When should Bisohexal® not be used?
Absolute contraindications Relative contraindication The anaesthetist should be informed about the intake of bisoprolol before general anaesthesia, as there may be interactions between bisoprolol and the anaesthetics. Special patient groups Since bisoprolol is tolerated differently, it cannot be ruled out that the ability to react when operating machines or driving may be impaired; however, no direct effect is known. This should be taken into account especially at the beginning of treatment, when adjusting the dose or changing the preparation.
- Chronic heart failure, acute or decompensated
- Very slowed pulse (so-called bradycardia; heart rate below 50 beats/min before the start of treatment)
- Excitation conduction disorders between the pacemakers of the heart (sinusatrial block; AV block II and III degree)
- Pathological sinus node syndrome (sick sinus syndrome)
- Low blood pressure (so-called hypotension; systolic blood pressure or upper value <90mmHg)
- Chronic obstructive pulmonary diseases such as COPD (severe chronic obstructive pulmonary disorder) or bronchial asthma
- Numbness and pain in hands and/or feet caused by vascular spasms (Raynaud’s syndrome)
- Diabetes mellitus
- Psoriasis
- Untreated tumors of the adrenal medulla (pheochromocytoma)
- Older patients: In case of very poor kidney and liver function the dose should be adjusted and kept as low as possible. – Pregnant women: Only after consultation with the doctor and careful risk-benefit analysis, as the drug can enter the bloodstream of the unborn child and thus disturb its development. It is also not recommended to take it while breastfeeding, as there are no sufficient results on whether bisoprolol can pass into breast milk. – Children: As no therapeutic experience is available, children should not be treated with bisoprolol. – Athletes: Taking bisoprolol can lead to a positive result in the doping test.
Bisoprolol and alcohol
Simultaneous consumption of alcohol can increase the effect of bisoprolol.
Interactions
Simultaneous use of other medications should be discussed with the doctor or pharmacist, this applies in particular to centrally acting antihypertensive drugs such as clonidine or the combination with other antihypertensive drugs such as diuretics, calcium antagonists of the verapamil and dilitazem type, antiarrhythmic drugs (drugs for cardiac arrhythmia), non-steroidal anti-inflammatory drugs (NSAIDs), blood sugar-lowering drugs or insulin, cardiac glycosides (digitalis), drugs for depression and the antimalarial drug mefloquine. There are no known interactions.
Side effects
Especially at the beginning of the treatment dizziness and headaches (improvement usually after 1-2 weeks), nausea, vomiting and other gastrointestinal complaints, tiredness, circulatory problems and a drop in blood pressure can occur. In addition, sleep disturbances, dry eyes, confusion, mood swings, increased sweating, erectile dysfunction, hypersensitivity reactions and cramping of the respiratory muscles of the bronchi have been observed.
