Bisoprolol

2 medicines

Bisoprolol is a beta-blocker used for high blood pressure, angina and heart failure. It must never be stopped suddenly, since abrupt withdrawal can trigger rebound angina, a blood pressure surge or a heart attack.

Zebeta

Bisoprolol

5/10mg

Zebeta is a heart blood pressure medication containing Bisoprolol, available as 5/10mg tablets.

from $0.47 / tablet View

Ziac

Hydrochlorothiazide, Bisoprolol

2.5/6.25mg

Ziac is a heart blood pressure medication containing Hydrochlorothiazide + Bisoprolol, available as 2.5/6.25mg tablets.

from $1.95 / tablet View

Key facts

  • Bisoprolol (sold as Zebeta, and combined with a diuretic in Ziac) is a cardioselective beta-blocker that slows and steadies the heart, used for high blood pressure, angina, and long-term heart-failure treatment.
  • It's taken once daily, usually in the morning, and can take several weeks to show its full effect on blood pressure and heart failure symptoms.
  • Never stop bisoprolol suddenly: abrupt withdrawal can trigger rebound high blood pressure, worsening angina, or a heart attack. Any stopping must be tapered by your prescriber.
  • Seek urgent care for a heart rate under 50 beats a minute, fainting, or sudden worsening breathlessness or leg swelling.

What bisoprolol treats

Bisoprolol treats high blood pressure, angina (chest discomfort from reduced blood flow to the heart), and chronic heart failure with reduced pumping function, where it is started at a very low dose and increased slowly to reduce long-term strain on the heart. It is also used off-label to help control heart rate in some arrhythmias such as atrial fibrillation.

How bisoprolol works

Bisoprolol blocks beta-1 receptors, found mainly in the heart, so adrenaline and noradrenaline have less effect on it. This slows the heart rate, reduces the force of each contraction, and lowers the heart's oxygen demand and the pressure it generates against artery walls. Because it targets beta-1 receptors preferentially, it affects the beta-2 receptors in the lungs less than older, non-selective beta-blockers.

Before you take it

  • Do not take bisoprolol if you have a very slow heart rate, certain heart-block rhythms without a pacemaker, uncontrolled heart failure, or severe asthma.
  • Tell your prescriber if you have diabetes, since bisoprolol can hide the early warning signs of low blood sugar, such as a racing heart.
  • Other heart-rate or blood-pressure lowering medicines, including some calcium-channel blockers, can add to bisoprolol's effects and cause an excessively slow heart rate.
  • If you need surgery, tell the anaesthetist you take bisoprolol, since it should not usually be stopped beforehand.

Side effects

Common effects are tiredness, cold hands and feet, dizziness, and a slower resting heart rate.

Stop and seek urgent medical care for:

  • A heart rate under 50 beats a minute, fainting, or severe dizziness.
  • New or worsening shortness of breath, or swelling of the ankles and legs.
  • Chest pain that is new or getting worse.

Safety essentials

  • Never stop bisoprolol abruptly, even to switch to another medicine: sudden withdrawal after regular use can cause rebound angina, a surge in blood pressure, or a heart attack. Your prescriber will taper the dose over one to two weeks.
  • If you have diabetes, monitor your blood sugar carefully, since bisoprolol can blunt the warning signs of hypoglycaemia.
  • Carry a note stating you take a beta-blocker if you have surgery or an emergency planned.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.