Generic Name

Bisoprolol

Precaution

Impaired Renal or Hepatic Function. Lactation: excretion in milk unknown; use caution

Indication

Hypertension, Angina pectoris, Congestive heart failure

Contra Indication

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

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

Child Dose

N/A

Renal Dose

Renal impairment: CrCl (ml/min) <40 Initial: 2.5 mg/day.

Administration

May be taken with or without food.