GENERIC NAME: Bisoprolol Fumarate

COMMON BRANDS: Zebeta, Monocor

Bisoprolol is an oral prescription drug belongs to a class of medications known as “cardioselective beta blockers” without intrinsic sympathomimetic activity. Bisoprolol comes as an oral tablet form commonly sold under the brand name “Zebeta” used to treat high blood pressure. It is also available as a generic drug.

Bisoprolol work by preventing catecholamine (norepinephrine) from acting on beta-adrenoreceptors that are present in blood vessels and the heart. This causes blood vessels to relax and slow down the heart rate to improve blood flow, decrease blood pressure and reduce strain on the heart.

What is Bisoprolol used for?


This drug is used to treat hypertension in adults either alone or in combination with other antihypertensive medications (such as thiazide diuretics). Lowering blood pressure helps to prevent strokes, heart attacks, and kidney problems.


This drug is also used to prevent chest pain caused by angina and to treat atrial fibrillation and arrhythmias (irregular heartbeat).

How to use Bisoprolol?

Take bisoprolol tablet orally with food or without food, as directed by the doctor, usually once a day. The dosage of this drug depends on your medical condition and response to the treatment.

To help you remember to take this drug at the same time each day. Carefully follow all the directions on your prescription label, and ask your doctor or pharmacist to explain any part you do not understand.

Take bisoprolol exactly as directed. Do not alter your dose or take it more frequently than prescribed by your doctor. Use this medication regularly as instructed by your doctor to get the most benefit from it. It is crucial to continue this drug even if you feel better. Most of the people having high blood pressure do not feel sick.

If you abruptly discontinue taking bisoprolol, you may experience heart problems like angina (chest pain) or heart attack.

Wait for at least 2 weeks to observe the full benefit of this medicine. Inform your doctor if your medical condition remains unchanged or if it worsens (for example, if your blood pressure remains high or chest pain occurs more often).

What are the side effects of Bisoprolol?

The common side effects observed with the use of this drug include dizziness, lightheadedness, excessive tiredness, headache, upper respiratory infection, edema (swelling in the legs and feet) constipation, diarrhea, arthralgia (stomach upset and Joint pain). If any of these effects remain or worsen, inform your doctor/pharmacist immediately.

Bisoprolol may reduce blood flow to your hands and feet, making them feel cold. Limit smoking or chewing of tobacco as this may worsen this effect.

Get up slowly from a sitting/lying position, as this may help to lessen the risk of dizziness and lightheadedness.

Notify your prescriber immediately if you notice any of these unlikely, but serious side effects such as slow heartbeat, severe dizziness, fainting, blue fingers/toes, trouble breathing, mental/mood changes (confusion, mood swings, depression).

A severe allergic reaction to this drug is very rare. However, severe allergic reaction symptoms such as rashes, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing may occur. Get emergency medical assistance immediately if you notice any of the above side effects.

This is not a complete record of all possible side effects. Inform your doctor at the earliest, if you notice any of the side effects that are not mentioned in this article.

See also Warning and Precautions sections.

What are the precautions while using Bisoprolol?

Inform your doctor/pharmacist before taking bisoprolol, if you are allergic to it; or if you have other allergies. This drug may also contain some inactive ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for more information.

Inform your doctor/pharmacist about all the products you are using including prescription, non-prescription, vitamins, nutritional supplements, and herbal products.

Share your medical history with doctor, before using this drug mainly of breathing problems (like asthma, chronic bronchitis, emphysema), kidney disease, liver disease, hyperthyroidism, severe allergic reactions including those needing treatment with epinephrine, blood circulation problems (like Raynaud’s disease, peripheral vascular disease), mental/mood disorders (like depression), myasthenia gravis (muscle disease), eye problems (cataracts, glaucoma).

The use of this drug is contraindicated if you have certain medical conditions like a slow heartbeat, second or third-degree atrioventricular block, severe heart failure. Before using this medicine, Discuss with your doctor.

If you have diabetes, bisoprolol may mask the symptoms of hypoglycemia (sudden fall in blood sugar level) such as fast/pounding heartbeat you would usually feel when you are hypoglycemic. Other symptoms of hypoglycemia such as sweating and dizziness, does not change by this drug.

This drug can make it difficult to control your blood sugar level. Regularly monitor your blood sugar levels and share the results with the doctor. Notify your doctor quickly if you notice any symptoms of hyperglycemia (high blood sugar level) such as an increase in thirst or urination. Your doctor may adjust your diabetes medication.

In pregnancy, this medication should be used only when benefits outweigh the risk. It may harm an unborn baby. It may be harmful to the fetus. It is not clear whether this drug cross into breast milk and for more information about the safety of drug talk to your doctor.

What are the drug interactions of Bisoprolol?

Bisoprolol may interact with other medications, herbs, or vitamins you may be using. A drug interaction is when a substance changes the way a drug works which can be harmful or hinder the drug from working well.

Do not start, stop, or alter the dose of the drug without discussing your doctor because your doctor may be monitoring you for possible drug interactions.

Using reserpine and guanethidine with bisoprolol may cause a drop in your blood pressure when you change your position from sitting to standing or from lying down to sitting. This can increase your risk of falls.

Some products may interact with bisoprolol such as beta-blockers (atenolol, propranolol, acebutolol and others), clonidine, fenoldopam, fingolimod thioridazine and decrease its effectiveness.

Bisoprolol and diltiazem have a similar effect on the heart. Using diltiazem along with bisoprolol can cause low blood pressure, low heart rate and even heart failure.

Taking heart rhythm drugs (amiodarone, bretylium, quinidine, digoxin, disopyramide, encainide) with bisoprolol can cause more severe side effects like low your heart rate or blood pressure, or worsen a heart blockage. Your doctor may oversee you for these effects or adjust the dosage of bisoprolol or your heart rhythm drug.

NSAIDs (such as diclofenac, ibuprofen, indomethacin, ketorolac, nabumetone, naproxen), a nasal decongestant (such as phenylephrine, pseudoephedrine), cough-and-cold products, may decrease the effectiveness of bisoprolol.


Stopping the drug:

Do not suddenly discontinue this medication without informing your doctor. Some conditions may become dangerous when you suddenly stop this drug. In some people who have abruptly terminated taking similar drugs have had chest pain, heart attack, and even irregular heartbeat. If your doctor recommends you to stop this drug, your doctor may ask you to reduce your dose gradually.

When you gradually decrease the dose of this drug before discontinuing this medication, your doctor may recommend you to restrict physical activity to reduce pressure on your heart. Get medical emergency assistance immediately if you notice symptoms such as chest pain/tightness/pressure, unusual sweating, trouble in breathing, chest pain spreading to the jaw/neck/arm, or fast/irregular heartbeat.

Bisoprolol and all beta blockers are contraindicated in bronchial asthma, cardiac failure, cardiogenic shock, second and third-degree heart block, severe bradycardia (slow heart rate).

Other conditions:

Before taking bisoprolol, inform your doctor about all of your health conditions such as diabetes, chronic obstructive pulmonary disease (COPD), asthma, poor circulation, heart failure or other heart problems, hyperthyroidism.

What are the forms and strengths of Bisoprolol?

Form: Tablets
Strengths: 5mg, 10mg

What is the dosage of Bisoprolol?

For Hypertension (high blood pressure):

Adult (18–64 years):

Initial dose: Take 5mg orally once daily. If required your prescriber may increase your dose by 10mg per.
Maximum dose: Dose should not exceed 20mg per day.

Children (0 to 17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established yet.

Geriatric (65 years and older):

Older adults are susceptible to the side effects of this drug due to slow kidney and liver function. To avoid this, your doctor may initiate your treatment on a low dose.

Special Dosage Considerations:

Respiratory disease:

For people with a respiratory disease like asthma, the doctor may start you on 2.5mg of bisoprolol per day and increase your dosage slowly to avoid any respiratory complication.

Renal impairment:

For people with renal disease, the doctor may start you on 2.5mg of bisoprolol per day and slowly increase your dose.

Hepatic impairment:

For people with liver problems, the doctor may start you on 2.5mg of bisoprolol per day and slowly increase your dose.

Most common questions asked about Bisoprolol / Q&A’s:

What is the best time of taking Bisoprolol?

The best time to take bisoprolol tablets is in the morning with a glass of water, either with or without food. If you miss taking your dose, take it as soon as you remember, but do not take a double dose, if you miss your dose.

What are the symptoms of Bisoprolol overdose?

Bisoprolol overdose symptoms may include swelling of the hands/feet/ankles/lower legs, unusual weight gain, difficulty breathing/swallowing, dizziness, fainting, shakiness, sweating, numbness or tingling of the mouth, confusion, blurred vision, headache, weakness, extreme tiredness, sudden hunger. Seek a medical emergency as soon as possible if you experience any of these symptoms.


TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.