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CARDIOVASCULAR SYSTEM › BETA BLOCKING AGENTS › BETA BLOCKING AGENTS › Beta blocking agents, selective
bisoprolol
C07AB07
Forms & Strengths
- Oral tablets: 5 mg
- Oral tablets: 10 mg
Adult Dosing
- Hypertension: Initial 5 mg once daily, titrate to max 20 mg daily
- Heart Failure with reduced ejection fraction: Initial 1.25 mg once daily, double every 2 weeks as tolerated to target 10 mg once daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Hypertension
- Chronic heart failure with reduced systolic function
Mechanism of Action
- Cardioselective beta-1 adrenergic receptor blocker
- Decreases heart rate, myocardial contractility, and cardiac output
- Decreases renin secretion by the kidneys
Contraindications
- Severe bradycardia
- Cardiogenic shock
- Decompensated heart failure requiring inotropic therapy
- Second- or third-degree AV block without a pacemaker
- Severe sick sinus syndrome
- Severe peripheral arterial disease
- Hypersensitivity to bisoprolol
Adverse Reactions
- Dizziness
- Fatigue
- Bradycardia
- Hypotension
- Bronchospasm
- Worsening heart failure
- Depression
- Masking of hypoglycemia symptoms
Drug Interactions
- CYP3A4 inhibitors (e.g., ketoconazole) may increase bisoprolol plasma concentrations
- CYP3A4 inducers (e.g., rifampin) may decrease bisoprolol efficacy
- CCBs (e.g., verapamil, diltiazem) increase risk of bradycardia and AV block
- Antihypertensive agents and diuretics cause additive hypotensive effects
- Digitalis glycosides may increase risk of bradycardia
- Disopyramide and other antiarrhythmics may potentiate negative inotropic effects
Curated Content: Needs Vetting Before Put to Clinical Use