Bisoprolol is a beta-blocker which is commonly used to treat high blood pressure and other conditions related to the heart. Bisoprolol lowers blood pressure and can prevent more serious conditions arising such as heart disease, heart attacks and strokes.


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What is Bisoprolol

Bisoprolol is a beta-blocker which is commonly used to treat high blood pressure (hypertension) and heart failure. By lowering high blood pressure, we can prevent more serious conditions arising such as heart disease, heart attacks or strokes. It can also be effective in the treatment of angina and other conditions affecting the heart such as irregular heartbeats and atrial fibrillation. By slowing down your heart rate, Bisoprolol makes it easier for the heart to pump blood around the body.

Bisoprolol Dosage and Strengths

Depending on your condition, doctors will usually try and start you off on the lowest dose possible to treat you. It is at your pharmacist or doctors’ discretion as to how they increase the dosage strength if the 2.5mg does not appear to be effective enough.

Bisoprolol 2.5mg

If you are suffering from Hypertension, you will initially be prescribed to take either 2.5mg or 5mg once a day. This lower strength is most commonly used as the initial strength for most conditions and will be increased if your doctor believes it is not strong enough for your ailments.

Bisoprolol 5mg

For high blood pressure and angina symptoms you may initially be started on 5mg once a day. Your doctor may then increase it up to 20mg.

Bisoprolol 10mg

It will usually take some weeks to be increased up to a 10mg dose as the doctor will want to review how your body is responding to the medicine. For heart failure you would begin on 1.25mg and slowly increased to 10mg a day.

How should Bisoprolol be taken?

You should take Bisoprolol once in the morning each day. For your first dose, you can take it before you go to bed as it may make you feel slightly dizzy. If you do not experience dizziness it will be safe to take each morning after the initial test.

You can take the medicine before or after eating, with a glass of water. If you realise that you have forgotten to take a dose of Bisoprolol you should try and take it as soon as possible. You should always take the medication as prescribed your doctor.

What if I forget to take it?

If you have missed a dose you should take the pill on the same day. If you do not remember until the next day, skip the forgotten pill and continue as normal. You should never double up on doses to make up for the missed dose. In order to stick to your schedule of remembering to take your medication, you can set an alarm.

Alternative methods include a pill box which contains a set number of pills per day to help you stay organised when it comes to taking your medication, you should speak to your doctor or pharmacist for further advice.

What happens if I take too much?

If you think you may have taken too much Bisoprolol you must contact your doctor or local hospital straight away. An overdose can make you have difficulty breathing by slowing down your heart rate too much. It can also cause increased dizziness or trembling.

Your doctor will give you individual guidance on how to take Bisoprolol. They will increase the dosage depending on how it interacts with your body and its effectiveness. If you cannot remember how you have been instructed to take the medicine check the leaflet within the box or contact your doctor or pharmacist.

What are the side effects of Bisoprolol?

All medicines come with the risk of side effects. Below are some side effects which have been reported after using Bisoprolol. Many people experience no side effects at all, and the handful that does will report that they improved as their body became accustomed to taking the medicine. If you experience any side effects and are worried contact your doctor or pharmacist. If the side effect is more serious, seek medical attention right away.

Common Side Effects

  • Headache
  • Experiencing dizziness or weakness
  • Hands and feet feeling cold
  • Nausea or vomiting
  • Diarrhoea or constipation
  • Body aches or pains

Uncommon Side Effects

  • Difficulty Sleeping
  • Breathing problems
  • Hearing problems
  • Liver complications causing yellowing of skin and eyes
  • Skin reactions in the form of itching, flush or rash
  • Loss of libido
  • Hallucinations
  • Alopecia

Please note that this list is not exhaustive. For a more extensive list please see the leaflet inside the medication box.

In rare cases patients taking Bisoprolol can suffer from a severe allergic reaction to the medicine. If you experience any of the warning symptoms you MUST contact an emergency service such as 111 or 999 immediately. The signs of a severe allergic reaction are:

  • Developing a skin rash which is itchy, red, swollen, blistered or peeling
  • Your chest or throat feeling tight. This can also be displayed through wheezing.
  • Experiencing difficulty in breathing or talking
  • Your facial extremities become swollen i.e. you mouth, face, lips, tongue or throat.

Bisoprolol during Pregnancy

Bisoprolol is not usually the first line treatment when it comes to high blood pressure treatments  during pregnancy, Labetalol is the preferred choice.

Bisoprolol is not recommended for use during pregnancy or breastfeeding. If you have currently been prescribed bisoprolol and have recently become pregnant or are trying to conceive, talk to your doctor about the potential risks involved.

There is sometimes confusion around whether Bisoprolol will affect female methods of contraception. The uncertainty may have arisen from your doctor telling you not to continue or begin taking contraceptive methods such as the combined pill or contraceptive patch. This is not because Bisoprolol will affect the contraception’s’ effectiveness. Instead, it is due to those two methods being associated with increasing a patient’s blood pressure.

If the contraception did increase a patient’s blood pressure then the effects of the beta blocker would be lessened if not lost. If you are concerned about your contraception and are unsure if it will effect Bisoprolol then you should talk to your doctor before beginning your course.

Bisoprolol during breastfeeding

There is not a lot of evidence to suggest that bisoprolol is safe to use during breastfeeding.

Small amounts of bisoprolol may get into your breastmilk; this can potentially cause your baby to get a low blood pressure due to bisoprolol’s ability to lower blood pressure in adults.

If you are currently breastfeeding we recommend talking to your pharmacist of GP as there may be an alternative high blood pressure medication that is more suitable for use during breastfeeding and pregnancy.

Always talk to your doctor if:

  • You are trying to get pregnant
  • If you are pregnant
  • Breastfeeding

What is Bisoprolol used for?

Bisoprolol is generally prescribed to treat problems such as high blood pressure, angina which causes chest pain as the arteries that supply blood to the heart become narrowed, heart failure and irregular heartbeat. They can also sometimes be used to treat or prevent migraine, situational anxiety disorders (although the recommended first line treatment is propranolol for anxiety), overactive thyroids or glaucoma.

Medicines under the family of Beta Blockers, work by changing how your body responds to the impulses our nerves make particularly in your heart. By changing the nerve impulse reaction, your heart rate will be lower which means your heart will find it easier to pump blood around your body.

Bisoprolol Alcohol Warning

If you have just started taking Bisoprolol, or have been given an increase in your dosage, you should not drink alcohol until you are sure of how it affects you. By drinking alcohol, you risk the chance of increasing the medicines blood pressure lowering effect which can cause you to feel nauseous, dizzy or light headed. If you already feel dizzy when taking Bisoprolol without drinking, you are best off not consuming alcohol whilst taking the medicine.

How long does Bisoprolol take to start working?

Bisoprolol can begin reducing blood pressure in as little as 2 weeks; however, for it to fully come into effect it will take around 2-6 weeks. If you are using the medicine to treat high blood pressure, then it will be unlikely that you will feel a change even when it begins to work. It is important that you do not stop taking the medicine because of feeling like you are experiencing any difference, as this does not mean that it is not already lowering your blood pressure.

For the treatment of Angina, you will begin to experience improvements to your health after around 2 weeks of taking Bisoprolol. This means that you will continue to experience some chest pain for a fortnight into the course, but do not stop taking the medicine in the belief that it is not working. Ensure that you have your medicine to treat Angina attacks with you at all times and that you use it if you necessary.

Bisoprolol takes longer to treat heart failure; in fact it can take several weeks before you notice an improvement in yourself.

Bisoprolol Drug Interactions

If you are taking any other medications, it is possible that these may affect the way bisoprolol works.

Please inform your doctor if you are taking any other medications. The most common medications that can interact with the effectiveness of bisoprolol are:

  • Other High Blood pressure medicines (this can result in developing a low blood pressure)
  • Any other medications that can lower your blood pressure as a side effect such as some antidepressants
  • Medicines for enlarged prostate gland
  • Parkinson’s disease medicines such as Co-careldopa and Levodopa
  • NSAID’s (anti-inflammatory medicines like Naproxen and Ibuprofen)
  • Prednisolone
  • Asthma medicines
  • Allergy medicines such as ephedrine and adrenaline
  • Cough medicines both prescription and over the counter containing pseudoephedrine
  • Diabetes medicines as a low blood sugar level makes it harder to identify the warning signs of developing a low blood sugar level

Please tell your pharmacist or Doctor if you are taking any other forms of medications, either prescription or over the counter medicines. This also includes any vitamins or supplements.

Who can take Bisoprolol?

Bisoprolol can be taken by anyone over the age of 18, however we recommend letting your doctor know if any of the below relate to you:

  • Are allergic to Bisoprolol or any of its ingredients
  • You have or have previously been diagnosed with a low heart rate
  • Heart failure or have recently suffered a heart attack
  • Raynaud's disease which affects blood circulation
  • Have severe Asthma or lung disease
  • Metabolic Acidosis
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