BISOPROLOL oral

Prescription under medical supervision

Therapeutic action

– Cardioselective beta-blocker

Indications

– Hypertension, treatment of chronic stable angina pectoris
– Chronic stable heart failure in combination with a converting enzyme inhibitor (enalapril)

Forms and strengths

– 2.5 mg breakable tablet 
– 10 mg breakable in ¼ tablet 

Dosage

– Hypertension, angina pectoris
Adult: 5 to 10 mg once daily, preferably in the morning (max. 20 mg daily)
In patients with renal or hepatic impairment: start with 2.5 mg once daily then increase, if necessary, according to clinical response (max. 10 mg daily)

 Heart failure
Adult: start with 1.25 mg once daily and increase according to the table below, as long as the drug is well tolerated (heart rate, blood pressure, signs of worsening heart failure)

Weeks

Daily dose

Tablet(s)

Week 1

1.25 mg once daily

2.5 mg tab: ½ tab daily

Week 2

2.5 mg once daily

2.5 mg tab: 1 tab daily
or
10 mg tab: ¼ tab daily

Week 3

3.75 mg once daily

2.5 mg tab: 1½ tab daily

Week 4 to 8

5 mg once daily

10 mg tab: ½ tab daily

Week 9 to 12

7.5 mg once daily

2.5 mg tab: 1 tab daily + 10 mg tab: ½ tab daily
or
10 mg tab: ¾ tab daily

From week 13

10 mg once daily
(max. 10 mg daily)

10 mg tab: 1 tab daily

Duration

– According to clinical response. Do not stop treatment abruptly, decrease doses gradually.

Contra-indications, adverse effects, precautions

– Do not administer to patients with asthma, chronic obstructive bronchopneumonia, acute heart failure, severe hypotension, bradycardia < 50/minute, atrio-ventricular heart blocks, Raynaud's syndrome.
– May cause:
• bradycardia, hypotension, worsening of heart failure (reduce dose);
• bronchospasm in patients with an obstructive respiratory disease;
• hypoglycaemia, gastrointestinal disturbances, headache, fatigue, muscle weakness, erectile dysfunction.
– Administer with caution to patients with diabetes (risk of hypoglycaemia).
– In the event of anaphylactic shock, risk of resistance to epinephrine.
– Avoid or monitor combination with:
• mefloquine, digoxin, amiodarone, diltiazem, verapamil (risk of bradycardia);
• tricyclic antidepressants, antipsychotics, anti-hypertensive drugs (risk of hypotension).
– Pregnancy and breast-feeding: use labetalol, particularly for the management of hypertension in pregnancy.

Remarks

  Storage: below 25 °C -  -