Bisoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Bisoprolol is used to treat hypertension (high blood pressure).

Bisoprolol may also be used for purposes not listed in this medication guide.

Do not skip doses or stop taking bisoprolol without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using this medicine.

You should not use bisoprolol if you have a serious heart condition such as "AV block," severe heart failure, or slow heartbeats that have caused you to faint.

Keep using bisoprolol as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Bisoprolol comes as a tablet to take by mouth. It is usually taken once a day. To help you remember to take bisoprolol, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bisoprolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of bisoprolol and gradually increase your dose. Talk to your doctor about how you feel and about any symptoms you experience during this time.

Bisoprolol controls high blood pressure but does not cure it. It may take a few weeks before you feel the full benefit of bisoprolol. Continue to take bisoprolol even if you feel well. Do not stop taking bisoprolol without talking to your doctor. If you suddenly stop taking bisoprolol, you may experience serious heart problems such as angina (chest pain), heart attack, or irregular heartbeat. Your doctor will probably decrease your dose gradually over 1 week. Your doctor will watch you carefully and will probably tell you to avoid physical activity during this time.

Take bisoprolol exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not skip doses or stop taking bisoprolol without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems.

If you need surgery, tell the surgeon ahead of time that you are using bisoprolol.

Your blood pressure will need to be checked often.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store bisoprolol at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

You should not use bisoprolol if you you are allergic to it, or if you have a serious heart condition such as:

• "AV block";

• severe heart failure; or

• slow heartbeats that have caused you to faint.

To make sure bisoprolol is safe for you, tell your doctor if you have:

• congestive heart failure or other heart problems;

• coronary artery disease;

• circulation problems (such as Peripheral Vascular Disease or Raynaud's syndrome);

• asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder;

• diabetes (taking bisoprolol can make it harder for you to tell when you have low blood sugar);

• liver or kidney disease;

• a thyroid disorder; or

• a history of allergies.

It is not known whether bisoprolol is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether bisoprolol passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Bisoprolol is not approved for use by anyone younger than 18 years old.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Minimize drinking alcohol. It can increase some of the side effects of bisoprolol.

Get emergency medical help if you have signs of an allergic reaction to bisoprolol: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• shortness of breath (even with mild exertion), swelling, rapid weight gain;

• slow heart rate;

• pounding heartbeats or fluttering in your chest;

• numbness, tingling, or cold feeling in your hands or feet;

• a light-headed feeling, like you might pass out;

• eye pain, vision problems; or

• bronchospasm (wheezing, chest tightness, trouble breathing).

Common bisoprolol side effects may include:

• headache;

• feeling tired;

• sleep problems (insomnia);

• joint pain;

• swelling; or

• cold symptoms such as stuffy nose, runny nose, cough, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines and any you start or stop using, especially:

• insulin or oral diabetes medicine;

• rifampin; or

• heart or blood pressure medicine--clonidine, digitalis, digoxin, diltiazem, reserpine, or verapamil.

This list is not complete. Other drugs may interact with bisoprolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to bisoprolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Ziac® (containing Bisoprolol, Hydrochlorothiazide)