Detailed Drug Information:

DRUG CLASS AND MECHANISM: Bisoprolol blocks the action of thesympathetic nervous system on the heart by blocking the heart'sbeta-adrenergic receptors. Beta-adrenergic blocking agents such asbisoprolol reduce the heart rate and are useful in treating abnormallyrapid heart rhythms. Bisoprolol also reduces the force of contraction ofthe heart and lowers blood pressure. By reducing the heart rate and theforce of muscle contraction, beta-adrenergic blocking agents reduce theheart's need for oxygen. Since angina (heart pain) occurs when oxygenneed exceeds supply, beta-adrenergic blocking agents are useful intreating angina.

PREPARATIONS: Tablets: 5mg, 10mg.

STORAGE: Bisoprolol should be stored at room temperature, 59-86°F(15-30°C) in an air-tight container.

PRESCRIBED FOR: Bisoprolol is used for treating patients withhigh blood pressure. It may be used alone or together with othermedications.

DOSING: The usual dose of bisoprolol is 5 mg or 10 mg once dailyalthough doses up to 20 mg daily have been prescribed. Some patients, forexample, those with marked kidney, liver or lung diseases, may be given2.5 mg daily. Bisoprolol can be taken with or without food.

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

PREGNANCY: There is no information about the effects on thefetus of bisoprolol given to pregnant women. In rats given doses over100-fold greater (per weight) than those used in humans, there were somedamaging effects on the fetus. Physicians may elect to use bisoprolol inpregnancy if its benefits are deemed to outweigh potential risks.

NURSING MOTHERS: It is not known whether bisoprolol is secreted in breast milk, although many drugs are secreted in breast milk.Bisoprolol may be used in lactating women if the physician feels thebenefits outweigh the possible risks.

SIDE EFFECTS: Bisoprolol is generally well-tolerated, and sideeffects are mild and transient. Rare side effects include abdominalcramps, diarrhea, dizziness, headache, nausea, impotence, slow heart rate,low blood pressure, numbness, tingling, cold extremities, sore throat, andshortness of breath or wheezing.

Bisoprolol can aggravate breathing difficulties in patients with asthma,chronic bronchitis, or emphysema. In patients with existing slow heartrates (bradycardias) and heart blocks (defects in electrical conductionwithin the heart), bisoprolol can cause dangerously slow heart rates andeven shock. Bisoprolol reduces the force of contraction of heart muscleand can aggravate symptoms of heart failure. In patients with coronaryartery disease, abruptly stopping bisoprolol can suddenly worsen angina,and occasionally precipitate heart attacks. If it is necessary todiscontinue bisoprolol, its dosage can be reduced gradually over one totwo weeks. Bisoprolol can mask the early warning symptoms of low bloodsugar (hypoglycemia), and should be used with caution in patientsreceiving treatment for diabetes.