Side effects of bisoprolol

Zebeta

SIDE EFFECTS

Safety data are available in more than 30,000 patients or volunteers. Frequency estimates and rates of withdrawal of therapy for adverse events were derived from two U.S. placebo-controlled studies.

In Study A, doses of 5, 10, and 20 mg bisoprolol fumarate were administered for 4 weeks. In Study B, doses of 2.5, 10, and 40 mg of bisoprolol fumarate were administered for 12 weeks. A total of 273 patients were treated with 5-20 mg of bisoprolol fumarate; 132 received placebo.

Withdrawal of therapy for adverse events was 3.3% for patients receiving bisoprolol fumarate and 6.8% for patients on placebo. Withdrawals were less than 1% for either bradycardia or fatigue/lack of energy.

The following table presents adverse experiences, whether or not considered drug related, reported in at least 1% of patients in these studies, for all patients studied in placebo-controlled clinical trials (2.5- 40 mg), as well as for a subgroup that was treated with doses within the recommended dosage range (5- 20 mg). Of the adverse events listed in the table, bradycardia, diarrhea, asthenia, fatigue, and sinusitis appear to be dose related.

The following is a comprehensive list of adverse experiences reported with bisoprolol fumarate in worldwide studies, or in postmarketing experience (in italics):

Central Nervous System

Dizziness, unsteadiness, vertigo, syncope, headache, paresthesia, hypoesthesia, hyperesthesia, somnolence, sleep disturbances, anxiety/restlessness, decreased concentration/memory.

Autonomic Nervous System

Dry mouth.

Bradycardia, palpitations and other rhythm disturbances, cold extremities, claudication, hypotension, orthostatic hypotension, chest pain, congestive heart failure, dyspnea on exertion.

Vivid dreams, insomnia, depression.

Gastric/epigastric/abdominal pain, gastritis, dyspepsia, nausea, vomiting, diarrhea, constipation, peptic ulcer.

Muscle/joint pain, arthralgia, back/neck pain, muscle cramps, twitching/tremor.

Skin

Special Senses

Visual disturbances, ocular pain/pressure, abnormal lacrimation, tinnitus, decreased hearing, earache, taste abnormalities.

Gout.

Asthma/bronchospasm, bronchitis, coughing, dyspnea, pharyngitis, rhinitis, sinusitis, URI.

Decreased libido/impotence, Peyronie’s disease, cystitis, renal colic, polyuria.

Purpura.

Fatigue, asthenia, chest pain, malaise, edema, weight gain, angioedema.

In addition, a variety of adverse effects have been reported with other beta-adrenergic blocking agents and should be considered potential adverse effects of ZEBETA:

Reversible mental depression progressing to catatonia, hallucinations, an acute reversible syndrome characterized by disorientation to time and place, emotional lability, slightly clouded sensorium.

Allergic

Fever, combined with aching and sore throat, laryngospasm, respiratory distress.

Agranulocytosis, thrombocytopenia, thrombocytopenic purpura.

Mesenteric arterial thrombosis, ischemic colitis.

Miscellaneous

The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with ZEBETA (bisoprolol fumarate) during investigational use or extensive foreign marketing experience.

Laboratory Abnormalities

In clinical trials, the most frequently reported laboratory change was an increase in serum triglycerides, but this was not a consistent finding.

Sporadic liver test abnormalities have been reported. In the U.S. controlled trials experience with bisoprolol fumarate treatment for 4-12 weeks, the incidence of concomitant elevations in SGOT and SGPT from 1 to 2 times normal was 3.9%, compared to 2.5% for placebo. No patient had concomitant elevations greater than twice normal.

In the long-term, uncontrolled experience with bisoprolol fumarate treatment for 6-18 months, the incidence of one or more concomitant elevations in SGOT and SGPT from 1 to 2 times normal was 6.2%. The incidence of multiple occurrences was 1.9%. For concomitant elevations in SGOT and SGPT of greater than twice normal, the incidence was 1.5%. The incidence of multiple occurrences was 0.3%. In many cases these elevations were attributed to underlying disorders, or resolved during continued treatment with bisoprolol fumarate.

Other laboratory changes included small increases in uric acid, creatinine, BUN, serum potassium, glucose, and phosphorus and decreases in WBC and platelets. These were generally not of clinical importance and rarely resulted in discontinuation of bisoprolol fumarate.

As with other beta-blockers, ANA conversions have also been reported on bisoprolol fumarate. About 15% of patients in long-term studies converted to a positive titer, although about one-third of these patients subsequently reconverted to a negative titer while on continued therapy.

Read the entire FDA prescribing information for Zebeta (Bisoprolol Fumarate)

The following are some of the side effects that may be associated with bisoprolol fumarate. Just because a side effect is listed here doesn’t mean that all people taking bisoprolol will experience that or any side effect. Medicines can affect people in different ways.

If you do get any side effects, try to persevere with taking bisoprolol, as many problems improve as your body gets used to the medicine. However if something is particularly troubling ask your doctor or pharmacist for advice.

Common bisoprolol side effects (affect between 1 in 10 and 1 in 100 people)

  • Dizziness. This is usually mild and improves after one to two weeks of treatment. If you feel dizzy you should lie down until this passes. Try to always get up slowly to avoid getting dizzy.
  • Headache. This is usually mild and improves after one to two weeks of treatment.
  • Fatigue. This is usually mild and improves after one to two weeks of treatment.
  • Feeling weak.
  • Cold hands and feet.
  • Low blood pressure, particularly in people with heart failure.
  • Feeling sick or vomiting.
  • Diarrhoea or constipation.

Related Story

Uncommon bisoprolol side effects (affect between 1 in 100 and 1 in 1000 people)

  • Sleep disturbances.
  • Depression.
  • Slow heartbeat.
  • Wheezing or breathing difficulties in people with asthma or COPD. Tell your doctor if you experience this.
  • Muscle weakness or cramps.

Rare bisoprolol side effects (affect between 1 in 1000 and 1 in 10,000 people)

  • Nightmares.
  • Hallucinations (seeing or hearing things that aren’t really there).
  • Fainting.
  • Dry eyes.
  • Hearing problems.
  • Hayfever symptoms.
  • Inflammation of the liver (hepatitis). See your doctor if you notice any yellowing of your skin or whites of your eyes.
  • Allergic skin reactions such as flushing, itching or rash.
  • Problems getting an erection (erectile dysfunction or impotence).

If you want any more information about the possible side effects of bisoprolol you should talk to your doctor or pharmacist, or read the leaflet that comes with the medicine. If you think you have experienced a side effect, did you know you can report this using the yellow card website?

More information about bisoprolol

  • What is bisoprolol used for and how does it work?
  • Who can and can’t take bisoprolol?
  • Can I take bisoprolol while pregnant or breastfeeding?
  • What should I know before taking bisoprolol?
  • How do I take bisoprolol?
  • Can I take other medicines with bisoprolol?

Last updated: 28.03.2019

Helen Marshall, BPharm, MRPharmS Helen Marshall, BPharm, MRPharmS A UK registered pharmacist with a background in hospital pharmacy.

Bisoprolol (Oral)

bis-oh-PROE-lol

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

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Commonly used brand name(s)

In the U.S.

  • Zebeta

Available Dosage Forms:

  • Tablet

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Beta-Adrenergic Blocker, Cardioselective

Uses for bisoprolol

Bisoprolol is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled .

Bisoprolol is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart .

Bisoprolol is available only with your doctor’s prescription .

Before using bisoprolol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bisoprolol, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to bisoprolol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of bisoprolol in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of bisoprolol in the elderly .

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking bisoprolol, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using bisoprolol with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Clonidine
  • Crizotinib
  • Diltiazem
  • Dronedarone
  • Fenoldopam
  • Fingolimod
  • Iohexol
  • Lacosamide
  • Rivastigmine
  • Verapamil

Using bisoprolol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acetyldigoxin
  • Albiglutide
  • Alfuzosin
  • Alogliptin
  • Amtolmetin Guacil
  • Arbutamine
  • Aspirin
  • Bromfenac
  • Bufexamac
  • Bunazosin
  • Canagliflozin
  • Celecoxib
  • Chlorpropamide
  • Choline Salicylate
  • Clonixin
  • Dapagliflozin
  • Deslanoside
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digitoxin
  • Digoxin
  • Dipyrone
  • Doxazosin
  • Droxicam
  • Dulaglutide
  • Empagliflozin
  • Ertugliflozin
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Exenatide
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Glimepiride
  • Glipizide
  • Glyburide
  • Ibuprofen
  • Indomethacin
  • Insulin Aspart, Recombinant
  • Insulin Degludec
  • Insulin Detemir
  • Insulin Glargine, Recombinant
  • Insulin Glulisine
  • Insulin Human Inhaled
  • Insulin Human Isophane (NPH)
  • Insulin Human Regular
  • Insulin Lispro, Recombinant
  • Ketoprofen
  • Ketorolac
  • Linagliptin
  • Liraglutide
  • Lixisenatide
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Methyldopa
  • Metildigoxin
  • Mibefradil
  • Miglitol
  • Morniflumate
  • Moxisylyte
  • Nabumetone
  • Naproxen
  • Nateglinide
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenoxybenzamine
  • Phentolamine
  • Phenylbutazone
  • Piketoprofen
  • Pioglitazone
  • Piroxicam
  • Pramlintide
  • Pranoprofen
  • Prazosin
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Repaglinide
  • Rifapentine
  • Rofecoxib
  • Rosiglitazone
  • Salicylic Acid
  • Salsalate
  • Saxagliptin
  • Sitagliptin
  • Sodium Salicylate
  • St John’s Wort
  • Sulindac
  • Tamsulosin
  • Tenoxicam
  • Terazosin
  • Tiaprofenic Acid
  • Tolazamide
  • Tolbutamide
  • Tolfenamic Acid
  • Tolmetin
  • Trimazosin
  • Urapidil
  • Valdecoxib
  • Vildagliptin

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of bisoprolol. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (severe chest pain)—May provoke chest pain if stopped too quickly .
  • Blood vessel disease—Use with caution. Bisoprolol may make this condition worse .
  • Bradycardia (slow heartbeat) or
  • Heart block or
  • Heart failure—Should not use in patients with these conditions .
  • Diabetes or
  • Hyperthyroidism (overactive thyroid) or
  • Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat .
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body .
  • Lung disease (e.g., asthma, bronchitis, emphysema)—May cause difficulty with breathing in patients with this condition .

Proper use of bisoprolol

In addition to the use of bisoprolol, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet .

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well .

Remember that bisoprolol will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease .

Do not interrupt or stop taking bisoprolol without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous .

Dosing

The dose of bisoprolol will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of bisoprolol. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, 5 milligrams (mg) once a day. Some patients may take 2.5 mg once day as a starting dose. Your doctor may increase your dose up to 20 mg once a day if needed.
      • Children—Use and dose must be determined by your doctor .

Missed dose

If you miss a dose of bisoprolol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using bisoprolol

It is very important that your doctor check your progress at regular visits to make sure bisoprolol is working properly and to check for unwanted effects .

Bisoprolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .

Bisoprolol may cause changes in your blood sugar levels. Also, bisoprolol may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .

Make sure any doctor or dentist who treats you knows that you are using bisoprolol. You may need to stop using bisoprolol several days before having surgery .

Bisoprolol may cause some people to become less alert than they are normally. If this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while taking bisoprolol .

Bisoprolol side effects

Along with its needed effects, a medicine 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:

Less common

  • Body aches or pain
  • chest pain
  • chills
  • cough
  • difficult or labored breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • pain or tenderness around eyes and cheekbones
  • shortness of breath or troubled breathing
  • sneezing
  • sore throat
  • stuffy or runny nose
  • tightness in chest
  • unusual tiredness or weakness
  • wheezing

Rare

  • Chest discomfort
  • lightheadedness, dizziness, or fainting
  • slow or irregular heartbeat

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Anxiety
  • blurred vision
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • decreased urine output
  • depression
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • extreme fatigue
  • fast heartbeat
  • increased hunger
  • irregular breathing
  • nausea
  • nervousness
  • nightmares
  • noisy breathing
  • seizures
  • shakiness
  • slurred speech
  • sweating
  • swelling of face, fingers, feet, or lower legs
  • weight gain

Some side effects 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

  • Abnormal or decreased touch sensation
  • diarrhea
  • difficulty in moving
  • lack or loss of strength
  • muscle pain or stiffness
  • pain in joints
  • sleeplessness
  • trouble sleeping
  • unable to sleep
  • vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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

Copyright 2019 Truven Health Analytics, Inc. All Rights Reserved.

Medical Disclaimer

More about bisoprolol

  • Side Effects
  • During Pregnancy or Breastfeeding
  • Dosage Information
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  • Drug Images
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  • Compare Alternatives
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  • En Español
  • 40 Reviews
  • Drug class: cardioselective beta blockers

Consumer resources

  • Bisoprolol

Other brands: Zebeta

Professional resources

  • Bisoprolol Fumarate (AHFS Monograph)
  • … +2 more

Related treatment guides

  • Supraventricular Tachycardia
  • High Blood Pressure
  • Angina Pectoris Prophylaxis
  • Heart Failure
  • Premature Ventricular Depolarizations
  • Mitral Valve Prolapse

Weight Gain

Effect of beta blockers on your bodyfe.

As mentioned,

Beta blockers decrease the rate of heart beat, and hence blood pressure.

Availability of lower amounts of blood to the body means decrease in the availability of nutrients and oxygen to all the body cells. They also increase the oxidation of proteins.

All these factors collectively results in the reduction of the rate of metabolism.

A slow metabolism further leads to decrease in the consumption of calories.

This is the first way that how beta blockers and weight gain are related to each other. As per studies, beta blockers cause a reduction in energy expenditure by 4-9%. This raises the percentage of weight gain by almost 11% in the patient who are on long term prescription of beta blockers.

The second way involved is, beta blockers impart a feeling of tiredness and fatigue. This causes a marked reduction in fidgeting. Decreasing the desire to exercise or to do any kind of physical activity. This the another way that explains a relationship between beta blockers and weight gain.

Thirdly, fat cells have beta receptors on their surfaces. The beta receptors play an important role in the metabolism of fat. Beta blockers block these beta receptors and interfere with the fat cells’ metabolic activities. Thus, the long term intake of beta blockers cause accumulation of body fat and decrease in the concentration of fat free tissue. This particularly causes accumulation of fat around the abdominal region. This is another way that establishes a relationship between beta blockers and weight gain.

In Summary

More frequently reported side effects include: fatigue. See below for a comprehensive list of adverse effects.

For Healthcare Professionals

Applies to bisoprolol: oral tablet

General

The more commonly reported side effects observed with this drug are bradycardia, dizziness, and hypotension.

Cardiovascular

Bradycardia occurred as a dose-related event.

Cardiac failure occurred in 18.4% of patients (n=1328) compared with 22.8% of placebo-treated patients (n=1321).

Very common (10% or more): Bradycardia (up to 15.2%)

Common (1% to 10%): Chest pain, heart failure aggravation, hypotension, cold extremities, peripheral edema, ischemia, conduction disorder, left cardiac failure, palpitation, vein disorder

Uncommon (0.1% to 1%): Atrioventricular (AV) disturbances, orthostatic hypotension

Frequency not reported: Other rhythm disturbances, claudication

Nervous system

Very common (10% or more): Dizziness (up to 13.3%)

Common (1% to 10%): Headache, extremity numbness, cerebrovascular disorder, syncope, hypoesthesia

Frequency not reported: Vertigo, paresthesia, hypoesthesia, hyperesthesia, somnolence, decreased concentration/memory, tremor, taste abnormalities

Postmarketing reports: Unsteadiness

Respiratory

Very common (10% or more): Dyspnea (up to 13.8%)

Common (1% to 10%): Pneumonia, bronchitis, coughing, exertional dyspnea, upper respiratory tract infection, respiratory distress, stridor, respiratory tract edema, respiratory tract hemorrhage, sinusitis

Uncommon (0.1% to 1%): Bronchospasm

Rare (0.01% to 0.1%): Allergic rhinitis

Sinusitis occurred as a dose-related event.

Immunologic

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

Common (1% to 10%): Viral infection

Dermatologic

Common (1% to 10%): Pruritus

Uncommon (0.1% to 1%): Sweating

Rare (0.01% to 0.1%): Itching, flushing, rash

Very rare (less than 0.01%): Alopecia, psoriasis-like rash, psoriasis exacerbation

Frequency not reported: Acne, eczema, skin irritation, cutaneous vasculitis

Postmarketing reports: Dermatitis, exfoliative dermatitis

Gastrointestinal

Diarrhea occurred as a dose-related event.

Frequency not reported: Gastric pain, peptic ulcer

Metabolic

Common (1% to 10%): Purine metabolism disorder, carbohydrate metabolism disturbed, weight changes, cholesterol changes, potassium levels altered, blood lipid changes

Rare (0.01% to 0.1%): Increased triglycerides

Frequency not reported: Gout

Postmarketing reports: Increased uric acid and glucose

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

Musculoskeletal

Common (1% to 10%): Limb pain, myalgia, arthropathy, arthralgia

Uncommon (0.1% to 1%): Muscular weakness, cramps

Frequency not reported: Back pain, neck pain, twitching

Other

Common (1% to 10%): Asthenia, fatigue, body pain, fever, malaise

Rare (0.01% to 0.1%): Hearing disorders

Frequency not reported: Earache, tinnitus

Fatigue and asthenia occurred as dose-related events.

Psychiatric

Common (1% to 10%): Insomnia, anxiety

Uncommon (0.1% to 1%): Sleep disorders, depression

Rare (0.01% to 0.1%): Nightmares, hallucinations

Frequency not reported: Restlessness

Genitourinary

Common (1% to 10%): Urinary tract infection

Rare (0.01% to 0.1%): Potency disorders

Frequency not reported: Decreased libido, Peyronie’s disease, polyuria

Hepatic

Common (1% to 10%): Hepatomegaly

Rare (0.01% to 0.1%): Increased liver enzymes (ALT, AST), hepatitis

Transaminase 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.

Hypersensitivity

Rare (0.01% to 0.1%): Hypersensitivity

Postmarketing reports: Angioedema

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

Ocular

Rare (0.01% to 0.1%): Reduced tear flow

Very rare (less than 0.01%): Conjunctivitis

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

Renal

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

Frequency not reported: Cystitis, renal colic

Postmarketing reports: Increased creatinine and BUN

Hematologic

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

Postmarketing reports: Purpura, decreases in WBC and platelets

1. “Product Information. Zebeta (bisoprolol).” Lederle Laboratories, Wayne, NJ.

2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

3. Cerner Multum, Inc. “Australian Product Information.” O 0

Bisoprolol

Easy-to-read medicine information about bisoprolol – what is it, how to take bisoprolol safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines called beta-blockers
  • Bosvate®

What is bisoprolol?

Bisoprolol is usually used with other medicines to treat heart failure, high blood pressure (hypertension) or to prevent chest pain (angina). It belongs to a group of medicines called beta-blockers. Beta-blockers work by blocking some natural chemicals in the body, to slow the heart rate and lower blood pressure. Read more about heart failure, high blood pressure and chest pain. In New Zealand bisoprolol comes as tablets.

Dose

  • The usual dose of bisoprolol is 10 milligrams once a day.
  • If you are taking bisoprolol for heart failure, your doctor will usually start you on a low dose and increase this over a few weeks. This allows your body to get used to the medicine and reduces side effects.
  • For example: you will be started on 1.25 mg once daily for 1 week, then increased to
    2.5 mg once daily for 1 week, then
    3.75 mg once daily for 1 week, then
    5 mg once daily for 4 weeks, then
    7.5 mg once daily for 4 weeks, then
    10 mg once daily.
  • Bisoprolol comes in different strengths of tablets: 2.5 mg, 5 mg, and 10 mg. Check to make sure you receive the strength you are expecting.
  • Always take your bisoprolol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much bisoprolol to take, how often to take it, and any special instructions.

My dose is:

Date Dose

Notes:

  • Take bisoprolol once a day, in the morning.
  • Swallow your tablet with a glass of water.
  • You can take bisoprolol either with or without food.
  • Limit or avoid drinking alcohol while you are taking bisoprolol.
  • If you forget your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Do not stop taking bisoprolol suddenly; speak to your doctor or nurse before stopping.

Precautions – before taking bisoprolol

  • Do you have asthma?
  • Do you have diabetes?
  • Do you have problems with your kidneys?
  • Do you play a professional sport?
  • Are you pregnant or breastfeeding?
  • Have you ever had an allergic reaction to a medicine?
  • Are you are taking or using any other medicines? This includes any medicines you are using which are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking bisoprolol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Like all medicines, bisoprolol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Diabetes

If you have diabetes you need to take extra care to measure your blood glucose levels regularly.

  • Beta-blockers can cause an increase in blood glucose levels, especially when you first start taking them. This effect usually settles with time.
  • Beta-blockers may reduce the warning signs of a low blood sugar level (hypoglycaemia – often called a hypo). For example, you may not have the feeling of fast, irregular or strong heartbeats (palpitations) or tremor, which can occur when your blood glucose is going too low. If you are worried about this, talk to your doctor. Do not stop taking your beta-blocker without checking with your doctor first. Read more about hypoglycaemia.

Asthma

If you have asthma, taking a beta blocker may trigger your asthma symptoms or make them worse. Not everybody with asthma is sensitive to these medicines and this is rare with bisoprolol. If you are worried about this, talk to your doctor. They may be able to prescribe a different medicine or increase the dose of your asthma preventer medication. Do not suddenly stop taking your beta-blocker without talking to your doctor first. This can be dangerous and make you feel unwell. Read more about medicines that may trigger asthma symptoms.

Other side effects

Side effects What should I do?
  • Tiredness
  • Headache
  • Problems falling asleep
  • Nausea (feeling sick) or vomiting
  • These are quite common when you first start taking bisoprolol and usually go away with time.
  • Tell your doctor if troublesome.
  • Dizziness
  • Feeling faint when you stand up
  • This is common when you first start taking bisoprolol.
  • Be careful when getting up from either lying down or sitting to avoid falls.
  • Cold hands and feet
  • Tell your doctor if troublesome
  • Depression or low mood
  • Sexual problems
  • Tell your doctor
  • Problems with breathing such as chest tightness, or wheezing or swelling of the ankles or feet.
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Interactions

  • Check with a pharmacist before taking over the counter medicines such as:
    • Cold or flu tablets containing phenylephrine (e.g. Sudafed PE), or diphenhydramine (e.g. Benadryl Original)
    • Anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), mefenamic acid (e.g. Ponstan), naproxen (e.g. Naprogesic)
  • Bisoprolol may interact with other medications and herbal supplements, so check with your doctor or pharmacist before starting bisoprolol or before starting any new medicines.

Learn more

The following links provide further information on bisoprolol:

Medsafe Consumer Information Sheet: Bosvate
New Zealand Formulary Patient Information: bisoprolol

  1. Bisoprolol fumarate New Zealand Formulary

Generic Name: bisoprolol (BIS oh PROE lol)
Brand Names: Zebeta

Medically reviewed by Drugs.com. Last updated on Aug 12, 2019.

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

The Zebeta brand name has been discontinued in the U.S. If generic versions of this product have been approved by the FDA, there may be generic equivalents available.

What is Zebeta?

Zebeta (bisoprolol) is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Zebeta is used to treat hypertension (high blood pressure).

Zebeta may also be used for purposes not listed in this medication guide.

Important information

Do not skip doses or stop taking Zebeta without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using this medicine.

You should not use Zebeta if you have a serious heart condition such as “AV block,” severe heart failure, or slow heartbeats that have caused you to faint.

Keep using Zebeta as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Before taking this medicine

You should not use Zebeta if you you are allergic to bisoprolol, or if you have a serious heart condition such as:

  • “AV block”;

  • severe heart failure; or

  • slow heartbeats that have caused you to faint.

To make sure Zebeta is safe for you, tell your doctor if you have:

  • congestive heart failure or other heart problems;

  • coronary artery disease (hardened arteries);

  • circulation problems (such as Raynaud’s syndrome);

  • asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder;

  • diabetes (taking Zebeta can make it harder for you to tell when you have low blood sugar);

  • liver or kidney disease;

  • a thyroid disorder; or

  • a history of allergies.

It is not known whether Zebeta is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether bisoprolol passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Zebeta is not approved for use by anyone younger than 18 years old.

How should I take Zebeta?

Take Zebeta exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not skip doses or stop taking Zebeta without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems.

If you need surgery, tell the surgeon ahead of time that you are using Zebeta.

Your blood pressure will need to be checked often.

Keep using Zebeta as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Zebeta?

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. It can increase some of the side effects of Zebeta.

Zebeta side effects

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

Call your doctor at once if you have:

  • shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • slow heart rate;

  • pounding heartbeats or fluttering in your chest;

  • numbness, tingling, or cold feeling in your hands or feet;

  • a light-headed feeling, like you might pass out;

  • eye pain, vision problems; or

  • bronchospasm (wheezing, chest tightness, trouble breathing).

Common Zebeta side effects may include:

  • headache;

  • feeling tired;

  • sleep problems (insomnia);

  • joint pain;

  • swelling; or

  • cold symptoms such as stuffy nose, runny nose, cough, sore throat.

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.

Zebeta dosing information

Usual Adult Dose of Zebeta for Hypertension:

Initial dose: 5 mg orally once a day
Dose Titration: If desired response is not achieved, may increase the dose to 10 mg, then 20 mg if necessary
Maximum dose: 20 mg per day

-Dosage should be individualized to the patient; some patients may benefit from a starting dose of 2.5 mg once a day.
-In clinical trials, blood pressure lowering effects were seen at 1 week and changed little thereafter.
Use: Management of hypertension, alone or with other antihypertensive agents

What other drugs will affect Zebeta?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • insulin or oral diabetes medicine;

  • rifampin; or

  • heart or blood pressure medicine–clonidine, digitalis, digoxin, diltiazem, reserpine, or verapamil.

This list is not complete. Other drugs may interact with bisoprolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zebeta only for the indication prescribed.

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

Copyright 1996-2020 Cerner Multum, Inc. Version: 9.01.

Medical Disclaimer

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