Class: Cardioselective β-Adrenergic Blocker
Dosage Forms. Tablet: 2.5 mg, 5 mg, 10 mg
Common FDA Label Indication, Dosing, and Titration.
1. Hypertension: 2.5-5 mg po daily, may titrate to max of 20 mg po daily
Off-Label Uses.
1. Angina: 5-20 mg po daily
2. CHF: 1.25-10 mg po daily
MOA. Bisoprolol is a cardioselective β-adrenergic that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmias. The antihypertensive mechanism is unknown, but contributing factors are a CNS mechanism, renin blockade, and decreases in myocardial contractility and cardiac output.
Drug Characteristics: Bisoprolol
Medication Safety Issues: Bisoprolol
Drug Interactions: Bisoprolol
Adverse Reactions: Bisoprolol
Efficacy Monitoring Parameters. Decreased BP.
Toxicity Monitoring Parameters. Signs/symptoms of heart failure, decreased heart rate, ECG. Baseline and periodic serum, and urine electrolytes; renal function; uric acid and FBG.
Key Patient Counseling Points. Instruct patient to report signs/symptoms of dyspnea, hypotension, or heart failure. May cause dizziness; avoid alcohol, CNS depressants, or activities that require alertness. Rise slowly from a sitting/supine position, as drug may cause orthostatic hypotension. Avoid abrupt discontinuation, may cause rebound hypertension. Recommend avoiding NSAIDs while taking this drug.
Clinical Pearls. Safety in children has not been established.