Treatment for: Hypertension (High Blood Pressure)

Type of drug: Beta Blocker

Prescription or over-the-counter: Prescription-only medication

Branded or generic: Generic

Active ingredient: Bisopropolol fumarate

Dosages available: 1.25mg, 2.5mg, 5mg and 10mg

Time to start working: 2 hours

Common side effects include: stomach pain or discomfort, depression, dizziness, dry eyes, erectile dysfunction, feeling weak or faint, feeling tired, headache, nausea, mild skin rash

Bisoprolol is a beta-adrenergic receptor blocking agent (beta-blocker) used to treat high blood pressure or hypertension. It works by blocking the effects of hormones like adrenaline that increase your heart rate. This slows down the heart, allowing for blood to be pumped around the body more easily. 

Bisoprolol works by reducing your heart rate, and makes it easier for blood to flow around your body. Bisoprolol, and other beta blockers, prevents the effects of stress hormones like adrenaline and noradrenaline in the body by blocking the receptors where these hormones work. This changes how the body responds to nerve impulses in the heart that would cause the heart rate to speed up and pump harder.

Other uses of bisoprolol

This drug can also be used to treat other heart related conditions like angina, and stable chronic heart failure. When prescribed as a treatment for blood pressure, bisoprolol is often used alongside other medications. It may also be used as a second option where other blood pressure medication has been tried and failed.

How quickly does bisoprolol work?

This medication can begin reducing blood pressure just 2 hours after swallowing the first tablet. The full effect can take as long as 2 to 6 weeks to happen. It’s hard for the patient to detect any changes in blood pressure without measuring it when taking bisoprolol, as there are often no symptoms of high blood pressure. You will need to confirm it’s working by having your blood pressure checked regularly.

If taking bisoprolol for angina, you may have to wait at least 2 weeks before you begin to feel better. Those taking bisoprolol for heart failure may have to wait several weeks to months before they feel better.

Bisoprolol is available in tablet form only. The tablet is available in doses of 1.25mg, 2.5mg, 5mg, and 10mg and is taken once a day by mouth. The first dose is usually prescribed to be taken at night. This is because it may cause some dizziness. Afterwards you will be advised to take it in the mornings.

What if I miss a dose?

Your doctor may decide to adjust your dosage with time. Ensure that you stick to the dosage prescribed. If you happen to miss a dose, skip it and just wait until the normal time to take your next dose. Do not take a double dose on the same day.

It’s important to keep taking your medication as it was prescribed. Even if you begin to feel better, do not skip any doses. If you suddenly stop taking bisoprolol, you risk letting your blood pressure rise again. You also increase the risk of suffering a heart attack or stroke.

Bisoprolol is prescribed in the following dosages:

• 1.25 mg
• 2.5 mg
• 3.75 mg
• 5 mg
• 7.5 mg
• 10 mg
• 20mg

The dosage prescribed may vary according to which condition is being treated and to see what effect it is having on the body. If you are also taking other medications, this will also have to be factored in.

Dosage for high blood pressure

For high blood pressure and angina in adults between 18 to 64 years, you will likely be started on a dose of either 5mg or 10mg a day. If the effect is not strong enough, your doctor may slowly increase the dosage up to 20mg a day. For those that are aged 65 or above, their metabolism tends to be slower, so your doctor will likely start with a lower dosage or opt for an alternative blood pressure medication.

Dosage for other conditions

To treat heart failure, your doctor will likely start with the lowest dose of 1.25mg a day. Over the following months, this dosage may be increased up to 10mg a day.

Can I buy bisoprolol online?

Yes, you can safely and legally buy bisprolol online from licensed providers such as Superdrug Online Doctor. Before you can get this medication online, you will need to have a prescription from your GP and take the medication for at least 3 months. You can then contact one of our doctors, who can renew your prescription, and you can order bisopropolol online for pickup or delivery.

You can get bisoprolol at Superdrug Online Doctor from £19 for a 3 month prescription.

Can I get bisopropolol over the counter?

No, bisopropolol is a prescription medication. This means that you can't get it over the counter from a pharmacy without a prescription from a doctor.

Can I get bisoprolol on the NHS?

Yes, you can get bisopropolol on the NHS. You will need to contact your GP and arrange an appointment.

Taking bisoprolol may result in side effects, but for most people they tend to be mild and temporary. They could be a result of your body adjusting to the new medication. Other side effects may last longer or be more severe. In such cases, it is advisable to get in touch with your doctor right away.

Some of the common side effects of bisoprolol include:

• slow heart rate
• dizziness
• tiredness
• weakness
• diarrhoea or constipation
• headaches
• nausea or vomiting
• cold or flu symptoms
• swelling
• cold hands or feet

Less common side effects of bisoprolol include:

• low blood pressure (hypotension)
• depression
• breathing problems in patients with asthma or other lung diseases
• sleep disturbances
• muscle weakness
• stomach cramps

Rare side effects of bisoprolol include:

• severe dizziness
• fainting
• difficulty breathing
• very slow heartbeat
• blue fingers or toes
• mental confusion or mood swings
• erectile dysfunction
• liver problems

It is possible to have an allergic reaction to bisoprolol. Get urgent medical help if you have:

• hives
• difficulty breathing
• swelling in your face, tongue, or throat

Bisoprolol is generally considered safe for long term use. Its impact of reducing blood pressure makes its long term use beneficial in reducing the risk of developing heart conditions, or suffering a heart attack or stroke.

What if I stop taking bisoprolol?

Like with most other blood pressure and heart related medications, it is not advisable to suddenly stop taking bisoprolol even if your blood pressure is now within normal range. If your blood pressure is improved, you can talk to your doctor about options to keep blood pressure low for the long term. A sudden stop may cause your blood pressure or heart condition to worsen. If you are having side effects or have another reason to want to stop taking bisoprolol, consult with your doctor. They should be able to prescribe an alternative medication that will help your condition. Do this before you stop taking bisoprolol because it can take just 24 hours for the drug to clear from your system.

Other potential side effects

Some studies say that weight gain can also be a side effect of beta-blockers. Some have suggested that this problem can be due to the feelings of weakness and tiredness that make it harder to exercise. Lifestyle and diet changes are often prescribed for those affected this way. If the weight gain is too much, talk to your doctor about switching to another drug.

Note that these are not all the side effects that can occur by taking bisoprolol. It does it mean that if you are suffering any of these symptoms that bisoprolol is the only possible cause. If you have any concerns, consult with your doctor for an accurate diagnosis.

Ensure that when consulting your doctor, you tell them about any other medications you are taking. Some drugs may interact with bisoprolol and cause dangerous side effects, and in addition some drugs can interfere with how it works.

These can include:

• other blood pressure medications, including other beta-blockers, which if combined can reduce blood pressure to dangerous levels (although you may be taking more than one blood pressure medication if guided to do so by your doctor)
• heart rhythm drugs
• antidepressants
• muscle relaxants
• non-steroidal anti-inflammatory medications (NSAIDs)
• steroids
• cough and allergy medicine that contains pseudoephedrine
• diabetes medication
• anaesthetic
• antibiotics
• stimulants

It’s common to take over the counter NSAIDs like ibuprofen for pain relief. Make sure you consult with your doctor because these drugs can stop bisoprolol from working well. Your doctor may need to adjust your dosage to correct this.

Bisoprolol and erectile dysfunction

For men affected by erectile dysfunction (ED), Viagra is a common treatment. However, Viagra can lower blood pressure further when taken with bisoprolol. It’s possible to have low blood pressure symptoms of dizziness, lightheadedness, fainting, headache, and rapid heart rate. Contact your doctor if these symptoms occur.

Bisoprolol and asthma

Patients with stable asthma may be able to safely use bisoprolol. Those with more severe or unstable asthma should not use bisoprolol as it can cause the worsening of asthma symptoms. It has also been found that asthma symptoms may worsen with the first dose.

Inform your doctor of all medication you are taking including prescription, over the counter, vitamins, and herbal supplements. This is not an exhaustive list of all possible drug interactions so do consult your doctor if you are taking any other medications.

Can I drink on bisoprolol?

It is usually safe to drink alcohol while taking bisoprolol, but it is not recommended. Alcohol can lower your blood pressure, which when combined with the effects of bisoprolol could cause side effects such as dizziness or lightheadedness.This effect can be experienced more intensely when you first start taking bisoprolol, or if you start taking a higher dose.

Coronavirus and bisoprolol

Studies have shown that there is no increased chance of getting a positive Covid-19 test result, or experiencing severe Covid-19 in those that do test positive, if taking 5 of the most common antihypertensive medications. This includes beta-blockers like bisoprolol. Beta-blockers like bisoprolol are considered safe for use and should not be stopped unless suggested by your doctor who should prescribe an alternate medication.

It is normal for patients with high blood pressure to take more than one drug to manage their condition. While it is not safe to take another beta-blocker with bisoprolol, other medications can be used in combination or as an alternative when recommended by your doctor.

These include:

• angiotensin-converting enzyme (ACE) inhibitors such as ramipril
• angiotensin receptor blockers
• calcium channel blockers like amlodipine
• diuretics

Beta-blockers are effective at reducing blood pressure. Bisoprolol has fewer side effects than other beta-blockers because it is cardio-selective. This means it works mainly on the heart, whereas other beta-blockers, like propranolol, can affect other body parts. 

Atenolol has been a popular beta-blocker for many years. However, bisoprolol has become increasingly popular because it is more cardio-focused. Other commonly used beta-blockers include metoprolol and propranolol.