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Compare Propranolol vs. Bisoprolol

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Propranolol (Inderal LA, Inderal XL, Innopran XL) and bisoprolol (Zebeta) are both beta blockers used to treat high blood pressure, but they have some key differences. Propranolol is a non-selective beta blocker, meaning it affects both the heart and other parts of the body, while bisoprolol is a selective beta blocker that mainly targets the heart. Propranolol is used for a wider range of conditions, including chronic chest pain and migraines, and tremors, whereas bisoprolol is primarily used for high blood pressure. You might need to take propranolol multiple times a day depending on the form, but bisoprolol is usually taken once daily. Propranolol can cause side effects like dizziness and tiredness, and it’s not safe for people with asthma. Bisoprolol can also cause tiredness and dizziness, but it’s less likely to cause breathing problems. Both medications can hide symptoms of low blood sugar, so you need to be cautious if you have diabetes.

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  • Propranolol
    Bisoprolol
  • Propranolol
    Bisoprolol

  • Summary of Propranolol vs. Bisoprolol

    Summary for Beta blocker
    Prescription only

    Propranolol is a non-selective beta blocker. It helps with a range of medical conditions, including high blood pressure, tremors, and migraine prevention. Sometimes, providers prescribe propranolol off-label to ease performance anxiety. You take this medication by mouth, typically 1 to 4 times daily, depending on if you're taking the immediate-release (IR) or extended-release (ER) medication. Keep in mind the IR and ER versions don't treat the same medical conditions. Some of the more common side effects of propranolol include dizziness, tiredness, or weakness.

    Summary for Beta blocker
    Prescription only

    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.

  • Indications of Propranolol vs. Bisoprolol

    Indications for
    •High blood pressure
    •Chronic chest pain
    •Migraine
    •Hypertrophic subaortic stenosis
    •Atrial fibrillation (A.Fib)
    •Heart protection after a heart attack
    •Tremors
    •Pheochromocytoma (a rare tumor of the adrenal gland)
    Indications for
    •High blood pressure

  • Pros and Cons of Propranolol vs. Bisoprolol

    Pros and Const for Beta blocker
    Pros
    •Taken by mouth
    •Long-acting version only needs to be taken once a day
    •Oral solution might be a good option for people who can't swallow pills
    •Available as lower-cost generics
    Cons
    •Not safe for people with asthma or certain serious heart conditions
    •Can hide many recognizable symptoms of low blood sugar, such as fast heart beat or tremors, which might prevent timely treatment
    •Missing doses or suddenly stopping propranolol can raise your risk of heart attacks
    Pros and Const for Beta blocker
    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

  • Common Side Effects of Propranolol vs. Bisoprolol

    Common Side Effects for
    •Dizziness
    •Tiredness
    •Feeling weak
    Common Side Effects for
    •Headache (9%)
    •Fatigue (7%)
    •Upper respiratory tract infection (5%)
    •Swelling in arms or legs (4%)
    •Dizziness (3%)
    •Runny nose (3%)

  • Warnings of Propranolol vs. Bisoprolol

    Common Side Effects for
    •Worsening of chest pain or heart attack
    •Higher risk or worsening of heart failure
    •Hidden symptoms of low blood sugar
    •Hidden symptoms of overactive thyroid
    •Trouble breathing (bronchospastic disease)
    •Serious skin reactions
    •Greater risk during surgery
    Common Side Effects for
    •Heart attack or irregular heart rhythm
    •Heart failure
    •Trouble breathing (people with bronchospastic conditions)
    •Hiding symptoms of low blood sugar
    •Hiding symptoms of high thyroid hormone
    •Severe allergic reactions
    •Worsening of poor circulation

  • Prices with our coupons for Propranolol vs. Bisoprolol

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