Treatment with bisoprolol is usually long-term. Continue to take the tablets regularly unless you are told otherwise.
There are several different strengths of tablet. If your tablets look unexpectedly different from before, ask your pharmacist to check them for you.
The most common side-effects are feeling tired, cold fingers or toes, headache and stomach upset.
Clinical author's note: Michael Stewart 15/11/2018: Following an MHRA update, new advice has been added to this leaflet for people also taking the blood pressure medicine hydrochlorothiazide. Hydrochlorothiazide is only available in the UK in combination with other blood pressure medicines. It may be available on its own in other countries. For more information see 'Getting the most from your treatment' below or view the MHRA Alert.
|Type of medicine||A beta-adrenoceptor blocking medicine (often referred to as a beta-blocker)|
|Used for||High blood pressure, angina, heart failure|
|Also called (UK)||Cardicor®|
|Also called (USA)||Ziac® (bisoprolol with hydrochlorothiazide)|
Bisoprolol belongs to the group of medicines referred to as beta-blockers. Bisoprolol works on the heart and blood vessels. It does this by blocking tiny areas (called beta-adrenergic receptors) where messages sent by some nerves are received by your heart and blood vessels. As a result, your heart beats more slowly and with less force. The pressure of blood within your blood vessels is reduced and it is easier for your heart to pump blood around your body.
These actions are of benefit if you have high blood pressure (hypertension), or if you have heart failure which is a condition where your heart is not working as well as it should. Because your heart is using less energy, it also helps to reduce chest pain if you have angina.
Before taking bisoprolol
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking bisoprolol it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have asthma or any other breathing disorder.
- If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
- If you have low blood pressure or poor circulation.
- If you have diabetes.
- If you have a skin problem called psoriasis.
- If you have a condition causing muscle weakness, called myasthenia gravis.
- If you have been told you have a slow heartbeat or heart block (a slow and irregular heartbeat).
- If you have been told you have chest pain caused by spasms of your heart's blood vessels, called Prinzmetal's angina.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine, or if you have ever had any other serious allergic reaction.
How to take bisoprolol
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about bisoprolol and will provide you with a full list of side-effects which you may experience from taking it.
- Take bisoprolol exactly as your doctor tells you to. The usual dose is one tablet each day, although the strength of your tablet will depend upon the reason why you are taking it. If you are taking it for heart failure, you will be started on a low-strength tablet (1.25 mg) and then you will be prescribed a different strength of tablet each week for the first few weeks. This is so your doctor can increase your dose gradually. Your dose and the strength of the tablets will be on the label of the pack. There are several strengths of tablet available: 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg. Each time you collect a fresh supply of tablets it is a good idea to check to make sure you receive the strength you are expecting. If you have any questions, please ask your pharmacist to advise you.
- You can take the tablets either with or without food, but try to take your doses at the same time of day each day as this will help you to remember to take bisoprolol regularly. The tablets are best swallowed in the morning with a drink of water.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, leave out the forgotten dose from the previous day and take the dose that is due as normal. Do not take two doses at the same time to make up for a missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If you are due to have an operation or dental treatment, it is important to tell the person carrying out the treatment that you are taking a beta-blocker. This is particularly important if you are likely to be given an anaesthetic.
- If you drink alcohol, ask your doctor for advice about taking bisoprolol and alcohol. Alcohol will add to the blood pressure-lowering effect of bisoprolol which will make you feel dizzy and so may not be recommended for you.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take with bisoprolol. Some medicines may not be (including some anti-inflammatory painkillers, and cold or flu remedies).
- Your doctor may give you dietary and lifestyle advice about eating a healthy diet, not smoking, and taking regular exercise. If so, it is important that you follow the advice you are given.
- If you have diabetes, bisoprolol can block the symptoms of low blood sugar. Your doctor will advise you about this.
- Treatment with bisoprolol is usually long-term. Continue to take the tablets unless your doctor tells you to stop. Stopping treatment suddenly can cause problems in some people, so your doctor may want you to reduce your dose gradually if this becomes necessary.
If you are also taking hydrochlorothiazide in combination with this medicine
- Studies have suggested that taking higher doses of hydrochlorothiazide for long periods of time may increase the risk of certain skin cancers.
- Tell your doctor if you have ever been treated for skin cancer before.
- Tell your doctor about any new or changed moles or worrying marks on your skin.
- Use a sunscreen in strong sunlight. Do not use sunbeds.
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with bisoprolol. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common bisoprolol side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy, sleepy, tired or light-headed||Getting up and moving more slowly may help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. This usually improves after the first week or two, but if it continues, speak with your doctor. If affected, do not drive and do not use tools or machines until you feel better|
|Feeling sick (nausea) or being sick (vomiting), diarrhoea or constipation||Stick to simple foods and drink plenty of water|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, speak with your doctor|
|Cold fingers or toes, disturbed sleep, slow heartbeat||Speak with your doctor if any of these become troublesome|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store bisoprolol
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine, ask your pharmacist.
Further reading and references
Manufacturer's PIL, Cardicor® 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg tablets; Merck Serono Ltd, The electronic Medicines Compendium. Dated July 2021.
British National Formulary, 83rd Edition (Mar 2022); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.