Bisoprolol

Bisoprolol:

• is a type of medicine known as a beta-blocker
• contains the active substance bisoprolol fumarate
• comes in tablet form

Beta-blockers like bisoprolol are used to:

• lower the heart rate
• treat high blood pressure (hypertension)
• treat chronic chest pain (angina)
• treat 'stable heart failure'

ZAVA doctors can provide a repeat prescription for bisoprolol treatment for high blood pressure, if you’re stable on your dose and have had a regular GP check up.

If you’re using bisoprolol for conditions other than high blood pressure it’s important that this is monitored by your GP or specialist.

Bisoprolol treats high blood pressure by reducing the effects of the hormone ‘adrenaline’. Beta-blockers like bisoprolol slow down your heart rate, meaning that your heart beats slower and with less force. This makes blood circulation more efficient around the body, and reduces your blood pressure levels.

Bisoprolol is a treatment for high blood pressure (hypertension) that’s usually used when other treatments have not worked, or in combination with other treatments.

Other treatments for high blood pressure include:

• ACE inhibitors (like perindopril)
• diuretics
• alpha-blockers

The point of high blood pressure treatment is to get your blood pressure within a healthy range. As a general guide:

• low blood pressure is 90/60mmHg or below
• healthy levels of blood pressure are between 90/60mmHg and 120/80mmHg
• high blood pressure is 140/90mmHg or above

Having high blood pressure can be dangerous. It puts you at risk of getting heart disease, having a heart attack or stroke, and puts an extra strain on your heart and other organs.

If you have high blood pressure and want to achieve a healthier level, bisoprolol may be the right medical treatment for you, although it is not normally a first choice drug to control blood pressure

Visit your nurse or GP for a full consultation to assess whether bisoprolol is a suitable medicine for you. They will assess your past and current medical history. This is important because bisoprolol can interfere or react negatively when used in combination with certain other medicines or if you have other health conditions.

You should not take bisoprolol if you:

• are allergic to any of its listed ingredients
• are pregnant or breastfeeding
• have severe asthma or chronic lung disease
• have a slow or irregular heartbeat
• have very low blood pressure
• have severe blood circulation problems
• have heart failure
• have the condition called metabolic acidosis (excess levels of acid in the blood)
• have a tumour in the adrenal gland (phaeochromocytoma)

Always tell your nurse, GP, or surgeon well in advance if you're taking bisoprolol and are going to be given a general anaesthetic for an operation.

Bisoprolol is a prescription-only medicine. This means that you cannot buy it over-the-counter. You can only get it after an assessment with a doctor who agrees it’s right for you.

To get your first prescription for bisoprolol, you’ll need to get a diagnosis and prescription from your GP or specialist.

Once you have your first prescription, you can get your medication dispensed from most pharmacies. You can also re-order your next batch of tablets using an online service like ZAVA. This is a safe and convenient way to get your regular medication.

Currently, the only way to diagnose high blood pressure is to have a blood pressure test. You can have this done at:

• your local GP surgery
• some pharmacies
• some workplaces

You can also measure your blood pressure at home with a blood pressure monitoring machine but for a first time diagnosis your doctor will need to check themselves.

Starting dose – typically, for high blood pressure or chest pain, you will start on the lowest possible dose for treating these conditions, which is 5mg per day. Your doctor may increase this dose depending on how your body reacts to treatment.

Maximum dose - the maximum recommended dose of bisoprolol for high blood pressure or chest pain is 10mg per day.

What if I forget a dose or take too much by mistake?

• if you forget a dose of bisoprolol - simply take your next dose at the right time, as soon as you remember. Don’t ever double-up on your dose to make up for the one you missed. If you miss several days’ worth of bisoprolol, contact your nurse or GP for advice
• if you take more bisoprolol than you should, you should seek urgent medical attention. Bring the remaining tablets and the tablet container with you to show your doctor or the staff at the A&E department of your local hospital

Medicines used to treat high blood pressure work best when used in combination with healthy lifestyle changes:

• medications are the best short-term solution to protect you from the risks of blood pressure but they don’t cure the underlying cause of your high blood pressure
• lifestyle changes won’t protect you from the immediate risks of high blood pressure, which is why medication is important, but it can help you control your blood pressure long-term

Some recommendations for healthy lifestyle changes include:

• regular exercise. Stick to aerobic exercise like walking, jogging, swimming, or cycling, and avoid weight-lifting
• eating a low-calorie diet (avoiding too much salt, fatty foods and red meat) if you’re overweight
• drinking lots of water
• cutting back on caffeine and alcohol, and try to quit smoking
• getting at least 6 hours of sleep per night
• avoiding stress as much as possible (many people find that practising yoga or meditation helps keep their stress levels down)

As with any medicine, it is possible that you will experience side effects as a result of taking bisoprolol. However, these side effects are usually mild, and not everyone gets them. Many people find that their side effects disappear after the first 1-2 weeks of treatment, once their body gets used to the medicine.

Rare side effects (affecting up to 1 in 1,000 people) are:

• jaundice (yellowing of the eyes and skin), and hepatitis (inflammation of the liver)
• a blocked nose
• reduced flow of tears (this can affect people who wear contact lenses)
• hearing problems
• reduced sexual performance
• skin rash, itching or redness
• nightmares or hallucinations
• fainting

Bisoprolol can sometimes cause dizziness or fatigue. If you experience these side effects, do not drive vehicles or operate heavy machinery, as this could be extremely dangerous to you and those around you.

If you ever experience any severe or unpleasant side effects when taking bisoprolol, seek urgent medical attention.

If you get any side effects which are not listed here, or in the patient information leaflet that comes with your tablets, talk to your nurse or GP. You can also report side effects directly via the Yellow Card Scheme at: https://yellowcard.mhra.gov.uk/ to help provide more information on the safety and efficacy of this medicine.

Electronic Medicines Compendium (2017). Bisoprolol fumarate 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg, 10 mg film-coated tablets. medicines.org. [online] Available at: https://www.medicines.org.uk/emc/files/pil.6126.pdf [accessed 18th December 2017).

Mylan (2017). Bisoprolol fumarate 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg or 10 mg film-coated tablets. Hertfordshire: EMC.