5 Outdated High Blood Pressure Medications You Should Consider Upgrading
Some blood pressure medications may no longer be the best choice for helping your blood pressure. Here are five outdated medications, plus alternative options.
bisoprolol
Used for Hypertension
Used for Hypertension
Bisoprolol, or bisoprolol fumarate, is a tablet that's used to treat high blood pressure. It belongs to a group of medications called beta blockers. It's usually only given when first-choice blood pressure medications aren't working well enough. Some common side effects of bisoprolol include headache, feeling tired, and diarrhea. It has some interactions with alcohol and taking bisoprolol with alcohol can worsen dizziness and raise the risk for fainting.
What is Bisoprolol?
What is Bisoprolol used for?
- High blood pressure
How Bisoprolol works
Bisoprolol is a selective beta blocker. It works to lower blood pressure by slowing down the heart rate to give your heart some time to relax between contractions.
Drug facts
| Common Brands | Zebeta |
|---|---|
| Drug Class | Beta blocker |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Bisoprolol essentials
Side effects of Bisoprolol
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (9%)
- Fatigue (7%)
- Upper respiratory tract infection (5%)
- Swelling in arms or legs (4%)
- Dizziness (3%)
- Runny nose (3%)
Less Common Side Effects
- Diarrhea
- Cough
- Joint pain
Bisoprolol serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart failure: trouble breathing, fast weight gain, feeling very tired, chest pain, swelling in the legs, ankles, or feet
- Bronchospasm: tightness in the chest, trouble catching your breath, difficulty breathing, wheezing, cough, dizziness, extreme tiredness
The following Bisoprolol side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Body aches or pain
chills
difficult or labored breathing
ear congestion
headache
loss of voice
pain or tenderness around eyes and cheekbones
shortness of breath or troubled breathing
stuffy or runny nose
tightness in chest
unusual tiredness or weakness
Rare
Chest discomfort
lightheadedness, dizziness, or fainting
slow or irregular heartbeat
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
blurred vision
cold sweats
coma
confusion
cool, pale skin
decreased urine output
dilated neck veins
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
extreme fatigue
fast heartbeat
increased hunger
irregular breathing
nervousness
nightmares
noisy breathing
seizures
shakiness
slurred speech
sweating
swelling of face, fingers, feet, or lower legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abnormal or decreased touch sensation
difficulty in moving
lack or loss of strength
muscle pain or stiffness
pain in joints
trouble sleeping
unable to sleep
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$9.000
GoodRx discount
$9.00
Pros and cons of Bisoprolol
Pros
- Works well to lower blood pressure
- Available as a lower-cost generic
- Only need to take it once a day
- Can take it with or without food
Cons
- Not a first-choice medication to lower blood pressure
- Skipping or missing doses can lead to high blood pressure and higher risk of heart attacks
- Can make you feel more tired
- Can hide symptoms of low blood sugar if you have diabetes
Pharmacist tips for Bisoprolol
- Bisoprolol works the best when you take it consistently every day. Don't stop taking bisoprolol suddenly without talking to your healthcare provider as this could make chest pain or other heart conditions (such as coronary artery disease) worse. If you want to stop the medication, speak with your healthcare provider. They can work with you to lower your dose safely over time (which typically occurs over 1-2 weeks).
- Bisoprolol can make you feel dizzy for a few days after first starting it or changing the dose. Be sure to change positions slowly (going from sitting to standing or from lying down to sitting up). Also, make sure you know how this medication affects you before driving or performing activities that require you to be alert, such as driving.
- It might be helpful to check and record your blood pressure at home. You can bring your notes to your next appointment so your provider can see how well bisoprolol is working to lower your blood pressure.
- Bisoprolol can interact with other medications. Be sure to tell your provider all of the medications you're taking, and check with them before starting any new medications.
- Both beta-blockers and medications used for anesthesia can lower your heart rate. So, if you’re planning to undergo a major surgery that requires anesthesia, tell your surgeon that you’re on bisoprolol so that they can monitor your heart closely.
More on Bisoprolol tips
Risks and warnings for Bisoprolol
Bisoprolol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack or irregular heart rhythm
- Risk factors: Stopping bisoprolol suddenly
Don't stop taking bisoprolol suddenly without talking to your provider first, especially if you have heart disease. Doing so can cause chest pain, irregular heart rhythm, high blood pressure, and even a heart attack. If you need to stop taking bisoprolol, work with your provider to lower your dose gradually over time, typically over 1 week.
Heart failure
- Risk factors: Heart failure
People with heart failure shouldn't take bisoprolol if their heart failure symptoms aren’t well-managed. That’s because this medication can make your condition worse. But you might be able to take bisoprolol if your healthcare provider thinks your symptoms are under controlled. Keep in mind that, though rare, sometimes taking a beta-blocker, like bisoprolol over time might lead to heart failure even in people without this condition. Let your healthcare provider know right away if you experience symptoms of heart failure, such as fluid build-up in different areas of the body including the ankles, legs, and lungs, and difficulty breathing.
Trouble breathing (people with bronchospastic conditions)
- Risk factors: History of asthma or COPD
Beta-blocker medications like bisoprolol are generally not recommended for people with bronchospastic conditions, like asthma or chronic obstructive pulmonary disease (COPD), because it can trigger difficulty breathing. Bisoprolol has a lower chance of causing difficulty breathing because it works specifically on the heart, but should only be used under careful supervision of a healthcare provider if you have any conditions that can cause breathing problems.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes
Taking bisoprolol can make it difficult for you to identify symptoms of low blood sugar, such as fast heart beat or tremors. If you’re taking medications, like glipizide or insulin, to lower your blood sugar, you might not be able to rely on all the typical symptoms of low blood sugar (e.g., irritability, sight tremors, confusion, and fast heartbeat) to warn you of a dangerous drop in your sugar levels. Sweating might be the only symptom not affected by taking bisoprolol. Speak with your healthcare provider about when and how to monitor your blood sugar if you start bisoprolol.
Hiding symptoms of high thyroid hormone
- Risk factors: Hyperthyroidism
Bisoprolol can hide signs of hyperthyroidism, especially a fast heart rate. It's important to talk to your provider before stopping bisoprolol suddenly, since doing so can worsen thyroid problems.
Severe allergic reactions
- Risk factors: History of severe allergic reaction
Beta blockers like bisoprolol can lessen your response to life-saving treatments for severe allergic reactions (anaphylaxis). They can also cause your allergic reaction to be more severe than usual. Discuss all of your allergies with your provider and a plan on what to do if you experience an allergic reaction while taking bisoprolol.
Worsening of poor circulation
- Risk factors: History of peripheral artery disease
Bisoprolol can cause the symptoms of peripheral artery disease (PAD) to worsen. This can lead to worsening of blood circulation, which can result in tiredness, aching, and cramping in the legs. Be sure to tell your provider if you have PAD before starting bisoprolol because they might want to monitor you more closely.
Bisoprolol dosage
The average cost for 30 tablets of 5mg of Bisoprolol is $9.00 with a free GoodRx coupon. This is 0.00% off the average retail price of $9.00. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 90 tablets | $33.67 | $0.37 |
| 5mg | 30 tablets | $9.00 | $0.30 |
| 2.5mg of | 30 tablets | $29.24 | $0.97 |
Typical dosage for Bisoprolol
The typical starting dose is 5 mg by mouth once daily. Your provider might raise your dose if your blood pressure is not well-controlled. The maximum daily dose is 20 mg.
Your dose might differ if you have liver or kidney problems.
More on Bisoprolol dosage
Interactions between Bisoprolol and other drugs
Bisoprolol may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Bisoprolol. Please note that only the generic name of each medication is listed below.
More on Bisoprolol interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Albuterol
- Ceritinib
- Clonidine
- Crizotinib
- Diltiazem
- Dronedarone
- Fenoldopam
- Fingolimod
- Formoterol
- Indacaterol
- Iohexol
- Lacosamide
- Levalbuterol
- Olodaterol
- Ponesimod
- Rivastigmine
- Salmeterol
- Siponimod
- Terbutaline
- Verapamil
- Vilanterol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albiglutide
- Alfuzosin
- Alogliptin
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Canagliflozin
- Celecoxib
- Chlorpropamide
- Choline Salicylate
- Clonixin
- Dapagliflozin
- Deslanoside
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitoxin
- Digoxin
- Dipyrone
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Glimepiride
- Glipizide
- Glyburide
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Ketoprofen
- Ketorolac
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Methyldopa
- Metildigoxin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Piketoprofen
- Pioglitazone
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propyphenazone
- Proquazone
- Repaglinide
- Rifapentine
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Urapidil
- Valdecoxib
- Vildagliptin
How much does Bisoprolol cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Bisoprolol (generic)
$9.00
Bisoprolol contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Bisoprolol will not be safe for you to take.
- Extremely slow heart rate
- Heart problems (e.g., certain types of heart block, heart failure, cardiac shock)
What are alternatives to Bisoprolol?
There are a number of medications that your doctor can prescribe in place of Bisoprolol. Compare a few possible alternatives below.
News about Bisoprolol
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9 Bisoprolol Side Effects You Should Know About
Bisoprolol is a beta blocker primarily used to treat high blood pressure and heart conditions. It can cause fatigue, dizziness, and other side effects.
Bisoprolol images
