Drug Detail:Bisoprolol (Bisoprolol [ bis-oh-proe-lol ])
Drug Class: Cardioselective beta blockers
Usual Adult Dose for Hypertension
Initial dose: 5 mg orally once a day
Dose Titration: If desired response is not achieved, may increase the dose to 10 mg, then 20 mg if necessary
Maximum dose: 20 mg per day
Comments:
- Dosage should be individualized to the patient; some patients may benefit from a starting dose of 2.5 mg once a day.
- In clinical trials, blood pressure lowering effects were seen at 1 week and changed little thereafter.
Use: Management of hypertension, alone or with other antihypertensive agents
Renal Dose Adjustments
CrCl less than 40 mL/min:
- Initial dose: 2.5 mg orally once a day; use caution with dose-titration
Liver Dose Adjustments
- Initial dose: 2.5 mg orally once a day; use caution with dose-titration
Dose Adjustments
Bronchospastic disease:
- Use not recommended
- However, if use is necessary, consider an initial dose of 2.5 mg orally once a day and ensure a bronchodilator is available
Cessation of therapy:
- Abrupt discontinuation should be avoided; taper therapy over approximately 1 week.
- If withdrawal symptoms occur, therapy may be temporarily reinstituted.
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
No adjustment recommended
Other Comments
Administration advice:
- Take orally once a day in the morning with or without food
General:
- Transient worsening of heart failure, hypotension, and bradycardia may occur during titration.
- This drug interferes with allergic reaction modulation and may increase the risk of anaphylactic reactions; additionally, patients may be refractory to epinephrine in treatment for anaphylactic reactions.
Monitoring:
- Heart rate and blood pressure
- Signs and symptoms of heart failure (e.g., shortness of breath, edema, and weight gain), especially in at risk patients
- Patients with coronary artery disease: angina, especially during withdrawal
Patient advice:
- Warn patients to avoid interruptions or abrupt discontinuation of this drug.
- Instruct the patient to notify their healthcare provider upon signs and symptoms of angina, bradycardia, hypotension, or heart failure (e.g., shortness of breath, edema, and weight gain).
- Avoid driving or operating machinery until the full effects are known.
- Advise patient to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding.
- Patients with diabetes should be informed that this drug may mask hypoglycemic reactions.
Frequently asked questions
- What is the best time of day to take blood pressure medication?
