Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: bisoprolol
BRAND NAME: Zebeta
DRUG CLASS AND MECHANISM: Bisoprolol belongs to a class of drugs called
beta-adrenergic receptor blocking agents that also includes propranolol
(Inderal), atenolol (Tenormin), and timolol (Blocadren). Bisoprolol is used for
treating high blood pressure and heart pain (angina). Bisoprolol prevents the
neurotransmitters (chemicals that nerves use to communicate with other nerves),
norepinephrine and epinephrine (adrenaline), from binding to beta receptors on
nerves. By blocking the effect of norepinephrine and epinephrine on the nerves
reaching the heart and blood vessels, beta blockers reduce heart rate and the
force with which the heart contracts and reduce blood pressure by dilating blood
vessels but may constrict air passages by stimulating the muscles that surround
the air passages. Angina occurs when the heart's need for oxygen exceeds the
supply of oxygen-carrying blood. By slowing heart rate and decreasing the force
with which the heart muscle contracts, bisoprolol reduces the work of the heart
and the demand of the heart for oxygen. The FDA approved bisoprolol in July
1992.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 5 and 10 mg.
STORAGE: Bisoprolol should be stored at room temperature, 59-86 F (15-30 C)
in an air-tight container.
PRESCRIBED FOR: Bisoprolol is used alone or with other drugs for treating
patients with high blood pressure. It also is used for treating angina and
congestive heart failure.
DOSING: The usual adult dose of bisoprolol is 2.5-20 mg once daily.
DRUG INTERACTIONS: Rifampin may 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 also may cause an
excessive reduction in heart rate.
Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Motrin,
Advil) and naproxen (Naprosyn, Anaprox, Aleve), can reduce the blood pressure
lowering effects of beta- blockers.
PREGNANCY: There are no adequate studies in
pregnant women.
NURSING MOTHERS: It is not known if bisoprolol is secreted in
breast milk.
SIDE EFFECTS: Bisoprolol is generally well-tolerated, and side effects are
mild and transient. Side effects include abdominal cramps, diarrhea, dizziness,
fatigue, depression, 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, or
chronic bronchitis and emphysema that have a component of bronchial spasm. In
patients with existing slow heart rates (bradycardias) and heart blocks (defects
in the 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 cause 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.
Reference: FDA Prescribing Information
Last Editorial Review: 9/2/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Beta Blockers - Learn more about Beta Blockers, a drug that treats angina and other heart rhythm disorders, migraines, high blood pressure, panic attacks, and tremors. Generic and brand names are included in the article.
- Congestive Heart Failure - Read about congestive heart failure symptoms like fatigue, abdomen, leg and ankle swelling, shortness of breath, sleeplessness, increased urination, nausea, abdominal pain, and decreased appetite.
- metoprolol, Lopressor, Toprol XL - Learn more about Metoprolol, a drug to treat high blood pressure, heart pain, abnormal rhythms of the heart, and some neurological conditions. Information includes a description, generic and brand names, drug class and mechanism, preparations, storage, reasons for prescription, dosing, drug interactions, effect on pregnancy, and common side effects.
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