Common questions about bisoprolol

Bisoprolol is a type of medicine called a beta blocker.

Like other beta blockers, bisoprolol works by changing the way your body responds to some nerve impulses, especially in the heart.

It slows down your heart rate and makes it easier for your heart to pump blood around your body.

Bisoprolol starts to work after about 2 hours to reduce high blood pressure, but it can take 2 to 6 weeks to fully take effect.

If you're taking bisoprolol for high blood pressure, you may not feel any different when you take it. This does not mean the medicine is not working. It's important to keep taking it.

If you're taking bisoprolol for angina, it will probably take a couple of weeks before you feel better. Until then, you will still sometimes have chest pain. You may even find the pain gets worse to start with.

Make sure you have your medicine (spray or tablets) for treating angina attacks with you at all times, and use it if you need to.

If you're taking bisoprolol for heart failure, it may take several weeks, even months, before you feel better.

Bisoprolol is generally safe to take for a long time.

In fact, it works best when you take it for a long time.

Talk to your doctor if you want to stop taking bisoprolol.

Stopping bisoprolol can make your blood pressure rise, and this may increase your risk of heart attack and stroke.

If you're bothered by side effects, your doctor may be able to prescribe a different medicine to lower you blood pressure.

If you stop taking bisoprolol, it will take 2 to 3 days for it to be completely out of your body.

Bisoprolol works as well as other beta blockers for reducing blood pressure, but it's less likely to cause side effects.

That's because bisoprolol works mainly on the heart. Other beta blockers, such as propranolol, work on the heart, but affect other parts of the body as well.

There are lots of other medicines to lower your blood pressure and treat chest pain or heart failure.

They work in a different way from beta blockers and include:

• ACE inhibitors such as ramipril and lisinopril
• angiotensin receptor blockers such as candesartan
• calcium channel blockers like amlodipine
• medicines that make you pee more (diuretics) like furosemide

Beta blockers are not usually the first choice treatment for high blood pressure.

The medicine your doctor prescribes will depend on your age and ethnicity:

• if you're under 55 and you're not of African Caribbean or black African origin, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker
• if you're 55 or older, or you're any age and of African Caribbean or black African origin, you'll usually be offered a calcium channel blocker

You may have to try other medicines to lower your blood pressure if you get side effects.

Many people need to take a combination of different medicines.

Tell your doctor that you're taking bisoprolol if you're going to be put to sleep (have a general anaesthetic) for an operation, or if you're going to have a major operation, such as a caesarean section, without a general anaesthetic.

Your doctor may advise you to stop taking bisoprolol 48 hours before surgery.

This is because if you have bisoprolol with some anaesthetics it can lower your blood pressure too much.

Bisoprolol will not stop your contraception working.

But some types of hormonal methods of contraception, such as the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking or using a combined hormonal contraceptive.

If bisoprolol makes you sick (vomit) or gives you severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Some people on bisoprolol say their sex drive goes down or they cannot get an erection.

But this is not a common side effect and there's not enough evidence to say for sure that bisoprolol is causing it.

If you're having problems with your sex life, talk to your doctor.

You do not need to stop playing sports if you take bisoprolol. But do not push yourself too much.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

Be aware, though, that in some sports bisoprolol is not allowed if you're competing at a high level.

Bisoprolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose.

If this happens to you, do not drive a car, ride a bike, or use tools or machinery.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking bisoprolol. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol can increase the blood pressure-lowering effect of bisoprolol, which can make you feel dizzy or lightheaded.

During the first few days of taking bisoprolol or after your dose increases, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find bisoprolol makes you feel dizzy, it's best to stop drinking alcohol.

Apart from being careful with alcohol, you can eat and drink normally while taking bisoprolol.

Eating well can help if you have high blood pressure or heart failure.

You can boost the health of your heart by making some key lifestyle changes.

These will also help if you have high blood pressure.

• VaccinationsQuit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke too.
• Cut down on alcohol – drinking too much alcohol raises blood pressure over time. It makes heart failure worse, too. Try to keep to the recommended guidelines of no more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day is enough.
• Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products, and lean proteins. It's a good idea to follow these tips for a lower salt diet, too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Deal with stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse, too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year and the pneumococcal vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS. COVID-19 vaccination is recommended for most people. Make sure you've had all the doses that you are eligible for. Talk to your doctor if you think you might be in one of the at risk groups.