Bisoprolol
A cardioselective beta blocker used for high blood pressure, angina and, with other medicines, heart failure.
Drug card
- Class
- Beta blocker
- How it works
- Blocking beta receptors, so the heart beats slower and less forcefully
- Used for
- High blood pressure
- Angina
- Heart failure, alongside other medicines
- Known for
- Slow heart rate (bradycardia)
- Hidden warning signs of low blood sugar
- Its name
- -olol means a beta blocker
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does bisoprolol work?
Bisoprolol blocks mainly β1 receptors and has no intrinsic sympathomimetic activity. Half of a dose leaves unchanged through the kidneys and half is metabolized by the liver to inactive products, and its half-life of 9 to 12 hours gives a long action.
Like other beta blockers: They block β-adrenergic receptors, so epinephrine and norepinephrine act less: in the heart (β1) rate and force of contraction fall and AV conduction slows, and the kidneys release less renin. Cardioselective ones (atenolol, bisoprolol, metoprolol) act mainly on β1; non-selective ones also block β2 in airways and vessels; carvedilol and labetalol block α1 as well.
Uses
What is bisoprolol used for?
- High blood pressure
- Angina
- Heart failure, alongside other medicines
Side effects
Side effects of bisoprolol
- Slow heart rate (bradycardia)Known for
- Hidden warning signs of low blood sugarKnown forSerious
- Tiredness and weakness
- Cold, numb or tingling hands and feet
- Headache
- Dizziness
- Low blood pressure
- Diarrhea
- Constipation
- Worsening heart failureSerious
- Wheezing (bronchospasm)Serious
- Hepatitis (rare)Serious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Not for marked sinus bradycardia, 2nd- or 3rd-degree AV block, cardiogenic shock or overt heart failure.
- Stop gradually: sudden withdrawal has worsened angina and caused heart attacks and ventricular arrhythmias.
- Kidney or liver impairment: dose increases are made with extra care.
Good to know: The US label covers only high blood pressure; the NHS also lists angina and heart failure.
Remember it
A way to remember it
One heart, two lungs: β1 for the heart, β2 for the lungs.
β1 receptors dominate in the heart and β2 receptors in the airways. Cardioselective beta blockers act mainly on β1, so they narrow the airways less than non-selective ones such as propranolol, though all need care in asthma.
A mnemonic widely used in teaching
Its name
-olol means beta blocker
Labetalol (-alol) and carvedilol (-dilol) are beta blockers that also block alpha-1 receptors. Stanozolol, an anabolic steroid, ends in -olol by chance.
- Every drug name stem
Its class
Beta blockers
Other beta blockers with a card:
Easily mixed up with alpha-1 blockers and non-dihydropyridine calcium channel blockers.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Blood pressure
Bisoprolol is one of 27 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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