Concise Prescribing Info
Bisoprolol fumarate
2.5, 5 & 10 mg tab: Treatment of stable chronic heart failure w/ reduced systolic left ventricular function in addition to ACE inhibitors & diuretics & optionally cardiac glycosides. 5 & 10 mg tab: HTN & CHD (angina pectoris).
Dosage/Direction for Use
HTN & angina pectoris Initially 5 mg once daily, may be increased to 10 mg once daily. Max recommended dose is 20 mg once daily. Stable chronic heart failure Standard treatment of CHF consists of an ACE inhibitor, a β-blocker, diuretics & when appropriate cardiac glycosides. Patient should be stable (w/o acute failure) when bisoprolol is initiated. Recommended starting dose: 1.25 mg once daily. Depending on individual tolerance, the dose is increased to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg & 10 mg once daily, in intervals of 2 wk or longer. Max of 10 mg once daily.
May be taken with or without food: Take in the morning. Swallow w/ some liqd, do not chew.
Hypersensitivity to bisoprolol; acute heart failure or during episodes of heart failure decompensation requiring IV inotropic therapy; cardiogenic shock; 2nd or 3rd degree AV block; sick sinus syndrome; SA block; symptomatic bradycardia & hypotension; severe bronchial asthma, Raynaud's syndrome; pheochromocytoma; metabolic acidosis.
Special Precautions
DM w/ extremely fluctuating blood glucose levels (hypoglycemia), strict fasting, ongoing desensitization therapy, 1st-degree AV block, Prinzmetal's angina, peripheral arterial occlusive disease; increase sensitivity to allergens & severity of anaphylactic reactions; psoriasis; may mask symptoms of thyrotoxicosis; patients w/ pheochromocytoma. W/draw bisoprolol 48 hr prior anesth. Patient w/ obstructive airways disease. IDDM, severely impaired renal or hepatic function, restrictive cardiomyopathy, congenital heart disease, hemodynamically significant organic valvular disease, MI w/in the last 3 mth. Ability to drive a vehicle or to use machines may be impaired. Pregnancy & lactation.
Adverse Reactions
Bradycardia, worsening of preexisting heart failure (in patients w/ chronic heart failure); dizziness, headache; GI complaints eg, nausea, vomiting, diarrhea, constipation; feeling of coldness or numbness in the extremities, hypotension especially in patients w/ heart failure; asthenia (in patients w/ chronic heart failure), fatigue.
Drug Interactions
Potentiated effect on AV conduction time & increased -ve inotropic effect w/ class IA antiarrhythmic drugs (eg, quinidine, disopyramide, lidocaine, phenytoin, flecainide, propafenone). Profound hypotension & AV block w/ IV administration of verapamil. Decrease the central sympathetic tonus & thus lead to the reduction of heart rate & cardiac output & vasodilatation w/ concomitant use of centrally-acting antihypertensive drugs (eg, clonidine, methyldopa, moxonidine, rilmenidine). Increased risk of hypotension w/ concomitant use of Ca antagonists of dihydropyridine type (eg, felodipine & amlodipine) & other drugs w/ BP-lowering potential (eg, TCAs, barbiturates, phenothiazines). Potentiated effect on AV conduction time w/ class III antiarrhythmic drugs (eg, amiodarone). Added systemic effects w/ topical β-blockers (eg, eye drops for glaucoma treatment). Increased effect on AV conduction time & risk of bradycardia w/ parasympathomimetic drugs, cardiac glycosides (digitalis). Increased blood-sugar lowering effect of insulin or oral antidiabetic drugs. Attenuation of the reflex tachycardia & increased risk of hypotension w/ anesth agents. Reduced hypotensive effect w/ NSAIDs. Reduced effect of β-sympathomimetics (eg, isoprenaline, dobutamine). Increased BP & exacerbated intermittent claudication w/ non-selective β-blockers (eg, norepinephrine, epinephrine). Increased risk of bradycardia w/ mefloquine. Risk for hypertensive crisis w/ MAOIs (except MAO-B inhibitors). Slight reduction of t½ w/ rifampicin. Exacerbation of peripheral circulatory disturbances w/ ergotamine derivatives.
MIMS Class
ATC Classification
C07AB07 - bisoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Concore tab 10 mg
Concore tab 2.5 mg
Concore tab 5 mg
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