Patients with cardiogenic shock, overt cardiac failure, second or third degree AV block and marked sinus bradycardia.
Dose
N/A
Side Effect
1-10%
Dizziness (10%),Dyssomnia (8%-10%),Bradyarrhythmia (9%),Upper respiratory infection (5%),Diarrhea (4%),Rhinitis (4%),Arthralgia (3%),Cough (3%),Dyspnea (2%),Nausea (2%),Pharyngitis (2%),Sinusitis (2%),Vomiting (2%)
<1%
Cold extremities,Hypotension,Depression,Dyspepsia,Bronchospasm
Frequency Not Defined
Aggravate CHF,Decrease HDL,Hypertriglyceridemia,Mask symptoms of hypoglycemia,Decreased exercise tolerance,Raynaud's phenomenon,May increase triglyceride levels and insulin resistance
Pregnancy Category
Name :
C
Description
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Bisoprolol selectively and competitively blocks beta1-receptors but has little or no effect on beta2-receptors except at high doses.
Interaction
May potentiate AV conduction time and may increase negative inotropic effect w/ class I antiarrhythmic drugs (e.g. quinidine, disopyramide, propafenone). Concomitant catecholamine-depleting drugs (e.g. reserpine, guanethidine) may produce excessive sympathetic activity. May exacerbate rebound HTN upon discontinuance of clonidine treatment. Increased risk of bradycardia w/ digitalis glycosides. Reduced hypotensive effect w/ NSAIDs.
Pregnancy Category Note
Pregnancy Category: C
Lactation: excretion in milk unknown; use caution
Adult Dose
The usual starting dose is 5 mg once daily. In some patients, 2.5 mg may be an appropriate starting dose.
If the antihypertensive effect of 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily.
For heart failure: Initially 1.25 mg once daily (in the morning) for 1 week then, if well tolerated, 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; max. 10 mg daily.
Hepatic impairment: Severe: Initially, 2.5 mg/day. Max: 10 mg/day.
Elderly: Hypertension
2.5-20 mg PO qDay
Heart Failure
1.25 mg PO qDay; not to exceed 10 mg/day
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