cause mortality in patients with heart failure and decreased cardiac ejection fraction (EF).3,8

Mechanism of action

Though the mechanism of action of bisoprolol has not been fully elucidated in hypertension, it is thought that therapeutic effects are achieved through the antagonism of β-1adrenoceptors to result in lower cardiac output. Bisoprolol is a competitive, cardioselective β1-adrenergic antagonist. When β1-receptors (located mainly in the heart)14 are activated by adrenergic neurotransmitters such as epinephrine, both the blood pressure and heart rate increase, leading to greater cardiovascular work, increasing the demand for oxygen. Bisoprolol reduces cardiac workload by decreasing contractility and the need for oxygen through competitive inhibition of β1-adrenergic receptors.7,14

Bisoprolol is also thought to reduce the output of renin in the kidneys, which normally increases blood pressure. Additionally, some central nervous system effects of bisoprolol may include diminishing sympathetic nervous system output from the brain, decreasing blood pressure and heart rate.16

Target Actions Organism
ABeta-1 adrenergic receptor antagonist Humans
NBeta-2 adrenergic receptor antagonist Humans

Unlock Additional Data Additional Data Available Adverse Effects

Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.

Learn more Additional Data Available Contraindications

Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

Learn more Additional Data Available Blackbox Warnings

Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

Learn more Absorption

Bisoprolol is well absorbed in the gastrointestinal tract.17 The AUC is 642.87 g.hr/mL and bioavailability of bisoprolol is about 90% due to the minimal first pass effects.1 Absorption is unaffected by food intake. Peak plasma concentrations of bisoprolol are attained within 2-4 hours and steady-state concentrations are achieved within 5 days of administration.16 In a pharmacokinetic study, the mean peak concentration of bisoprolol was 52 micrograms/L.6 Cmax at steady state concentrations of bisoprolol is 64±21 ng/ml administered at 10 mg daily.17

Volume of distribution

The volume of distribution of bisoprolol is 3.5 L/kg.17 The mean volume of distribution was found to be 230 L/kg in heart failure patients, which was similar to the volume of distribution in healthy patients.10 Bisoprolol is known to cross the placenta.15

Protein binding

Binding to serum proteins is approximately 30%.9,17

Metabolism

About 50% of a single bisoprolol dose is metabolized mainly by the enzyme CYP3A4 to inactive metabolites.16

Route of elimination

Bisoprolol is eliminated equally by both renal and hepatic pathways. About 50% of an oral dose is excreted unchanged in the urine with the remainder of the dose excreted as inactive bisoprolol metabolites. Under 2% of the ingested dose is found to be excreted in the feces.16,17

Half life

A pharmacokinetic study in 12 healthy individuals determined the mean plasma half-life of bisoprolol to be 10-12 hours.4 Another study comprised of healthy patients determined the elimination half-life to be approximately 10 hours.6 Renal impairment increased the half-life to 18.5 hours.6

Clearance

Total body clearance in healthy patients was determined to be 14.2 L/h. In patients with renal impairment, clearance was reduced to 7.8 L/h. Hepatic dysfunction also reduced the clearance of bisoprolol.6

Toxicity

LD50 information Oral LD50 of bisoprolol in the mouse was 730 mg/kg.20

Overdose information

Signs of a β-blocker overdose include cardiovascular symptoms such as hypotension, congestive heart failure, and bradycardia. Other symptoms such as bronchospasm, and hypoglycemia may occur. If an overdose occurs with bisoprolol, supportive treatment should be initiated. Glucagon has been shown to be beneficial in bradycardia and hypotension associated with beta-blocker overdosage.11 Hypoglycemia may be managed by administering IV glucose.16 Monitor the patient and administer atropine in cases of bradycardia, pressors and fluids in the case of hypotension, and conventional heart failure therapy if heart failure occurs. If heart block occurs, the patient must be closely monitored and isoproterenol infusion or transvenous cardiac pacemaker insertion should take place.16 For the management of overdose-related bronchospasm, administer bronchodilators with or without IV aminophylline. Limited research suggests that bisoprolol fumarate is not removed adequately by hemodialysis sessions.12,16

Affected organisms

  • Humans and other mammals

Pathways

Pathway Category
Bisoprolol Action Pathway Drug action

Pharmacogenomic Effects/ADRs Not Available

Interactions

Drug Interactions This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

  • All Drugs
  • Approved
  • Vet approved
  • Nutraceutical
  • Illicit
  • Withdrawn
  • Investigational
  • Experimental
Drug Interaction
Unlock Additional Data
1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid 1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid may decrease the antihypertensive activities of Bisoprolol.
1-benzylimidazole 1-benzylimidazole may decrease the antihypertensive activities of Bisoprolol.
1,10-Phenanthroline 1,10-Phenanthroline may increase the bradycardic activities of Bisoprolol.
2,4-thiazolidinedione The therapeutic efficacy of 2,4-thiazolidinedione can be increased when used in combination with Bisoprolol.
2,5-Dimethoxy-4-ethylamphetamine The therapeutic efficacy of Bisoprolol can be decreased when used in combination with 2,5-Dimethoxy-4-ethylamphetamine.
2,5-Dimethoxy-4-ethylthioamphetamine The therapeutic efficacy of Bisoprolol can be decreased when used in combination with 2,5-Dimethoxy-4-ethylthioamphetamine.
25-desacetylrifapentine The metabolism of Bisoprolol can be increased when combined with 25-desacetylrifapentine.
3-isobutyl-1-methyl-7H-xanthine The risk or severity of adverse effects can be increased when Bisoprolol is combined with 3-isobutyl-1-methyl-7H-xanthine.
4-Bromo-2,5-dimethoxyamphetamine The therapeutic efficacy of Bisoprolol can be decreased when used in combination with 4-Bromo-2,5-dimethoxyamphetamine.
4-Bromo-2,5-dimethoxyphenethylamine The therapeutic efficacy of 4-Bromo-2,5-dimethoxyphenethylamine can be decreased when used in combination with Bisoprolol.

Additional Data Available

  • Extended Description Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

    Learn more

  • Severity Severity

    A severity rating for each drug interaction, from minor to major.

    Learn more

  • Evidence Level Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

    Learn more

  • Action Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

    Learn more

Food Interactions

  • Take without regard to meals.

Synthesis Reference

Yoshihiro Iwao, Katsuyuki Ookubo, Katsuhiro Okada, Kunihiro Minami, Shuichiro Yuasa, “Adhesive Pharmaceutical Preparation Containing Bisoprolol.” U.S. Patent US20090169604, issued July 02, 2009.

US20090169604 General References External Links Human Metabolome Database HMDB0014750 KEGG Drug D02342 KEGG Compound C06852 PubChem Compound 2405 PubChem Substance 46508844 ChemSpider 2312 BindingDB 25751 ChEBI 3127 ChEMBL CHEMBL645 Therapeutic Targets Database DAP000483 PharmGKB PA448641 RxList RxList Drug Page Drugs.com Drugs.com Drug Page PDRhealth PDRhealth Drug Page Wikipedia Bisoprolol ATC Codes C07FX04 — Bisoprolol and acetylsalicylic acid

  • C07FX — Beta blocking agents, other combinations
  • C07F — BETA BLOCKING AGENTS, OTHER COMBINATIONS
  • C07 — BETA BLOCKING AGENTS
  • C — CARDIOVASCULAR SYSTEM

C07BB07 — Bisoprolol and thiazides

  • C07BB — Beta blocking agents, selective, and thiazides
  • C07B — BETA BLOCKING AGENTS AND THIAZIDES
  • C07 — BETA BLOCKING AGENTS
  • C — CARDIOVASCULAR SYSTEM

C07AB07 — Bisoprolol

  • C07AB — Beta blocking agents, selective
  • C07A — BETA BLOCKING AGENTS
  • C07 — BETA BLOCKING AGENTS
  • C — CARDIOVASCULAR SYSTEM

C09BX02 — Perindopril and bisoprolol

  • C09BX — ACE inhibitors, other combinations
  • C09B — ACE INHIBITORS, COMBINATIONS
  • C09 — AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM
  • C — CARDIOVASCULAR SYSTEM

C07FB07 — Bisoprolol and amlodipine

  • C07FB — Beta blocking agents and calcium channel blockers
  • C07F — BETA BLOCKING AGENTS, OTHER COMBINATIONS
  • C07 — BETA BLOCKING AGENTS
  • C — CARDIOVASCULAR SYSTEM

AHFS Codes

  • 24:24.00 — Beta-adrenergic Blocking Agents

Clinical Trials

Clinical Trials

Phase Status Purpose Conditions Count
0 Completed Diagnostic Abdominal Aortic Aneurysm Patients Under Surveillance 1
0 Unknown Status Prevention Patients With Coronary Artery Disease Scheduled for by Pass Surgery 1
1 Completed Basic Science Healthy Volunteers / Pharmacodynamics of Mirabegron 1
1 Completed Other Healthy Volunteers 1
1 Completed Treatment Fasting 1
1 Completed Treatment Fed 1
1 Completed Treatment Healthy Volunteers 1
1 Withdrawn Basic Science Healthy Volunteers 1
1, 2 Unknown Status Treatment Idiopathic Pulmonary Arterial Hypertension 1
2 Terminated Treatment Chronic Obstructive Pulmonary Disease (COPD) / Heart Failure 1
2, 3 Completed Prevention Coronary Artery Disease / Diabetes Mellitus / Heart Failure 1
2, 3 Recruiting Treatment Congestive Cardiomyopathy / Duchenne’s Muscular Dystrophy (DMD) 1
3 Completed Treatment Chagas Cardiomyopathy / Chronic Heart Failure (CHF) 1
3 Completed Treatment High Blood Pressure (Hypertension) 1
3 Not Yet Recruiting Prevention Cardiovascular Heart Disease / Chronic Obstructive Pulmonary Disease (COPD) 1
3 Recruiting Prevention Breast Cancer / Cardiotoxicity 1
4 Active Not Recruiting Treatment Hypertension, Resistant to Conventional Therapy 1
4 Completed Health Services Research High Blood Pressure (Hypertension) / Metabolic Syndromes 1
4 Completed Prevention Adverse Effects / Coronary Artery Atherosclerosis / Insulin resistance syndrome 1
4 Completed Prevention Atrial Fibrillation (AF) / Coronary Artery Bypass Graft Surgery Patients / Prevention / Prevention of Atrial Fibrillation After CABG 1
4 Completed Supportive Care High Blood Pressure (Hypertension) 1
4 Completed Treatment Blood Pressures 2
4 Completed Treatment Chronic Heart Failure (CHF) 2
4 Completed Treatment Chronic Obstructive Pulmonary Disease (COPD) 2
4 Completed Treatment Congestive Heart Failure 1
4 Completed Treatment Heart Failure / Left Ventricular Dysfunction 1
4 Completed Treatment High Blood Pressure (Hypertension) 3
4 Completed Treatment High Blood Pressure (Hypertension) / Pharmacogenetics 1
4 Completed Treatment High Blood Pressure (Hypertension) / Type 2 Diabetes Mellitus 1
4 Completed Treatment Hypertension Resistant To Conventional Therapy 1
4 Completed Treatment Postural Orthostatic Tachycardia Syndrome (POTS) 1
4 Completed Treatment Untreated Essential Hypertension 1
4 Not Yet Recruiting Treatment Acute Myocardial Infarction (AMI) / Non-ST Elevation Myocardial Infarction (NSTEMI) / ST Elevation Myocardial Infarction 1
4 Recruiting Treatment Acute Myocardial Infarction (AMI) / Non-ST Elevation Myocardial Infarction / ST Elevation Myocardial Infarction 1
4 Recruiting Treatment Heart Diseases / Type 2 Diabetes Mellitus 1
4 Recruiting Treatment High Blood Pressure (Hypertension) 1
4 Recruiting Treatment Hypertension, Renal 1
4 Recruiting Treatment Myocardial Infarction 1
4 Recruiting Treatment Permanent Atrial Fibrillation 1
4 Suspended Treatment Heart Rate Control in ICD Patients With Heart Failure 1
4 Terminated Treatment Aortic Valve Stenosis 1
4 Terminated Treatment Heart Failure 1
4 Unknown Status Treatment High Blood Pressure (Hypertension) 1
4 Unknown Status Treatment Stable Angina (SA) 1
Not Available Active Not Recruiting Treatment Acute Coronary Syndromes (ACS) 1
Not Available Active Not Recruiting Treatment Decompensated Heart Failure / Heart Failure With Reduced Ejection Fraction (HFrEF) 1
Not Available Completed Not Available Anesthesia; Adverse Effect / Delirium 1
Not Available Completed Not Available High Blood Pressure (Hypertension) 2
Not Available Completed Basic Science Arterial Hypertension / Osteopenia 1
Not Available Completed Treatment Atrial Fibrillation (AF) / Chronic Heart Failure (CHF) 1
Not Available Completed Treatment Chronic Obstructive Pulmonary Disease (COPD) 1
Not Available Completed Treatment Clozapine-induced Sinustachycardia 1
Not Available Completed Treatment Myocardial Ischemia 1
Not Available Recruiting Not Available Aortic Valve Stenosis / Hypertension,Essential / Impaired kidney function / Secondary Hypertension 1
Not Available Recruiting Not Available Arterial Hypertension / CHD – Coronary Heart Disease 1
Not Available Recruiting Not Available Heart Failure With Reduced Ejection Fraction (HFrEF) 1
Not Available Unknown Status Not Available Heart Failure 1
Not Available Unknown Status Treatment Chronic Heart Failure (CHF) 1

Pharmacoeconomics

Manufacturers

  • Aurobindo pharma ltd
  • Mutual pharmaceutical co inc
  • Mylan pharmaceuticals inc
  • Sandoz inc
  • Teva pharmaceuticals usa
  • Unichem pharmaceuticals (usa) inc
  • Duramed pharmaceuticals inc sub barr laboratories inc

Packagers

  • Atlantic Biologicals Corporation
  • Aurobindo Pharma Ltd.
  • Duramed
  • Eon Labs
  • Greenstone LLC
  • Kaiser Foundation Hospital
  • Lake Erie Medical and Surgical Supply
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Novopharm Ltd.
  • Physicians Total Care Inc.
  • Resource Optimization and Innovation LLC
  • Teva Pharmaceutical Industries Ltd.
  • Unichem Laboratories Ltd.
  • Watson Pharmaceuticals
  • Wyeth Pharmaceuticals

Dosage forms

Form Route Strength
Tablet Oral 10 mg
Tablet Oral 5 mg
Tablet Oral 10 mg/1
Tablet Oral 5 mg/1
Tablet, coated Oral 10 mg/1
Tablet, coated Oral 5 mg/1
Tablet, film coated Oral 10 mg/1
Tablet, film coated Oral 5 mg/1
Tablet Oral
Tablet, coated Oral
Tablet, film coated Oral
Tablet Oral

Prices

Unit description Cost Unit
Condylox 0.5% Gel 3.5 gm Tube 304.93USD tube
Condylox 0.5% Solution 3.5ml Bottle 143.4USD bottle
Condylox 0.5% gel 97.73USD g
Zebeta 10 mg tablet 3.6USD tablet
Zebeta 5 mg tablet 3.6USD tablet
Bisoprolol fumarate 5 mg tablet 1.78USD tablet
Bisoprolol fumarate 10 mg tablet 1.24USD tablet
Bisoprolol-Hydrochlorothiazide 10-6.25 mg tablet 1.19USD tablet
Bisoprolol-Hydrochlorothiazide 2.5-6.25 mg tablet 1.19USD tablet
Bisoprolol-Hydrochlorothiazide 5-6.25 mg tablet 1.19USD tablet
Apo-Bisoprolol 10 mg Tablet 0.38USD tablet
Novo-Bisoprolol 10 mg Tablet 0.38USD tablet
Pms-Bisoprolol 10 mg Tablet 0.38USD tablet
Sandoz Bisoprolol 10 mg Tablet 0.38USD tablet
Apo-Bisoprolol 5 mg Tablet 0.23USD tablet
Novo-Bisoprolol 5 mg Tablet 0.23USD tablet
Pms-Bisoprolol 5 mg Tablet 0.23USD tablet
Sandoz Bisoprolol 5 mg Tablet 0.23USD tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only. Patents Not Available

Properties

State Solid Experimental Properties Predicted Properties

Property Value Source
Water Solubility 0.0707 mg/mL ALOGPS
logP 2.3 ALOGPS
logP 2.2 ChemAxon
logS -3.7 ALOGPS
pKa (Strongest Acidic) 14.09 ChemAxon
pKa (Strongest Basic) 9.67 ChemAxon
Physiological Charge 1 ChemAxon
Hydrogen Acceptor Count 5 ChemAxon
Hydrogen Donor Count 2 ChemAxon
Polar Surface Area 59.95 Å2 ChemAxon
Rotatable Bond Count 12 ChemAxon
Refractivity 92.15 m3·mol-1 ChemAxon
Polarizability 38.5 Å3 ChemAxon
Number of Rings 1 ChemAxon
Bioavailability 1 ChemAxon
Rule of Five Yes ChemAxon
Ghose Filter Yes ChemAxon
Veber’s Rule No ChemAxon
MDDR-like Rule No ChemAxon

Predicted ADMET features

Property Value Probability
Human Intestinal Absorption + 0.9445
Blood Brain Barrier 0.9077
Caco-2 permeable + 0.6149
P-glycoprotein substrate Substrate 0.7785
P-glycoprotein inhibitor I Non-inhibitor 0.807
P-glycoprotein inhibitor II Non-inhibitor 0.7821
Renal organic cation transporter Non-inhibitor 0.8568
CYP450 2C9 substrate Non-substrate 0.8134
CYP450 2D6 substrate Substrate 0.8919
CYP450 3A4 substrate Non-substrate 0.6113
CYP450 1A2 substrate Non-inhibitor 0.9046
CYP450 2C9 inhibitor Non-inhibitor 0.9071
CYP450 2D6 inhibitor Non-inhibitor 0.923
CYP450 2C19 inhibitor Non-inhibitor 0.9485
CYP450 3A4 inhibitor Non-inhibitor 0.8373
CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.9766
Ames test Non AMES toxic 0.9064
Carcinogenicity Non-carcinogens 0.9267
Biodegradation Not ready biodegradable 0.8962
Rat acute toxicity 2.0089 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.7877
hERG inhibition (predictor II) Non-inhibitor 0.6611

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST) Not Available Spectra

Taxonomy

Description This compound belongs to the class of organic compounds known as benzylethers. These are aromatic ethers with the general formula ROCR’ (R = alkyl, aryl; R’=benzene). Kingdom Organic compounds Super Class Benzenoids Class Benzene and substituted derivatives Sub Class Benzylethers Direct Parent Benzylethers Alternative Parents Phenoxy compounds / Phenol ethers / Alkyl aryl ethers / Secondary alcohols / 1,2-aminoalcohols / Dialkylamines / Dialkyl ethers / Organopnictogen compounds / Hydrocarbon derivatives Substituents Benzylether / Phenoxy compound / Phenol ether / Alkyl aryl ether / 1,2-aminoalcohol / Secondary alcohol / Dialkyl ether / Secondary amine / Secondary aliphatic amine / Ether Molecular Framework Aromatic homomonocyclic compounds External Descriptors secondary alcohol, secondary amine (CHEBI:3127)

Targets

Binding Properties

×

Property Measurement pH Temperature (°C)
Kd (nM) 15 7.4 37 15655528
Ki (nM) 22.4 N/A N/A 14730417

Details Binding Properties1. Beta-1 adrenergic receptor Kind Protein Organism Humans Pharmacological action Yes Actions Antagonist General Function Receptor signaling protein activity Specific Function Beta-adrenergic receptors mediate the catecholamine-induced activation of adenylate cyclase through the action of G proteins. This receptor binds epinephrine and norepinephrine with approximately e… Gene Name ADRB1 Uniprot ID P08588 Uniprot Name Beta-1 adrenergic receptor Molecular Weight 51322.1 Da Kind Protein Organism Humans Pharmacological action No Actions Antagonist Curator comments At higher doses, bisoprolol antagonizes the B2 receptors, but is normally selective for B1 receptors. General Function Protein homodimerization activity Specific Function Beta-adrenergic receptors mediate the catecholamine-induced activation of adenylate cyclase through the action of G proteins. The beta-2-adrenergic receptor binds epinephrine with an approximately … Gene Name ADRB2 Uniprot ID P07550 Uniprot Name Beta-2 adrenergic receptor Molecular Weight 46458.32 Da

  1. Mark G. Papich (2016). Saunders Handbook of Veterinary Drugs (4th ed.). Saunders.
  2. Summary of product characteristics

Enzymes

Kind Protein Organism Humans Pharmacological action Unknown Actions Substrate General Function Vitamin d3 25-hydroxylase activity Specific Function Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react… Gene Name CYP3A4 Uniprot ID P08684 Uniprot Name Cytochrome P450 3A4 Molecular Weight 57342.67 Da

Transporters

Kind Protein Organism Humans Pharmacological action Unknown Actions Substrate Inhibitor General Function Xenobiotic-transporting atpase activity Specific Function Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells. Gene Name ABCB1 Uniprot ID P08183 Uniprot Name Multidrug resistance protein 1 Molecular Weight 141477.255 Da ×

Unlock Data

There is additional data available for commercial users including Adverse Effects, Contraindications, and Blackbox Warnings. Contact us to learn more about these and other features.

Learn more

Drug created on June 13, 2005 07:24 / Updated on February 02, 2020 04:13

Bisoprolol / hydrochlorothiazide Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 11, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

In Summary

More frequently reported side effects include: diarrhea, dizziness, headache, and rhinitis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to bisoprolol / hydrochlorothiazide: oral tablet

Along with its needed effects, bisoprolol/hydrochlorothiazide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking bisoprolol / hydrochlorothiazide:

Less common

  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • chest pain or discomfort
  • lightheadedness, dizziness, or fainting
  • rapid weight gain
  • shortness of breath
  • slow or irregular heartbeat
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss

Get emergency help immediately if any of the following symptoms of overdose occur while taking bisoprolol / hydrochlorothiazide:

Symptoms of overdose

  • Anxiety
  • blurred vision
  • burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • change in consciousness
  • chills
  • cold, clammy skin
  • cold sweats
  • confusion as to time, place, or person
  • cool, pale skin
  • cough
  • decrease in amount of urine
  • depression
  • difficulty breathing
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • extreme fatigue
  • fast or pounding heartbeat or pulse
  • fast, weak pulse
  • frequent urination
  • hallucinations
  • holding false beliefs that cannot be changed by fact
  • increased hunger
  • increased thirst
  • increased volume of pale, dilute urine
  • irregular breathing
  • irritability
  • loss of appetite
  • loss of consciousness
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • nervousness
  • nightmares
  • no breathing
  • noisy breathing
  • not able to pass urine
  • numbness or tingling in the hands, feet, or lips
  • pain or aching in the lower legs
  • seizures
  • shakiness
  • slurred speech
  • sweating
  • swelling of the face, hands, fingers, feet, ankles, or lower legs
  • tightness in the chest
  • trembling
  • troubled breathing
  • unconsciousness
  • unusual drowsiness, dullness, or feeling of sluggishness
  • unusual excitement, nervousness, or restlessness
  • very drowsy or sleepy
  • weakness and heaviness of legs
  • weight gain
  • wheezing

Some side effects of bisoprolol / hydrochlorothiazide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • Acid or sour stomach
  • belching
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty with moving
  • heartburn
  • inability to have or keep an erection
  • indigestion
  • joint pain
  • loss in sexual ability, desire, drive, or performance
  • muscle aching or stiffness
  • sleepiness
  • stomach discomfort, upset, or pain
  • swollen joints

Rare

  • Runny nose
  • sneezing
  • stuffy nose

For Healthcare Professionals

Applies to bisoprolol / hydrochlorothiazide: oral tablet

General

Frequency not reported side effects were seen with hydrochlorothiazide doses of generally 25 mg and higher.

The more commonly reported side effects observed with this drug are fatigue, dizziness, and diarrhea.

Cardiovascular

Common (1% to 10%): Bradycardia, chest pain, peripheral edema

Frequency not reported: Arrhythmia, peripheral ischemia

Bisoprolol:

Frequency not reported: Bradycardia, palpitations, rhythm disturbances, cold extremities, claudication, hypotension, orthostatic hypotension, chest pain, congestive heart failure, exertional dyspnea, edema

Hydrochlorothiazide:

Frequency not reported: Orthostatic hypotension, necrotizing angiitis, vasculitis

Orthostatic hypotension may be potentiated by alcohol, barbiturates, or narcotics.

Gastrointestinal

Common (1% to 10%): Diarrhea, nausea, dyspepsia

Bisoprolol:

Frequency not reported: Gastric pain, epigastric pain, abdominal pain, peptic ulcer, gastritis, dyspepsia, nausea, vomiting, diarrhea, constipation, dry mouth, mesenteric arterial thrombosis, ischemic colitis

Hydrochlorothiazide:

Frequency not reported: Gastric irritation, constipation, pancreatitis, sialadenitis, dry mouth

Nervous system

Common (1% to 10%): Dizziness, somnolence

Frequency not reported: Headache

Bisoprolol:

Frequency not reported: Unsteadiness, dizziness, vertigo, headache, syncope, paresthesia, hypoesthesia, hyperesthesia, somnolence, decreased concentration, decreased memory, tremor, taste abnormality, slightly clouded sensorium

Hydrochlorothiazide:

Frequency not reported: Vertigo, paresthesia

Musculoskeletal

Common (1% to 10%): Muscle cramps, myalgia

Bisoprolol:

Frequency not reported: Arthralgia, muscle pain, joint pain, back pain, neck pain, muscle cramps, twitching

Hydrochlorothiazide:

Frequency not reported: Cramping, muscle spasm

Respiratory

Common (1% to 10%): Cough, upper respiratory tract infection

Uncommon (0.1% to 1%): Rhinitis

Bisoprolol:

Frequency not reported: Asthma, bronchospasm, bronchitis, dyspnea, pharyngitis, rhinitis, sinusitis, upper respiratory infection, sore throat, laryngospasm, respiratory distress

Hydrochlorothiazide:

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Other

Common (1% to 10%): Fatigue

Bisoprolol:

Frequency not reported: Tinnitus, decreased hearing, earache, fatigue, asthenia, malaise, fever, aching

Hydrochlorothiazide:

Frequency not reported: Weakness, fever

Genitourinary

Common (1% to 10%): Impotence

Bisoprolol:

Frequency not reported: Impotence, polyuria, Peyronie’s disease

Hydrochlorothiazide:

Frequency not reported: Sexual dysfunction

Metabolic

Uncommon (0.1% to 1%): Hypokalemia

Frequency not reported: Increased uric acid, increased serum triglycerides, decreased HDL

Bisoprolol:

Frequency not reported: Gout, weight gain, increased serum triglycerides, increased uric acid, increased serum potassium, increased glucose, increased phosphorus

Hydrochlorothiazide:

Common (1% to 10%): Hypokalemia

Frequency not reported: Anorexia, gout, hyperglycemia, hyperuricemia, hyperlipidemia, hypercalcemia, increased uric acid, other electrolyte imbalances

Bisoprolol: Uric acid, serum potassium, glucose, and phosphorus increases associated with use of this drug were not of clinical importance and rarely resulted in discontinuation.

Psychiatric

Frequency not reported: Insomnia, loss of libido

Bisoprolol:

Frequency not reported: Sleep disturbance, vivid dreams, insomnia, depression, anxiety, restlessness, decreased libido, hallucination, disorientation to time and space, emotional lability

Hydrochlorothiazide:

Frequency not reported: Restlessness

Immunologic

Of the 15% of patients who converted to a positive ANA status, one-third of the patients converted back to a negative ANA titer with continued use.

Bisoprolol:

Very common: Antinuclear antibody (ANA) conversions to a positive titer (up to 15%)

Renal

Bisoprolol:

Frequency not reported: Cystitis, renal colic, increased creatinine, increased BUN

Hydrochlorothiazide:

Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis, glycosuria

Creatinine and BUN were associated with slightly increased levels, but these effects were generally not of clinical importance and rarely resulted in discontinuation.

Dermatologic

Bisoprolol:

Frequency not reported: Rash, acne, eczema, psoriasis, skin irritation, pruritus, flushing, sweating, alopecia, dermatitis, cutaneous vasculitis, exfoliative dermatitis

Hydrochlorothiazide:

Frequency not reported: Photosensitivity, rash, cutaneous vasculitis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis

Ocular

Bisoprolol:

Frequency not reported: Visual disturbances, ocular pain, ocular pressure, abnormal lacrimation

Hydrochlorothiazide:

Frequency not reported: Transient blurred vision, xanthopsia

Hematologic

Bisoprolol:

Frequency not reported: Purpura, decreased WBCs, decreased platelets, eosinophilia, agranulocytosis, thrombocytopenia

Hydrochlorothiazide:

Frequency not reported: Purpura, leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia, hemolytic anemia

During treatment with this drug, eosinophilia and decreased levels of WBCs and platelets were not of clinical importance and rarely resulted in discontinuation.

Hypersensitivity

Bisoprolol:

Frequency not reported: Angioedema

Hydrochlorothiazide:

Frequency not reported: Urticaria, anaphylactic reactions

Hepatic

SGOT and SGPT elevations of 1 to 2 times the upper limit of normal were reported in 6.2% of patients, with a multiple occurrence rate of 1.9%. Generally, this increase was the result of underlying disorders or resolved with continued use of this drug.

Bisoprolol:

Common (1% to 10%): Increased serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT)

Hydrochlorothiazide:

Frequency not reported: Intrahepatic cholestatic jaundice, cholecystitis

1. “Product Information. Ziac (bisoprolol-hydrochlorothiazide).” Lederle Laboratories, Wayne, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about bisoprolol / hydrochlorothiazide

  • During Pregnancy
  • Dosage Information
  • Drug Images
  • Drug Interactions
  • Pricing & Coupons
  • En Español
  • 29 Reviews
  • Drug class: beta blockers with thiazides

Consumer resources

  • Hydrochlorothiazide and bisoprolol
  • Bisoprolol and Hydrochlorothiazide
  • Bisoprolol and hydrochlorothiazide (Advanced Reading)

Other brands: Ziac

Professional resources

  • Bisoprolol and Hydrochlorothiazide (Wolters Kluwer)
  • … +1 more

Related treatment guides

  • High Blood Pressure

About bisoprolol

Type of medicine A beta-adrenoceptor blocking medicine (often referred to as a beta-blocker)
Used for High blood pressure, angina, heart failure
Also called (UK) Cardicor®; Congescor®
Also called (USA) Ziac® (bisoprolol with hydrochlorothiazide)
Available as Tablets

Bisoprolol belongs to the group of medicines referred to as beta-blockers. It is a medicine which works on the heart and blood vessels. It does this by blocking tiny areas (called beta-adrenergic receptors) where messages sent by some nerves are received by your heart and blood vessels. As a result, your heart beats more slowly and with less force. The pressure of blood within your blood vessels is reduced and it is easier for your heart to pump blood around your body.

These actions are of benefit if you have high blood pressure (hypertension), or if you have heart failure which is a condition where your heart is not working as well as it should. Because your heart is using less energy, it also helps to reduce chest pain if you have angina.

Before taking bisoprolol

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking bisoprolol it is important that your doctor knows:

  • If you are pregnant or breastfeeding.
  • If you have asthma or any other breathing disorder.
  • If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
  • If you have low blood pressure or poor circulation.
  • If you have diabetes.
  • If you have a skin problem called psoriasis.
  • If you have a condition causing muscle weakness, called myasthenia gravis.
  • If you have been told you have a slow heartbeat or heart block (a slow and irregular heartbeat).
  • If you have been told you have chest pain caused by spasms of your heart’s blood vessels, called Prinzmetal’s angina.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine, or if you have ever had any other serious allergic reaction.

How to take bisoprolol

  • Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about bisoprolol and will provide you with a full list of side-effects which you may experience from taking it.
  • Take bisoprolol exactly as your doctor tells you to. The usual dose is one tablet each day, although the strength of your tablet will depend upon the reason why you are taking it. If you are taking it for heart failure, you will be started on a low-strength tablet (1.25 mg) and then you will be prescribed a different strength of tablet each week for the first few weeks. This is so your doctor can increase your dose gradually. Your dose and the strength of the tablets will be on the label of the pack. There are several strengths of tablet available: 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg. Each time you collect a fresh supply of tablets it is a good idea to check to make sure you receive the strength you are expecting. If you have any questions, please ask your pharmacist to advise you.
  • You can take the tablets either with or without food, but try to take your doses at the same time of day each day as this will help you to remember to take bisoprolol regularly. The tablets are best swallowed in the morning with a drink of water.
  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, leave out the forgotten dose from the previous day and take the dose that is due as normal. Do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • If you are due to have an operation or dental treatment, it is important to tell the person carrying out the treatment that you are taking a beta-blocker. This is particularly important if you are likely to be given an anaesthetic.
  • If you drink alcohol, ask your doctor for advice about taking bisoprolol and alcohol. Alcohol will add to the blood pressure-lowering effect of bisoprolol which will make you feel dizzy and so may not be recommended for you.
  • If you buy any medicines, check with a pharmacist that they are suitable for you to take with bisoprolol. Some medicines may not be (including some anti-inflammatory painkillers, and cold or flu remedies).
  • Your doctor may give you dietary and lifestyle advice about eating a healthy diet, not smoking, and taking regular exercise. If so, it is important that you follow the advice you are given.
  • If you have diabetes, bisoprolol can block the symptoms of low blood sugar. Your doctor will advise you about this.
  • Treatment with bisoprolol is usually long-term. Continue to take the tablets unless your doctor tells you to stop. Stopping treatment suddenly can cause problems in some people, so your doctor may want you to reduce your dose gradually if this becomes necessary.

If you are also taking hydrochlorothiazide in combination with this medicine

  • Studies have suggested that taking higher doses of hydrochlorothiazide for long periods of time may increase the risk of certain skin cancers.
  • Tell your doctor if you have ever been treated for skin cancer before.
  • Tell your doctor about any new or changed moles or worrying marks on your skin.
  • Use a sunscreen in strong sunlight. Do not use sunbeds.

Can bisoprolol cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with bisoprolol. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common bisoprolol side-effects (these affect less than 1 in 10 people) What can I do if I experience this?
Feeling dizzy, sleepy, tired or light-headed Getting up and moving more slowly may help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. This usually improves after the first week or two, but if it continues, speak with your doctor. If affected, do not drive and do not use tools or machines until you feel better
Feeling sick (nausea) or being sick (vomiting), diarrhoea or constipation Stick to simple foods and drink plenty of water
Headache Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, speak with your doctor
Cold fingers or toes, disturbed sleep, slow heartbeat Speak with your doctor if any of these become troublesome

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

How to store bisoprolol

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine, ask your pharmacist.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *