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Bisoprolol

    Brands

    DEA Class;  Rx

    Common Brand Names; Monocor, Zebeta

    • Beta-Blockers, Beta-1 Selective

    Oral beta-blocker used for HTN and CHF (not FDA-approved); beta1-receptor selective; hydrophilic; excreted by renal and non-renal routes; lacks partial agonist or membrane stabilizing activity.

    Indicated for the treatment of hypertension.

    For the treatment of heart failure
    For the treatment of angina.
    For heart rate control in patients who have atrial fibrillation or atrial flutter.
    For the treatment of diabetic cardiovascular autonomic neuropathy.

    Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without permanent pacemaker

    • Dizziness (10%)
    • Insomnia (8%-10%)
    • Bradyarrhythmia (9%)
    • Upper respiratory infection (5%)
    • Diarrhea (4%)
    • Rhinitis (4%)
    • Arthralgia (3%)
    • Cough (3%)
    • Dyspnea (2%)
    • Nausea (2%)
    • Pharyngitis (2%)
    • Sinusitis (2%)
    • Vomiting (2%)
    • Cold extremities
    • Hypotension
    • Depression
    • Dyspepsia
    • Bronchospasm
    • Aggravate CHF
    • Decrease HDL
    • Hypertriglyceridemia
    • Mask symptoms of hypoglycemia
    • Decreased exercise tolerance
    • Raynaud’s phenomenon
    • May increase triglyceride levels and insulin resistance

    Use caution in anesthesia/surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, CHF, cardiomegaly, DM, hyperthyroidism/thyrotoxicosis, myasthenia gravis, liver disease, renal impairment, peripheral vascular disease, use in pheochromocytoma, IDDM, history of psychiatric disease, pre-existing sick sinus syndrome or similar cardiac conditions

    Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

    Exacerbation of psoriasis reported with use

    Less effective than thiazide diuretics in black and geriatric patients

    Shown to decrease mortality in hypertension and post-myocardial infarction

    Pregnancy Category: C

    Lactation: excretion in milk unknown; use caution

    Adults

    20 mg/day PO for hypertension or angina; 10 mg/day PO for heart failure.

    Elderly

    20 mg/day PO for hypertension or angina; 10 mg/day PO for heart failure.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Bisoprolol fumarate

    tablet

    • 5mg
    • 10mg
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