How bisoprolol works
Bisoprolol is a drug from the beta-blocker group. By blocking certain binding sites for messenger substances (beta receptors), it lowers blood pressure, reduces heart rate (negative chronotropic), reduces the transmission of electrical signals in the heart (negative dromotropic) and reduces the contractility of the heart (negative inotropic).
In this way, the heart is relieved of its workload and uses less oxygen and energy. This benefits people with cardiovascular diseases.
Cardioselective action
Beta receptors are found in various tissues and organs. However, bisoprolol predominantly blocks beta receptors in the heart (cardioselective effect).
However, when bisoprolol occupies the beta receptors on the heart, the messenger substances can no longer dock and exert their effect. This economizes the entire work of the heart and thus relieves the heart muscle.
When is bisoprolol used?
The active ingredient bisoprolol is used in cardiovascular diseases. These include, above all:
- High blood pressure (arterial hypertension)
- angina pectoris (tightness of the heart) in coronary heart disease (CHD)
- Heart palpitations (tachycardia, including tachycardic arrhythmias)
- Chronic heart failure (heart failure)
The beta-blocker is also used in migraine, hyperthyroidism and preventively for bleeding from esophageal varices (off-label use).
How bisoprolol is used
Bisoprolol is available both as a monopreparation and as a combination preparation with a diuretic (diuretic). Many heart patients suffer from water retention in the body (edema), which can be flushed out with the help of diuretics.
The doctor determines the dosage of the beta blocker that is most beneficial in each individual case. The type and severity of the disease are the main factors. A low starting dose is used, which is then slowly increased to the target dose determined by the physician (“creeping in” of the therapy).
If bisoprolol is to be discontinued, the active ingredient should also be slowly reduced by the physician (“tapering” of the therapy). Abrupt discontinuation can trigger dangerous spikes in blood pressure (“rebound effect”).
What are the side effects of bisoprolol?
In rare cases bisoprolol causes hallucinations, mood swings and erectile dysfunction. In existing vascular diseases, its use may cause numbness and a feeling of coldness in the arms and legs. In patients with diabetes mellitus, the drug may mask hypoglycemia that occurs.
When should bisoprolol not be taken?
Contraindications
Bisoprolol is contraindicated in severe bronchial asthma, severe obstructive pulmonary disease (COPD), all slow forms of cardiac arrhythmia, low blood pressure, advanced vascular disease, and hyperacidity (acidosis) of the blood.
Interactions
Caution is also advised in combination with drugs that also have an effect on heart rhythm and heart rate. These include antiarrhythmics (e.g. amiodarone, flecainide, propafenone), cardiac glycosides (e.g. digoxin, digitoxin) and mefloquine (antimalarials).
Painkillers from the non-steroidal anti-inflammatory drug (NSAID) group, sympathomimetics (e.g., isoprenaline, dobutamine), and rifampicin (an antibiotic) may weaken the effect of bisoprolol.
Alcohol may increase the antihypertensive effect of bisoprolol.
Age Limitation
Due to lack of data, the use of bisoprolol is not recommended in children and adolescents under 18 years of age.
Pregnancy and lactation
It is not known whether bisoprolol passes into breast milk. In one case report, bisoprolol was not detected in breast milk during short-term use. If beta-blocker treatment is absolutely necessary during breastfeeding, metoprolol should still be preferred.
How to obtain medication with bisoprolol
Medicines containing bisoprolol require a prescription in Germany, Austria and Switzerland and can only be obtained from pharmacies on presentation of a doctor’s prescription.
Other interesting facts about bisoprolol
Beta-blockers such as bisoprolol have a calming effect on the cardiovascular system, reduce muscle tremors, and decrease nervousness and anxiety. For this reason, they are banned in certain sports and are on the doping list. These include shooting sports, darts, golf, billiards, ski jumping and archery.
