Can I take Bisoprolol and Metformin together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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Bisoprolol can hide the warning signs of low blood sugar (hypoglycaemia). It may also slightly change how your body manages blood sugar levels, potentially making metformin less effective or increasing the risk of a 'hypo'.
Why this happens
Bisoprolol is a beta-blocker. It works by slowing the heart rate and blocking certain stress hormones. These same hormones are what cause the 'shaky' or 'racing heart' feelings that warn you when your blood sugar is too low. Additionally, beta-blockers can interfere with the body's natural process of releasing glucose into the blood.
What you should do
You can take these medicines together, but you should monitor your blood sugar levels more closely, especially when starting or changing doses. Be aware that you might not feel the usual 'racing heart' if your sugar drops; instead, look out for signs like sweating, hunger, or confusion. If you notice unusual changes in your blood sugar readings, speak to your doctor.
Important precautions
Asthma or chronic obstructive pulmonary disease (COPD)
Bisoprolol can cause your airways to narrow, making it much harder to breathe or triggering a severe asthma attack. It is usually avoided if you have a history of wheezing or asthma.
Diabetes
Bisoprolol can mask the warning signs of low blood sugar (hypoglycaemia), such as a fast heartbeat or tremors. You will need to monitor your blood sugar more closely.
Severe kidney disease or dehydration
If you have severe kidney problems or become severely dehydrated (e.g., due to severe vomiting or diarrhoea), you must stop metformin temporarily. Continuing it can lead to a rare but life-threatening build-up of acid in the blood called lactic acidosis.
Food and drink warnings
Alcohol
Alcohol can increase the blood pressure-lowering effect of bisoprolol, which may make you feel dizzy, lightheaded, or faint, especially when you first start taking it or when your dose is increased. It is best to keep your alcohol intake within recommended limits and see how the medicine affects you before drinking.
General Food Intake
Metformin should be taken with or immediately after a meal. This helps to reduce common side effects such as indigestion, stomach ache, nausea, and diarrhoea.
Using other medicines
Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.
Disclaimer
This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
Article also available in English, German, Spanish, French, Italian, Portuguese, Hindi, Hebrew, Arabic, and Swedish.
25 Jan 2026 | Originally published

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