Classes
DEA Class; Rx
Common Brand Names; Monocor, Zebeta
- Beta-Blockers, Beta-1 Selective
Description
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.
Indications
Indicated for the treatment of hypertension.
Contraindications
Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without permanent pacemaker
Adverse Effects
- 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
Warnings
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Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical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 and Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use caution
Maximum Dosage
20 mg/day PO for hypertension or angina; 10 mg/day PO for heart failure.
20 mg/day PO for hypertension or angina; 10 mg/day PO for heart failure.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Bisoprolol fumarate
tablet
- 5mg
- 10mg