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Bisoprolol: Drug information

Bisoprolol: Drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Bisoprolol: Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: Canada
  • AG-Bisoprolol;
  • APO-Bisoprolol;
  • JAMP-Bisoprolol;
  • MINT-Bisoprolol;
  • PMS-Bisoprolol [DSC];
  • PRO-Bisoprolol-10;
  • PRO-Bisoprolol-5;
  • RIVA-Bisoprolol [DSC];
  • SANDOZ Bisoprolol;
  • TEVA-Bisoprolol
Pharmacologic Category
  • Antihypertensive;
  • Beta-Blocker, Beta-1 Selective
Dosing: Adult
Angina, chronic stable

Angina, chronic stable (off-label use):

Note: For vasospastic angina, beta-blockers are not recommended; calcium channel blockers and nitrates are preferred. For nonvasospastic angina, titrate beta-blocker to relieve angina or equivalent symptoms (Ref).

Oral: Initial: 2.5 mg once daily; may double the dose after ≥1 week to achieve the desired effect up to a maximum dose of 20 mg once daily (Ref).

Atrial fibrillation/flutter, maintenance of ventricular rate control

Atrial fibrillation/flutter, maintenance of ventricular rate control (off-label use):

Note: Initiate cautiously in patients with concomitant heart failure with reduced ejection fraction. Avoid initiating or up-titrating therapy in patients with decompensated heart failure; for unstable patients, electrical cardioversion is preferred (Ref).

Normal left ventricular systolic function: Oral: Initial: 2.5 to 5 mg once daily; increase dose gradually as tolerated to achieve ventricular rate control up to 20 mg once daily (Ref).

Heart failure with reduced ejection fraction: Refer to dosing for "Heart Failure With Reduced Ejection Fraction."

Heart failure with reduced ejection fraction

Heart failure with reduced ejection fraction (off-label use):

Note: Initiate only in stable, euvolemic patients. In hospitalized patients, volume status should be optimized and IV diuretics, IV vasodilators, and IV inotropic agents successfully discontinued prior to initiation of therapy. Use caution when initiating in patients with NYHA class IV symptoms or recent heart failure exacerbation (particularly if inotropes were required during hospital course) (Ref).

Oral: Initial: 1.25 mg once daily; up-titrate gradually (eg, doubling the dose every ≥1 to 2 weeks) to a target dose of 10 mg once daily while monitoring for signs and symptoms of heart failure (Ref). Note: A dose of 1.25 mg requires splitting a round 5 mg tablet into quarters in the United States, which may result in inaccurate dosing. Smaller tablet strengths are available in other countries.

Hypertension, chronic

Hypertension, chronic (alternative agent):

Note: Not recommended in the absence of specific comorbidities (eg, ischemic heart disease, heart failure with reduced ejection fraction, arrhythmia) (Ref).

Oral: Initial: 2.5 to 5 mg once daily; titrate at weekly (or longer) intervals as needed based on patient response; usual dosage range: 2.5 to 10 mg once daily; maximum dose: 20 mg/day (Ref).

Ventricular arrhythmias, suppression

Ventricular arrhythmias, suppression (alternative agent) (off-label use):

Oral: Initial: 2.5 mg once daily; titrate dose as needed based on response and tolerability up to a maximum dose of 10 mg once daily (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Bisoprolol has renal and hepatic clearance; total clearance in patients with severe kidney dysfunction (eg, CrCl <20 mL/minute/1.73 m2) is decreased ~50% compared to those with normal kidney function (Ref).

Altered kidney function:

CrCl ≥20 mL/minute/1.73 m2: No dosage adjustment necessary (Ref).

CrCl <20 mL/minute/1.73 m2: Start with low initial doses (eg, 1.25 to 2.5 mg daily, depending on indication); consider a reduced maximum dose of 10 mg daily (Ref).

Hemodialysis, intermittent (thrice weekly): Moderately dialyzable (25% to 35%) (Ref): Initial: 1.25 to 2.5 mg daily, depending on indication; consider a reduced maximum dose of 10 mg daily (Ref). When scheduled dose falls on a hemodialysis day, administer dose after hemodialysis (Ref).

Peritoneal dialysis: Slightly dialyzable (Ref): Initial 1.25 to 2.5 mg daily, depending on indication; consider a reduced maximum dose of 10 mg daily (Ref).

CRRT: Initial 1.25 to 2.5 mg daily, depending on indication; consider a reduced maximum dose of 10 mg daily (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Initial 1.25 to 2.5 mg daily, depending on indication; consider a reduced maximum dose of 10 mg daily (Ref).

Dosing: Liver Impairment: Adult

Hepatitis or cirrhosis: Initial: 2.5 mg once daily; increase cautiously.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions (Significant): Considerations
Bradyarrhythmias

Beta-blockers may cause first degree atrioventricular (AV) block, second degree atrioventricular block, or complete atrioventricular block (Ref). At maintenance dosing, second- or third-degree AV block are less likely (Ref). Beta-blocking agents with intrinsic sympathomimetic activity (eg, pindolol) may cause fewer AV conduction abnormalities than those without intrinsic sympathomimetic activity (eg, bisoprolol) due to their partial agonist effects (Ref). In most cases (up to 72%), AV block associated with a beta-blocker will resolve upon discontinuation; however, there are reported cases of recurrent AV block and nearly 50% of patients with more severe AV block may require a permanent pacemaker (Ref).

Mechanism: Dose-related; related to the pharmacologic action. Blockade of cardiac beta-1 adrenergic receptors results in slowed conduction and prolongation in the refractory period of the AV node. Slowing of AV conduction can lead to AV block (Ref).

Onset: Varied; one study included patients who were on beta-blocker for more than one month (Ref); however, other studies noted prolongation of the PR interval or AV nodal refractory period occurring anywhere from one dose to several days following treatment initiation (Ref).

Risk factors:

• Impaired AV node or sinus node dysfunction (Ref)

• Concurrent use of other agents that impair AV nodal conduction (eg, nondihydropyridine calcium channel blockers, digoxin, ivabradine, select antiarrhythmic agents) (Ref)

• Older patients (Ref)

Bronchospasm

Selective beta-blockers (eg, bisoprolol) have a lower risk of bronchospasm compared to noncardioselective beta-blockers (Ref). Specifically, patients with moderate to severe asthma or COPD have a higher risk of symptoms or exacerbation leading to hospitalization even with selective beta-blocker use (Ref). Concurrent use of inhaled bronchodilators and/or corticosteroids are protective against beta-blocker-induced bronchospasm in patients with COPD or asthma (Ref). Bronchospasm is reversible upon discontinuation or use of bronchodilators (Ref).

Mechanism: Dose-related; related to pharmacologic action. Beta-blocking agents can lead to airway smooth muscle constriction by antagonism of beta-2 receptors (Ref).

Onset: Rapid; reports suggest that single doses or acute use are more likely to cause changes in FEV1 compared to chronic use (Ref)

Risk factors:

• Acute use (Ref)

CNS effects

Beta-blockers may cause reversible CNS effects such as fatigue, insomnia, vivid dreams, memory impairment, and sexual disorder (Ref). Sexual disorders may occur; however, patients who require beta-blocker therapy have risk factors for erectile dysfunction (eg, coronary artery disease, heart failure) (Ref). In addition, there may be a psychosomatic component (Ref). Lipophilic beta-blockers (such as bisoprolol, which is moderately lipophilic) penetrate the blood-brain barrier to a greater extent than hydrophilic beta-blockers, possibly leading to a greater incidence of CNS effects; however, other studies have refuted this theory (Ref). CNS effects generally resolve with dose reduction or discontinuation (Ref).

Mechanism: Dose-related; exact mechanism is not fully understood. Proposed mechanisms include presence of beta receptors in the brain, affinity and in some instances, inhibition of beta-blocking agents towards serotonin (5-HT) receptors in the brain (affecting mood and sleep), and beta-blocker-induced decreases in central sympathetic output (Ref). Beta-1 blockade may also impact sleep by blocking sympathetic signaling to the pineal gland, resulting in suppression of nighttime levels of melatonin (Ref). Beta-blockers may cause erectile dysfunction through decreased sympathetic nervous system output and subsequent decreases in luteinizing hormone secretion and testosterone stimulation (Ref).

Onset: Intermediate; CNS effects often occur within the first few weeks of treatment (Ref).

Risk factors:

• Higher starting doses (Ref)

• Older patients (Ref)

Potentiation/masking of hypoglycemia

Beta-blockers may worsen, prolong, or cause hypoglycemia (Ref). Additionally, beta-blockers may mask symptoms of hypoglycemia (tremor, irritability, palpitations), making diaphoresis the only symptom unaffected by beta-blockers (Ref). It is unclear if nonselective or selective beta-blockers are more likely to cause hypoglycemia as data are conflicting. One study suggests bisoprolol has no effect on blood glucose (Ref).

Mechanism: Dose-related; related to the pharmacologic action. Beta-blockers inhibit hepatic gluconeogenesis and glycogenolysis (Ref). Beta-blockers also reduce activation of the sympathetic nervous system; therefore, masking hypoglycemic symptoms that are catecholamine-mediated (Ref).

Onset: Varied. Data are limited for bisoprolol; suggested that bisoprolol does not affect blood glucose (Ref). Onset is extrapolated from other beta-blocking agents. Blood glucose recovery was significantly reduced following one dose or one day of therapy (Ref). In another study, episodes of severe hypoglycemia were reported over the course of 4 years (Ref).

Risk factors:

• Insulin-dependent diabetes (Ref)

• Type 2 diabetes mellitus (Ref)

• Hospitalized patients not requiring basal insulin (Ref)

Withdrawal

Beta-blocker therapy should not be withdrawn abruptly, but gradually tapered to avoid acute tachycardia, hypertension, and/or ischemia in patients with underlying cardiovascular disease (Ref). Some studies have found an increase in propensity-adjusted mortality and cardiovascular events; however, one study did not find changes in infarct size and left ventricular function when beta-blocker was abruptly withdrawn in patients with myocardial infarction (Ref).

Mechanism: Dose-dependent; related to the pharmacologic action. Beta blockade causes upregulation of beta-receptors, enhanced receptor sensitivity, and decreased sympathetic nervous system response (Ref). Abrupt withdrawal leads to a transient sympathetic hyper-response (Ref). Another proposed mechanism involves increased platelet aggregability to epinephrine and thrombin (Ref).

Onset: Rapid/varied and transient; increases in heart rate and blood pressure appear 24 hours after abrupt withdrawal, peak after 48 hours, and subside after 7 days (Ref). Anginal symptoms reported to begin 12 to 24 hours after discontinuation (Ref). Development of adverse reactions also reported to occur 1 to 21 days after withdrawal (Ref).

Risk factors:

• Abrupt withdrawal in chronic users (Ref)

• Past medical history of coronary artery disease (including chronic stable angina) (Ref)

• Past medical history of hypertension (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Cardiovascular: Chest pain (1%)

Gastrointestinal: Diarrhea (3%), vomiting (1%)

Nervous system: Fatigue (7%) (table 1), hypoesthesia (1%)

Bisoprolol: Adverse Reaction: Fatigue

Drug (Bisoprolol)

Placebo

Dose

Number of Patients (Bisoprolol)

Number of Patients (Placebo)

7%

2%

5 mg to 20 mg

273

132

Respiratory: Dyspnea (1%), upper respiratory tract infection (5%)

<1%:

Cardiovascular: Bradycardia

Neuromuscular & skeletal: Asthenia

Frequency not defined:

Cardiovascular: Cardiac arrhythmia, claudication, cold extremity, edema, flushing, heart failure, hypotension, orthostatic hypotension, palpitations

Dermatologic: Alopecia, diaphoresis, eczema, pruritus, purpuric rash, skin irritation, skin rash

Endocrine & metabolic: Decreased libido, increased serum glucose, increased serum phosphate, increased serum potassium, increased serum triglycerides, increased uric acid, weight gain

Gastrointestinal: Abdominal pain, constipation, dysgeusia, dyspepsia, epigastric pain, gastritis, nausea, peptic ulcer, stomach pain, xerostomia

Genitourinary: Cystitis, sexual disorder

Hematologic & oncologic: Decreased white blood cell count, positive ANA titer, thrombocytopenia

Hepatic: Increased serum alanine aminotransferase, increased serum aspartate aminotransferase

Hypersensitivity: Hypersensitivity angiitis

Nervous system: Anxiety, depression, dizziness, drowsiness, headache, hyperesthesia, lack of concentration, malaise, memory impairment, paresthesia, restlessness, tremor, twitching, vertigo, vivid dream

Neuromuscular & skeletal: Back pain, gout, muscle cramps, myalgia, neck pain

Ophthalmic: Abnormal lacrimation, eye pain, sensation of eye pressure, visual disturbance

Otic: Otalgia, tinnitus

Renal: Increased blood urea nitrogen, increased serum creatinine, polyuria, renal colic

Respiratory: Asthma, bronchitis, bronchospasm, cough, dyspnea on exertion, pharyngitis, rhinitis, sinusitis

Postmarketing:

Cardiovascular: Complete atrioventricular block (Zeltser 2004), first-degree atrioventricular block (Zeltser 2004), second-degree atrioventricular block (Zeltser 2004), syncope

Dermatologic: Dermatitis, exacerbation of psoriasis (Waqar 2009), exfoliative dermatitis

Genitourinary: Peyronie disease

Hypersensitivity: Angioedema

Nervous system: Insomnia (Chang 2013), sleep disturbance, unsteadiness

Neuromuscular & skeletal: Arthralgia

Otic: Auditory impairment

Contraindications

Cardiogenic shock; overt cardiac failure; marked sinus bradycardia or heart block greater than first-degree (except in patients with a functioning artificial pacemaker).

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to bisoprolol or any component of the formulation; overt cardiac failure requiring IV inotropic therapy; sick sinus syndrome or sinoatrial block; hypotension (systolic BP <100 mm Hg); severe bronchial asthma or chronic obstructive pulmonary disease; peripheral arterial occlusive disease (late stages); Raynaud syndrome; pheochromocytoma (untreated); metabolic acidosis; hereditary galactose intolerance, glucose-galactose malabsorption, or the Lapp lactase deficiency.

Warnings/Precautions

Disease-related concerns:

• Anaphylaxis reactions: Beta-blockers are unlikely to cause anaphylaxis; however, in susceptible patients, beta-blockers have been associated with an increase in the severity of anaphylaxis. Anaphylaxis in the presence of a beta-blocker may be severe, protracted, and resistant to conventional treatment (Lang 2008; Toogood 1987). This is due to beta-2-adrenergic blockade and the resulting diminution of endogenous catecholamine effect.

• Heart failure with reduced ejection fraction: Stabilize patients on heart failure regimen prior to initiation or titration of beta-blocker. Beta-blocker therapy should be initiated at very low doses with gradual and careful titration. Worsening heart failure or fluid retention may occur during upward titration; dose reduction and/or slower titration may be necessary. Adjustment of other medications (ACE inhibitors and/or diuretics) may be required.

• Hepatic impairment: Use with caution in patients with hepatic impairment; dosage adjustment may be required.

• Kidney impairment: Use with caution in patients with kidney impairment; dosage adjustment may be required.

• Myasthenia gravis: Use with caution in patients with myasthenia gravis.

• Peripheral vascular disease (PVD) and Raynaud disease: Can precipitate or aggravate symptoms of arterial insufficiency in patients with PVD and Raynaud disease. Use with caution and monitor for progression of arterial obstruction.

• Pheochromocytoma (untreated): Adequate alpha-blockade is required prior to use of any beta-blocker.

• Psoriasis: Beta-blocker use has been associated with induction or exacerbation of psoriasis, but cause and effect have not been firmly established.

• Thyroid disease: May mask signs of hyperthyroidism (eg, tachycardia). If hyperthyroidism is suspected, carefully manage and monitor; abrupt withdrawal may precipitate thyroid storm.

• Vasospastic angina: Beta-blockers without alpha1-adrenergic receptor blocking activity should be avoided in patients with vasospastic angina since unopposed alpha1-adrenergic receptors mediate coronary vasoconstriction and can worsen anginal symptoms (Mayer 1998).

Special populations:

• Older adult: Dosage reductions may be necessary.

Other warnings/precautions:

• Abrupt withdrawal: Beta-blocker therapy should not be withdrawn abruptly (particularly in patients with CAD), but gradually tapered to avoid acute tachycardia, hypertension, and/or ischemia.

• Major surgery: Chronic beta-blocker therapy should not be routinely withdrawn prior to major surgery.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as fumarate:

Generic: 2.5 mg, 5 mg, 10 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Bisoprolol Fumarate Oral)

2.5 mg (per each): $3.43

5 mg (per each): $0.40 - $2.25

10 mg (per each): $0.40 - $2.25

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as fumarate:

Generic: 1.25 mg, 2.5 mg, 5 mg, 10 mg

Administration: Adult

Oral: May be administered without regard to meals. The smallest tablet size available in the United States is 5 mg; a dose of 1.25 mg for heart failure with reduced ejection fraction would require splitting a round tablet into quarters. The smallest tablet size available in Canada is 1.25 mg.

Use: Labeled Indications

Hypertension, chronic: Management of hypertension.

Use: Off-Label: Adult

Angina, chronic stable; Atrial fibrillation/flutter, maintenance of ventricular rate control; Heart failure with reduced ejection fraction; Ventricular arrhythmias, suppression

Medication Safety Issues
International issues:

Zebeta [Puerto Rico] may be confused with DiaBeta brand name for gliclazide [South Korea] and glyburide [Canada and multiple international markets] and Zetia brand name for ezetimibe [US and multiple international markets]

Metabolism/Transport Effects

Substrate of CYP2D6 (Minor), CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Alfuzosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Alpha2-Agonists: Beta-Blockers may increase rebound hypertensive effects of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Alpha2-Agonists may increase AV-blocking effects of Beta-Blockers. Sinus node dysfunction may also be enhanced. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Risk D: Consider Therapy Modification

Amifostine: Blood Pressure Lowering Agents may increase hypotensive effects of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider Therapy Modification

Amiodarone: May increase bradycardic effects of Beta-Blockers. Possibly to the point of cardiac arrest. Amiodarone may increase serum concentration of Beta-Blockers. Risk C: Monitor

Amphetamines: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Antidiabetic Agents: Beta-Blockers (Beta1 Selective) may increase adverse/toxic effects of Antidiabetic Agents. Specifically, beta-blockers may mask the hypoglycemic symptoms of antidiabetic agents. Risk C: Monitor

Antipsychotic Agents (Phenothiazines): May increase hypotensive effects of Beta-Blockers. Beta-Blockers may decrease metabolism of Antipsychotic Agents (Phenothiazines). Antipsychotic Agents (Phenothiazines) may decrease metabolism of Beta-Blockers. Risk C: Monitor

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may increase hypotensive effects of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor

Arginine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Barbiturates: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Benperidol: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Beta2-Agonists: Beta-Blockers (Beta1 Selective) may decrease bronchodilatory effects of Beta2-Agonists. Of particular concern with nonselective beta-blockers or higher doses of the beta1 selective beta-blockers. Risk C: Monitor

Bradycardia-Causing Agents: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Brigatinib: May decrease antihypertensive effects of Antihypertensive Agents. Brigatinib may increase bradycardic effects of Antihypertensive Agents. Risk C: Monitor

Brimonidine (Topical): May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Bromperidol: May decrease hypotensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase hypotensive effects of Bromperidol. Risk X: Avoid

Cafedrine: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may decrease therapeutic effects of Cafedrine. Risk C: Monitor

Cannabis: Beta-Blockers may increase adverse/toxic effects of Cannabis. Specifically, the risk of hypoglycemia may be increased. Risk C: Monitor

Ceritinib: Bradycardia-Causing Agents may increase bradycardic effects of Ceritinib. Management: If this combination cannot be avoided, monitor patients for evidence of symptomatic bradycardia, and closely monitor blood pressure and heart rate during therapy. Risk D: Consider Therapy Modification

Cholinergic Agonists: Beta-Blockers may increase adverse/toxic effects of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Risk C: Monitor

CYP3A4 Inducers (Strong): May decrease serum concentration of Bisoprolol. Risk C: Monitor

Dabigatran Etexilate: Bisoprolol may increase serum concentration of Dabigatran Etexilate. Risk C: Monitor

Dexmethylphenidate: May decrease therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Diazoxide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Dipyridamole: May increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Disopyramide: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may increase negative inotropic effects of Disopyramide. Risk C: Monitor

DOBUTamine: Beta-Blockers may decrease therapeutic effects of DOBUTamine. Risk C: Monitor

Dronedarone: May increase bradycardic effects of Beta-Blockers. Dronedarone may increase serum concentration of Beta-Blockers. This likely applies only to those agents that are metabolized by CYP2D6. Management: Use lower initial beta-blocker doses; adequate tolerance of the combination, based on ECG findings, should be confirmed prior to any increase in beta-blocker dose. Increase monitoring for clinical response and adverse effects. Risk D: Consider Therapy Modification

DULoxetine: Blood Pressure Lowering Agents may increase hypotensive effects of DULoxetine. Risk C: Monitor

EPHEDrine (Systemic): Beta-Blockers may decrease therapeutic effects of EPHEDrine (Systemic). Risk C: Monitor

EPINEPHrine (Nasal): Beta-Blockers (Beta1 Selective) may decrease therapeutic effects of EPINEPHrine (Nasal). Risk C: Monitor

EPINEPHrine (Oral Inhalation): Beta-Blockers (Beta1 Selective) may decrease therapeutic effects of EPINEPHrine (Oral Inhalation). Risk C: Monitor

EPINEPHrine (Systemic): Beta-Blockers (Beta1 Selective) may decrease therapeutic effects of EPINEPHrine (Systemic). Risk C: Monitor

Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): Beta-Blockers may increase vasoconstricting effects of Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates). Risk C: Monitor

Etilefrine: Beta-Blockers may decrease therapeutic effects of Etilefrine. Etilefrine may increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Etofylline: Beta-Blockers may decrease therapeutic effects of Etofylline. Risk X: Avoid

Etrasimod: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Fexinidazole: Bradycardia-Causing Agents may increase arrhythmogenic effects of Fexinidazole. Risk X: Avoid

Fingolimod: Bradycardia-Causing Agents may increase bradycardic effects of Fingolimod. Management: Consult with the prescriber of any bradycardia-causing agent to see if the agent could be switched to an agent that does not cause bradycardia prior to initiating fingolimod. If combined, perform continuous ECG monitoring after the first fingolimod dose. Risk D: Consider Therapy Modification

Flunarizine: May increase therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Grass Pollen Allergen Extract (5 Grass Extract): Beta-Blockers may increase adverse/toxic effects of Grass Pollen Allergen Extract (5 Grass Extract). More specifically, Beta-Blockers may inhibit the ability to effectively treat severe allergic reactions to Grass Pollen Allergen Extract (5 Grass Extract) with epinephrine. Some other effects of epinephrine may be unaffected or even enhanced (e.g., vasoconstriction) during treatment with Beta-Blockers. Management: Consider alternatives to either grass pollen allergen extract (5 grass extract) or beta-blockers in patients with indications for both agents. Canadian product labeling specifically lists this combination as contraindicated. Risk D: Consider Therapy Modification

Herbal Products with Blood Pressure Increasing Effects: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Herbal Products with Blood Pressure Lowering Effects: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Hypotension-Associated Agents: Blood Pressure Lowering Agents may increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Iloperidone: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Indoramin: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Isocarboxazid: May increase antihypertensive effects of Antihypertensive Agents. Risk X: Avoid

Isoproterenol: Beta-Blockers may decrease therapeutic effects of Isoproterenol. Risk C: Monitor

Ivabradine: Bradycardia-Causing Agents may increase bradycardic effects of Ivabradine. Risk C: Monitor

Lacosamide: Bradycardia-Causing Agents may increase AV-blocking effects of Lacosamide. Risk C: Monitor

Landiolol: Bradycardia-Causing Agents may increase bradycardic effects of Landiolol. Risk X: Avoid

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may increase hypotensive effects of Levodopa-Foslevodopa. Risk C: Monitor

Loop Diuretics: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Lormetazepam: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Mavacamten: Beta-Blockers may increase adverse/toxic effects of Mavacamten. Specifically, negative inotropic effects may be increased. Risk C: Monitor

Metergoline: May decrease antihypertensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase orthostatic hypotensive effects of Metergoline. Risk C: Monitor

Methacholine: Beta-Blockers may increase adverse/toxic effects of Methacholine. Risk C: Monitor

Methylphenidate: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Midodrine: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Mivacurium: Beta-Blockers may increase therapeutic effects of Mivacurium. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Naftopidil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicergoline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicorandil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

NIFEdipine (Topical): May increase adverse/toxic effects of Beta-Blockers. Risk C: Monitor

NIFEdipine: May increase hypotensive effects of Beta-Blockers. NIFEdipine may increase negative inotropic effects of Beta-Blockers. Risk C: Monitor

Nitrendipine: May increase therapeutic effects of Beta-Blockers. Risk C: Monitor

Nitroprusside: Blood Pressure Lowering Agents may increase hypotensive effects of Nitroprusside. Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents (Topical): May decrease therapeutic effects of Beta-Blockers. Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents: May decrease antihypertensive effects of Beta-Blockers. Risk C: Monitor

Obinutuzumab: May increase hypotensive effects of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider Therapy Modification

Opipramol: Beta-Blockers may increase serum concentration of Opipramol. Opipramol may increase serum concentration of Beta-Blockers. Risk C: Monitor

Ozanimod: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Patiromer: May decrease serum concentration of Bisoprolol. Management: Administer bisoprolol at least 3 hours before or 3 hours after patiromer. Risk D: Consider Therapy Modification

Pentoxifylline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Perazine: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Pholcodine: Blood Pressure Lowering Agents may increase hypotensive effects of Pholcodine. Risk C: Monitor

Phosphodiesterase 5 Inhibitors: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Ponesimod: Bradycardia-Causing Agents may increase bradycardic effects of Ponesimod. Management: Avoid coadministration of ponesimod with drugs that may cause bradycardia when possible. If combined, monitor heart rate closely and consider obtaining a cardiology consult. Do not initiate ponesimod in patients on beta-blockers if HR is less than 55 bpm. Risk D: Consider Therapy Modification

Prazosin: Antihypertensive Agents may increase hypotensive effects of Prazosin. Risk C: Monitor

Prostacyclin Analogues: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Quinagolide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Reserpine: May increase hypotensive effects of Beta-Blockers. Reserpine may increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Rivastigmine: May increase bradycardic effects of Beta-Blockers. Risk X: Avoid

Silodosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Siponimod: Bradycardia-Causing Agents may increase bradycardic effects of Siponimod. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia. If combined, consider obtaining a cardiology consult regarding patient monitoring. Risk D: Consider Therapy Modification

Succinylcholine: Beta-Blockers may increase neuromuscular-blocking effects of Succinylcholine. Risk C: Monitor

Tasimelteon: Beta-Blockers may decrease therapeutic effects of Tasimelteon. Management: Consider avoiding nighttime administration of beta-blockers during tasimelteon therapy due to the potential for reduced tasimelteon efficacy. Risk D: Consider Therapy Modification

Terazosin: Antihypertensive Agents may increase hypotensive effects of Terazosin. Risk C: Monitor

Theodrenaline: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may decrease therapeutic effects of Theodrenaline. Risk C: Monitor

Theophylline Derivatives: Beta-Blockers (Beta1 Selective) may decrease bronchodilatory effects of Theophylline Derivatives. Risk C: Monitor

Urapidil: Antihypertensive Agents may increase hypotensive effects of Urapidil. Risk C: Monitor

White Birch Allergen Extract: Beta-Blockers may increase adverse/toxic effects of White Birch Allergen Extract. Specifically, beta-blockers may reduce the effectiveness of beta-agonists that may be required to treat systemic reactions to white birch allergen extract. Risk X: Avoid

Reproductive Considerations

Medications considered acceptable for the treatment of chronic hypertension during pregnancy may generally be continued in patients trying to conceive. Bisoprolol is generally not a preferred agent for use in pregnant patients (ACC/AHA [Whelton 2018]; ACOG 2019; NICE 2019); however, use may be considered (ESC [Cífková 2020]).

Impotence is noted in product labeling following use of bisoprolol. As a class, outcomes from available studies evaluating beta-blockers and sexual dysfunction are inconsistent, and the negative effects on erectile function are considered controversial. A clear relationship between use of beta-blockers and erectile dysfunction has not been established. Hypertension itself is associated with erectile dysfunction. Patients on a beta-blocker presenting with sexual dysfunction should be evaluated for underlying disease (Farmakis 2022; Levine 2012; Semet 2017; Terentes-Printzios 2022; Viigimaa 2020).

Pregnancy Considerations

Outcome data following maternal use of bisoprolol during pregnancy are limited compared to other beta-1 selective beta-blockers (Hoeltzenbein 2018; Kayser 2020).

Exposure to beta-blockers during pregnancy may increase the risk for adverse events in the neonate. If maternal use of a beta-blocker is needed, monitor fetal growth during pregnancy; monitor the newborn for 48 hours after delivery for bradycardia, hypoglycemia, and respiratory depression (ESC [Regitz-Zagrosek 2018]).

Chronic maternal hypertension is also associated with adverse events in the fetus/infant. Chronic maternal hypertension may increase the risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to the duration and severity of maternal hypertension. Untreated chronic hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, preeclampsia, delivery complications, stroke, and myocardial infarction (ACOG 2019).

Patients with preexisting hypertension may continue their medication during pregnancy unless contraindications exist (ESC [Regitz-Zagrosek 2018]). When treatment of hypertension is initiated during pregnancy, agents other than bisoprolol may be preferred (ACOG 2019; ESC [Regitz-Zagrosek 2018]; SOGC [Magee 2022]); however, use of bisoprolol may be considered (ESC [Cífková 2020]).

Breastfeeding Considerations

It is not known if bisoprolol is present in breast milk.

Bisoprolol 5 mg/day was initiated in one patient 5 days postpartum. Bisoprolol was not detected in breast milk sampled 11 and 18 days later (lower limit of quantification 1 ng/mL) (Khurana 2014).

The manufacturer recommends that caution be exercised when administering bisoprolol to breastfeeding patients. Use of a beta-blocker other than bisoprolol may be preferred in lactating patients (ESC [Cífková 2020]).

Monitoring Parameters

Blood pressure, heart rate, ECG; serum glucose (in patients with diabetes); signs and symptoms of bronchospasm (in patients with preexisting bronchospastic disease); mental alertness.

Reference Range

Blood pressure goal: May vary depending on clinical conditions, different clinical practice guidelines, and expert opinion. Refer to "Clinical Practice Guidelines" for specific treatment goals.

Mechanism of Action

Selective inhibitor of beta1-adrenergic receptors; competitively blocks beta1-receptors, with little or no effect on beta2-receptors at doses ≤20 mg

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: 1 to 2 hours

Absorption: Rapid and almost complete

Distribution: Widely; highest concentrations in heart, liver, lungs, and saliva; crosses blood-brain barrier

Protein binding: ~30%

Metabolism: Extensively hepatic; significant first-pass effect (~20%)

Bioavailability: ~80%

Half-life elimination: Normal kidney function: 9 to 12 hours; CrCl <40 mL/minute: 27 to 36 hours; Hepatic cirrhosis: 8 to 22 hours

Time to peak: 2 to 4 hours

Excretion: Urine (50% as unchanged drug, remainder as inactive metabolites); feces (<2%)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Biscor | Bisodac | Bisolol | Concor | Concor cor | Selecta;
  • (AR) Argentina: Bicardil | Biprosol | Bisofec | Bisopil | Bisoprolol teva | Cardiplen | Concor | Corbis | Dromin | Etadiar | Lostaprolol | Problock;
  • (AT) Austria: Bilokord | Bisocor | Bisoprolol | Bisoprolol 1a Pharma | Bisoprolol Accord | Bisoprolol arcana | Bisoprolol sandoz | Concor | Rivacor;
  • (AU) Australia: Apo bisoprolol | Beprol | Bicard | Bicor | Biso | Bisoprolol | Bisoprolol an | Bisoprolol generichealth | Bisoprolol sandoz | Bispro | Chemmart Bisoprolol | Cipla bisoprolol | Noumed bisoprolol | Terry White Chemists Bisoprolol;
  • (BD) Bangladesh: Acubis | Adorbis | Ancor | B prolol | Betabis | Betacor | Betafix | Bislol | Bisocor | Bisoloc | Bisopress | Bisopro | Bisoren | Bisotab | Bisu | Cardicor | Cardinor | Conbis | Concor | Diobis | Orabis | Prelizer | Probis | Sb bisop | Selbis | Tenobis;
  • (BE) Belgium: Bisoprolol apotex | Bisoprolol EG | Bisoprolol Eurogenerics | Bisoprolol merck-generics | Bisoprolol mylan | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol teva generics belgium | Bisoprotop | Docbisopro | Emconcor | Isoten;
  • (BG) Bulgaria: Bibloc | Biprol | Bisocon | Bisogamma | Bisolen | Bisoprolol Accord | Bisoprolol mylan | Bisor | Bisostad | Blokbis | Blokbis cor | Concor | Concor cor | Coronal | Kardoritm | Rizoprol | Sobycor | Tevabisoprol | Tyrez;
  • (BR) Brazil: Concardio | Concor | Coraprol | Fumarato bisoprolol | Fumarato de bisoprolol | Hemifumarato de bisoprolol | Hemifumrato de bisoprolol | Iccor;
  • (CH) Switzerland: Bilol | Bisoprolol actavis | Bisoprolol basan | Bisoprolol helvepharm | Bisoprolol mepha | Bisoprolol nobel | Bisoprolol sandoz | Bisoprolol spirig hc | Bisoprolol zentiva | Concor | Concor cor;
  • (CI) Côte d'Ivoire: Bibloc | Bisoprolol;
  • (CL) Chile: Biprosel | Bisocor | Bisopril | Bisoprolol | Bisoprolol fumarato | Concor | Corentel | Eurocor | Tenbilol;
  • (CN) China: Bo su | Concor | Su lai le;
  • (CO) Colombia: Bisoprolol | Bisoprolol fumarato | Concor | Concor cor | Corbis | Zoprolol;
  • (CZ) Czech Republic: Bisocard | Bisogamma | Bisoprolol | Bisoprolol aurovitas | Bisoprolol medreg | Bisoprolol mylan | Bisoprolol Orion | Bisoprolol pmcs | Bisoprolol vitabalans | Byol | Conaret | Concor | Concor cor | Rivocor | Sobycor | Tyrez;
  • (DE) Germany: Biso | Biso-puren | Bisobeta | Bisobloc | Bisogamma | Bisohexal | Bisolich | Bisomerck | Bisoprolol | Bisoprolol 1a Pharma | Bisoprolol Accord | Bisoprolol actavis | Bisoprolol al | Bisoprolol atid | Bisoprolol aurobindo | Bisoprolol awd | Bisoprolol axcount | Bisoprolol ct | Bisoprolol Dexcel | Bisoprolol Dura | Bisoprolol Heumann | Bisoprolol mylan | Bisoprolol puren | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol stada | Bisoprolol tad | Bisoprolol teva | Bisoprolol Vem | Bisoprolol vitabalans | Bisoprolol-Corax | Bonfotin | Concor | Concor cor | Corocalm | Emconcor mitis | Fondril | Jutabis;
  • (DK) Denmark: Bisocor | Bisoprolol alpharma | Bisoprolol stada;
  • (DO) Dominican Republic: Betauno 10 | Betauno 2.5 | Betauno 5 | Bidicor | Biobloc | Biskrem | Bisocardil | Bisochem | Bisocor | Bisofel | Bisomax | Bisoprolol | Bisoprolol Alfa | Bisoprolol if | Bisoprolol Lam | Bisoprolol mk | Bisotab | Bloq | Cardibeta | Concor | Coradona | Coranprol | Corentel | Etablox | Eurobisop | Iberprodol | Linovo | Presolol | Prespol | Selecar MF | Solol;
  • (EC) Ecuador: Biprobloc | Bisonorm | Bisoprolol | Bisoprolol fumarato | Bisoprolol mk | Bisoprolol novartis access | Concardio | Concor | Corbis | Corentel | Eurocor;
  • (EE) Estonia: Bisoprolol Accord | Bisoprolol vitabalans | Bisoprolol zentiva | Bisprotin | Concor | Concor cor | Sobycor;
  • (EG) Egypt: Bisobeta | Bisocard | Bisolock | Bisoprol | Bistol | Concor | Concor cor | Egypro | Normocard | Soprol | Unibisol;
  • (ES) Spain: Bisoprolol aurovitas | Bisoprolol bluefish | Bisoprolol cinfa | Bisoprolol cor alter | Bisoprolol cor amneal | Bisoprolol Cor Apotex | Bisoprolol cor mylan | Bisoprolol cor sandoz | Bisoprolol edigen | Bisoprolol farmasierra | Bisoprolol kern | Bisoprolol krka | Bisoprolol mylan | Bisoprolol normon | Bisoprolol pensa | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol stada | Bisoprolol Sumol | Bisoprolol zentiva | Emconcor | Emconcor cor | Euradal;
  • (ET) Ethiopia: Bisoprolol;
  • (FI) Finland: Bisomerck | Bisomyl | Bisopral | Bisoproact | Bisoprolol | Bisoprolol Accord | Bisoprolol krka | Bisoprolol mylan | Bisoprolol Orion | Bisoprolol pliva | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol stada | Bisoprolol vitabalans | Bisoprololi Ennapharma | Bisprotin | Caraprol | Emconcor | Emconcor chf | Monocor | Orloc;
  • (FR) France: Bisoce | Bisoprolol Accord | Bisoprolol actavis | Bisoprolol Almus | Bisoprolol arrow | Bisoprolol Bgr | Bisoprolol biogaran | Bisoprolol crister | Bisoprolol Dci | Bisoprolol EG | Bisoprolol evolugen | Bisoprolol g gam | Bisoprolol gnr | Bisoprolol krka | Bisoprolol nor | Bisoprolol Qualimed | Bisoprolol quiver | Bisoprolol quiver lab | Bisoprolol ranbaxy | Bisoprolol ratiopharm | Bisoprolol ref | Bisoprolol rpg | Bisoprolol sandoz | Bisoprolol sun | Bisoprolol teva | Bisoprolol viatris | Bisoprolol zentiva | Bisoprolol Zentiva Lab | Bisoprolol zydus | Cardensiel | Cardiocor | Detensiel | Soprol;
  • (GB) United Kingdom: Bipranix | Bisoprolol | Bisoprolol Almus | Bisoprolol arrow | Bisoprolol cox | Bisoprolol focus | Bisoprolol kent | Bisoprolol sandoz | Cardicor | Congescor | Emcor | Monocor | Rizoprol | Soloc | Vivacor;
  • (GR) Greece: Bisoprolol | Blocatens | Emconcor | Pactens | Theracor;
  • (GT) Guatemala: Bysosan;
  • (HK) Hong Kong: Apo bisoprolol | Bisoprolol stada | Bisostad | Concor | Nikp bisoprolol;
  • (HR) Croatia: Biprol | Bisobel | Bisoprolol Pfizer | Byol | Byol Cor | Concor | Concor cor | Kordobis | Lybrol | Sobycor | Tyrez;
  • (HU) Hungary: Bisoblock | Bisocard | Bisogamma | Bisogen | Bisoprolol actavis | Bisoprolol hexal | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol vitabalans | Bisotens | Concor | Concor cor | Coviogal | Sobycor;
  • (ID) Indonesia: B beta | Beta one | Bipro | Biscor | Bisoprolol | Bisovell | Concor | Hapsen | Maintate | Tencard;
  • (IE) Ireland: Bisocor | Bisop | Bisopine | Bisoprolol | Bisoprolol actavis | Bisoprolol krka | Bisoprolol mylan | Bisoprolol Niche | Cardicor | Emcolol | Emcor | Soprol;
  • (IL) Israel: Cardiloc | Concor;
  • (IN) India: Acbiso | Besoloc | Bibeta | Biselect | Bisobis | Bisocar | Bisofig | Bisoheart | Bisokem | Bisolet | Bisolong | Bisonex | Bisonext | Bisopharm | Bisopron | Bisoride | Bisosafe | Bisotab | Bisveda | Blocpro | Concor | Corbis | Lonipress | Zabesta;
  • (IT) Italy: Bisoprololo | Bisoprololo aurobindo | Bisoprololo doc | Bisoprololo eg | Bisoprololo hexal | Bisoprololo krka | Bisoprololo mylan | Bisoprololo pensa | Bisoprololo Sandoz | Bisoprololo teva | Bisoprololo Winthrop | Bisoprololo zentiva | Cardicor | Concor | Congescor | Pluscor | Sequacor;
  • (JO) Jordan: Biscor | Bisoprol | Cardicor | Concor | Concor cor | Forcicor | Kokoro | Promivol;
  • (JP) Japan: Azopsin | Azopsin chemiphar | Azopsin merck hoei | Bisoprolol | Bisoprolol fumarate dsep | Bisoprolol fumarate meiji | Bisoprolol fumarate sawai | Bisoprolol fumarate towa | Bisoprolol Fumarate Yoshindo | Bisotate | Luke | Luke merck hoei | Luke zensei | Main heart amel | Mainheart | Mainries | Mainrol | Maintate | Maintowa | Meitat | Metolomain | Metolomain alfresa | Pramatate | Seafuri | Well Bi;
  • (KE) Kenya: Anginol | Bisocar | Bisocor | Bisodac hf | Bisolol | Bisopress | Bisoprolol | Bisotrol | Concor | Corbis;
  • (KR) Korea, Republic of: Beta one | Betadren | Betaprol | Biprol | Bisohexal | Bisonal | Bisopol | Bisorol | Conbloc | Concor | Concrin | Congclean | Hemiprol | Monocor | Sandoz bisoprolol;
  • (KW) Kuwait: Bisoprol | Concor | Concor cor;
  • (LB) Lebanon: Apo bisoprolol | Biscordex | Bisocor | Bisohexal | Bisoprolol | Bisoprolol quiver lab | Cardiosafe | Concor | Prescor;
  • (LT) Lithuania: Bisoprolol | Bisoprolol 1a Pharma | Bisoprolol actiofarma | Bisoprolol bijon | Bisoprolol fumarate zentiva | Bisopromerck | Bisprotin | Concor | Emconcor | Zonsiloc;
  • (LU) Luxembourg: Bisoprolol EG | Bisoprolol Eurogenerics | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisosandoz | Concor | Isoten;
  • (LV) Latvia: Bisocard | Bisogamma | Bisoprolol 1a Pharma | Bisoprolol Accord | Bisoprolol ratiopharm | Bisoprolol vitabalans | Bisoprolol zentiva | Bisprotin | Concor | Concor cor | Corbis | Coronal | Sobycor;
  • (MA) Morocco: Bicardol | Biprol | Bisocard | Bisopral | Cardensiel | Detensiel | Soprol;
  • (MX) Mexico: Bisoprolol | Bisoprolol cor sandoz | Bitecral | Caurodol | Comblock | Concor | Corebipro | Embicor | Loroprax | Sig | Vilopre;
  • (MY) Malaysia: Adroten | Bisloc | Bisocar | Bisocor | Bisodac hf | Bisohexal | Bisol | Concor | Hypercor | Tisderol | Vasoten;
  • (NG) Nigeria: Bisodac | Bisoprolol | Concor | Corbis;
  • (NL) Netherlands: Bisobloc | Bisoprolol-Fumaraat Actavis | Bisoprololfumaraat | Bisoprololfumaraat Accord | Bisoprololfumaraat aurobindo | Bisoprololfumaraat Gf | Bisoprololfumaraat PCH | Bisoprololfumaraat ratiopharm | Bisoprololfumaraat sandoz | Bisoprololfumaraat teva | Emconcor | Emcor;
  • (NO) Norway: Bisoprolol sandoz | Bisoprolol vitabalans | Bisoprolol zentiva | Emconcor | Emconcor chf | Stromolol;
  • (NZ) New Zealand: Bisoprolol mylan | Bisoprolol viatris | Bosvate;
  • (PE) Peru: Biprol-5 | Bisonorm | Bisoprolol | Bisopsi | Bisovitae | Cardioprol | Combicor | Concor | Corbis | Corentel | Eurocor | Goxicardin | Lostaprolol | Novoblock | Seleblock;
  • (PH) Philippines: Biscore | Bisoprolol sandoz | Bisosten | Concore;
  • (PK) Pakistan: Abcor | Actim | Actiprolol | Barilol | Beslol | Biscord | Biscot | Bisfat | Bisheart | Bisolol | Bison | Bisovel | Bisprol | Bpr | Concor | Corbis | Iprol | Lisoprolol | Monitor | Monocor | Probase | Safcor | Sopral | Valvozid | Vegaprol;
  • (PL) Poland: Antipres | Bibloc | Bicardef | Bicardiol | Bidop | Bilokord | Bisocard | Bisogamma | Bisohexal | Bisoprolol actavis | Bisoprolol aurobindo | Bisoprolol genoptim | Bisoprolol ozone | Bisoprolol vitabalans | Bisoprolol vp | Bisopromerck | Bisoratio | Blocard | Conaret | Concor | Concor cor | Corectin | Coronal | Corsib | Ripit | Sobycor;
  • (PR) Puerto Rico: Zebeta;
  • (PT) Portugal: Bisoprol | Bisoprol aurovitas | Bisoprolol | Bisoprolol Accord | Bisoprolol aurobindo | Bisoprolol Germed | Bisoprolol gp | Bisoprolol itf | Bisoprolol krka | Bisoprolol mylan | Bisoprolol ratiopharm | Bisoprolol tolife | Bisoprolol zentiva | Concor;
  • (PY) Paraguay: Corentel | Eurocor | Lostaprolol | Novoblock;
  • (QA) Qatar: B-Cor | Biscor | Bisopress | Bisoprol | Cardex | Cardiosafe | Concor | Concor COR;
  • (RO) Romania: Bisoblock | Bisogamma | Bisoprolol fumarat aurobindo | Bisoprolol lph | Bisostad | Bisotens | Concor | Concor cor | Corsib | Sobyc;
  • (RU) Russian Federation: Aritel | Aritel Cor | Bidop | Bidop cor | Biol | Biprol | Biscard | Bisogamma | Bisomor | Bisoprolol | Bisoprolol canon | Bisoprolol leksvm | Bisoprolol lugal | Bisoprolol obl | Bisoprolol pharmasyntez | Bisoprolol prana | Bisoprolol ratiopharm | Bisoprolol teva | Bisoproncor | Concor | Concor cor | Corbis | Cordinorm | Cordinorm cor | Coronal | Niperten | Tyrez;
  • (SA) Saudi Arabia: B Cor | Biscor | Bisolol | Bitrol | Cardex | Cardicor | Cardioprol | Concor | Concor cor | Pms bisoprolol | Selecta;
  • (SE) Sweden: Bisocard | Bisomyl | Bisoprolol 2care4 | Bisoprolol abacus medicine | Bisoprolol abboxia | Bisoprolol Accord | Bisoprolol actavis | Bisoprolol ebb | Bisoprolol krka | Bisoprolol medical valley | Bisoprolol mylan | Bisoprolol orifarm | Bisoprolol Orion | Bisoprolol paranova | Bisoprolol ratiopharm | Bisoprolol sandoz | Bisoprolol stada | Bisoprolol teva | Bisoprolol vitabalans | Bisoprolol zentiva | Bisostad | Cardicor | Emconcor | Emconcor chf | Speridol;
  • (SG) Singapore: Bisohexal | Blokbis | Concor;
  • (SI) Slovenia: Bisoblock | Borez | Byol | Concor | Concor cor | Sobycor;
  • (SK) Slovakia: Bisobela | Bisocard | Bisogamma | Bisomerck | Bisoprolol | Bisoprolol medreg | Bisoprolol Orion | Bisoprolol ozone | Bisoprolol sandoz | Bisoprolol vitabalans | Conaret | Concor | Coronal | Rivocor | Sobycor | Tyrez;
  • (SR) Suriname: Apo bisoprolol | Biscor | Bisoprolol | Bisoprolol fumaraat | Bisoprololfumaraat | Bisoprololfumaraat Accord | Bisoprololfumaraat actavis | Bisoprololfumaraat aurobindo | Bisoprololfumaraat deco aurobindo | Bisoprololfumaraat sandoz;
  • (TH) Thailand: Betacor | Bisloc | Concor | Hypercor | Nikp bisoprolol | Novacor | Sopalol;
  • (TN) Tunisia: Biprocard | Bisocor | Bisopral | Bisotens | Bonacor | Cincor | Detensiel | Evocor | Soprol;
  • (TR) Turkey: Concor | Kardoritm | Rizoprol | Soprano;
  • (TW) Taiwan: Betacor | Biocor | Biso | Bisocor | Bisol | Bistable | Biteven | Cidincor | Concor | Kenco | Monocor | Purcon | Sinbisol;
  • (UA) Ukraine: Bicard | Bidop | Biprolol | Bisocard | Bisoprolol | Bisoprolol apo | Bisoprolol astrafarm | Bisoprolol aurobindo | Bisoprolol hexal | Bisoprolol krka | Bisoprolol lugal | Bisoprolol ratiopharm | Bisoprolol richter | Bisoprolol sandoz | Bisoprolol teva | Bisoprolol zdorovje | Bisoprophar | Bisoprovel | Bisostad | Concor | Concor cor | Corbis | Cordinorm | Cordinorm cor | Coronal | Eurobisoprolol;
  • (UG) Uganda: Besicor | Bisodac hf | Bisoprol | Bisoprolol | Concor | Corbis;
  • (UY) Uruguay: Bicardil | Corentel | Novoblock | Vontrol;
  • (VE) Venezuela, Bolivarian Republic of: Algiol | Antaar | Bibloc | Bilol | Biotalol | Biprocor | Biprolil | Bisobloc | Bisoprolol | Bisopruni | Concor | Coranprol | Corbis | Corentel | Prebloc | Probis | Tisderol;
  • (VN) Viet Nam: Agicardi | Biginol | Bihasal | Biscapro | Corneil | Glocor | Haiblok | Maxxprolol | Misopato | Prololsavi | Savi Prolol | Zentobiso;
  • (ZA) South Africa: Adco-Bisocor | Bilocor | Bisbeta | Bislo | Bisohexal | Bisoprolol 10 accord | Bisoprolol Accord | Bisoprolol hexal | Bisoprolol unichem | Bisoprolol Unicorn | Bisoprolol zydus | Cardicor | Concor | Mylan bisoprolol | Presicard | Retocar | Ziapro;
  • (ZM) Zambia: Bisohexal | Corbis;
  • (ZW) Zimbabwe: Bilocor
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