Bisoprolol – Cardioselective beta-blocker for heart and blood pressure protection.
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What is Bisoprolol?
Bisoprolol is a highly cardioselective beta-blocker that provides excellent cardiovascular protection with once-daily convenience. Its proven benefits for heart failure, post-heart attack care, and blood pressure control make it one of the most prescribed beta-blockers in the UK.
Book an online consultation if you have high blood pressure, heart failure, have had a heart attack, or need cardiovascular protection assessment. Our GPs can evaluate your heart health needs and determine if Bisoprolol or other cardiovascular medications are appropriate for your specific condition.
What is Bisoprolol used for?
- High blood pressure (hypertension)
- Heart failure (chronic)
- Angina (chest pain)
- Post-heart attack protection
- Abnormal heart rhythms
- Cardiovascular disease prevention
- Migraine prevention (off-label)
How does Bisoprolol work?
A cardioselective beta-1 blocker that reduces heart rate and force of contraction, lowering blood pressure and reducing the heart's oxygen demand while providing cardiovascular protection.
Dosage and Administration
Adults
Hypertension: 5mg once daily, may increase to 10-20mg daily. Heart failure: start 1.25mg daily, gradually increase to 10mg daily.
Children
Not routinely used in children—specialist supervision required if prescribed.
Important Notes
- Take at the same time each day, preferably in the morning.
- Can be taken with or without food.
- Never stop suddenly—gradual dose reduction required.
- Start with lowest dose and increase gradually for heart failure.
Side Effects
Common Side Effects
- Fatigue and tiredness
- Dizziness
- Headache
- Cold hands and feet
- Slow heart rate (bradycardia)
- Nausea
- Diarrhoea
Serious Side Effects
Seek immediate medical attention if you experience:
- Severe heart block
- Severe low blood pressure
- Worsening heart failure (initially)
- Severe breathing difficulties
- Severe allergic reactions
- Depression
- Masking of hypoglycemia symptoms
Important Warnings
- Tell your GP if you have asthma, COPD, or severe heart block.
- Never stop suddenly—can cause dangerous rebound effects including heart attack.
- May mask symptoms of low blood sugar in diabetics.
- Can worsen circulation problems in hands and feet.
- Use with caution if you have liver or kidney problems.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- Calcium channel blockers (verapamil, diltiazem)—may cause severe heart block.
- NSAIDs—may reduce blood pressure lowering effects.
- Insulin and diabetes medications—may mask hypoglycemia symptoms.
- Other blood pressure medications—additive blood pressure lowering.
- Antiarrhythmic drugs—increased risk of heart rhythm problems.
Frequently Asked Questions
How is Bisoprolol different from Propranolol?
Bisoprolol is cardioselective (mainly affects the heart) and has a longer duration of action, allowing once-daily dosing, while Propranolol affects the whole body and requires multiple daily doses.
Why might my GP choose Bisoprolol over other beta-blockers?
Bisoprolol is highly cardioselective, has excellent evidence for heart failure and post-heart attack protection, and allows convenient once-daily dosing.
Can I exercise while taking Bisoprolol?
Yes, but your maximum heart rate will be lower. Your GP or cardiac rehabilitation team can advise on appropriate exercise targets.
How long does it take to work?
Blood pressure effects begin within hours, but full cardiovascular benefits may take several weeks. Heart failure benefits can take months to fully develop.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14