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Brand names: Concor, Monocor, Zebeta
Generic name: Bisoprolol
DRUG CLASS AND MECHANISM:
Bisoprolol blocks the action of the sympathetic nervous system on the heart by blocking the heart 's beta-adrenergic receptors. Beta-adrenergic blocking agents such as bisoprolol reduce the heart rate and are useful in treating abnormally rapid heart rhythms. Bisoprolol also reduces the force of contraction of the heart and lowers blood pressure. By reducing the heart rate and the force of muscle contraction, beta-adrenergic blocking agents reduce the heart's need for oxygen. Since angina (heart pain) occurs when oxygen need exceeds supply, beta-adrenergic blocking agents are useful in treating angina.
Bisoprolol should be stored at room temperature, 59-86°F (15-30°C) in an air-tight container.
Bisoprolol is used for treating patients with high blood pressure. It may be used alone or together with other medications.
The usual dose of bisoprolol is 5 mg or 10 mg once daily although doses up to 20 mg daily have been prescribed. Some patients, for example, those with marked kidney, liver or lung diseases, may be given 2.5 mg daily. Bisoprolol can be taken with or without food.
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 on the heart. In some patients, this may cause excessive slowing of the heart rate or reduce the heart's ability to beat. The use of digoxin (Lanoxin) with bisoprolol may also cause excessive reductions in heart rate.
There is no information about the effects on the fetus of bisoprolol given to pregnant women. In rats given doses over 100-fold greater (per weight) than those used in humans, there were some damaging effects on the fetus. Physicians may elect to use bisoprolol in pregnancy if its benefits are deemed to outweigh potential risks.
t 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 the benefits outweigh the possible risks.
Bisoprolol is generally well-tolerated, and side effects are mild and transient. Rare side effects include abdominal cramps, diarrhea, dizziness, headache, nausea, impotence, slow heart rate, low blood pressure, numbness, tingling, cold extremities, sore throat, and shortness of breath or wheezing.
Bisoprolol can aggravate breathing difficulties in patients with asthma, chronic bronchitis, or emphysema. In patients with existing slow heart rates (bradycardias) and heart blocks (defects in electrical conduction within the heart), bisoprolol can cause dangerously slow heart rates and even shock. Bisoprolol reduces the force of contraction of heart muscle and can aggravate symptoms of heart failure. In patients with coronary artery disease, abruptly stopping bisoprolol can suddenly worsen angina, and occasionally precipitate heart attacks. If it is necessary to discontinue bisoprolol, its dosage can be reduced gradually over one to two weeks. Bisoprolol can mask the early warning symptoms of low blood sugar (hypoglycemia), and should be used with caution in patients receiving treatment for diabetes.