Bisoprolol: uses, side effects and cautions

Bisoprolol treats high blood pressure and heart-related chest pain (angina) and can help manage heart failure when combined with other medicines. It belongs to the beta blocker group and is only available with a prescription. The NHS page does not name a brand.

Most adults can take bisoprolol. Tell your doctor if you have previously had an allergic reaction to bisoprolol or another beta blocker, have breathing problems such as asthma, low blood pressure, diabetes, kidney disease or poor blood flow in the legs (peripheral arterial disease). The NHS lists these among the situations where bisoprolol may be unsuitable or where extra care is needed.

Swallow the tablets whole with a glass of water and do not chew them. Try to take them at the same time each day, usually in the morning, and eat as normal. A doctor may start with a low dose and increase it after around a week or more; the NHS page gives no fixed figures.

If you forget a dose, take it when you remember unless the next is nearly due, in which case skip it. Do not take two. Taking too much can sometimes be dangerous, so call NHS 111 if you have exceeded your dose.

Do not stop taking bisoprolol without talking to your doctor, because your condition may get worse. If stopping is appropriate, the dose is reduced under medical supervision.

Headaches, tiredness and weakness, cold, numb or tingly hands and feet, dizziness from low blood pressure, and nausea or digestive upsets are the common ones. The NHS notes they usually occur when you first start or when the dose goes up, and often improve with time. Keep taking the medicine unless told otherwise, and ask a pharmacist or doctor if they bother you.

Serious but rare: allergic reactions with throat swelling or breathing difficulty, liver problems with jaundice, new breathing problems and worsening heart symptoms. Call NHS 111 if you think you may be experiencing a serious effect.

Alcohol may increase the risk of low blood pressure. Bisoprolol does not usually affect driving, but if you feel dizzy or have vision problems after taking it, wait until these have gone.

Named medicines to mention: flecainide, clonidine, ibuprofen and amitriptyline, as well as glaucoma eye medicines and medicines to clear a blocked nose. The NHS says that is not the full list.

The NHS says bisoprolol can be taken during pregnancy but you and your baby may be offered extra checks; when it is needed, the benefits usually outweigh the risks to the baby. Taking it while breastfeeding may cause side effects in the baby, so doctors weigh benefits and may suggest another beta blocker. Tell your doctor if you are pregnant or nursing.

Other beta blockers include atenolol, metoprolol, carvedilol and nebivolol. Report suspected side effects through the Yellow Card scheme.