1 May 2026Oral drugs
Bisoprolol oral
Bisoprolol guidance for hypertension, angina, and stable heart failure, including gradual titration and abrupt-stop warning.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Cardioselective beta-blocker.
Indications
- Hypertension and treatment of chronic stable angina pectoris.
- Chronic stable heart failure in combination with a converting enzyme inhibitor such as enalapril.
Forms and strengths
- 2.5 mg breakable tablet.
- 10 mg breakable into 1/4 tablet.
Dose
| Weeks | Daily dose | Tablet(s) |
|---|---|---|
| Week 1 | 1.25 mg once daily | 2.5 mg tab: ½ tab daily |
| Week 2 | 2.5 mg once daily | 2.5 mg tab: 1 tab daily or 10 mg tab: ¼ tab daily |
| Week 3 | 3.75 mg once daily | 2.5 mg tab: 1½ tab daily |
| Week 4 to 8 | 5 mg once daily | 10 mg tab: ½ tab daily |
| Week 9 to 12 | 7.5 mg once daily | 2.5 mg tab: 1 tab daily + 10 mg tab: ½ tab daily or 10 mg tab: ¾ tab daily |
| From week 13 | 10 mg once daily (max. 10 mg daily) | 10 mg tab: 1 tab daily |
Hypertension, angina pectoris
- Adult: 5 to 10 mg once daily, preferably in the morning, maximum 20 mg daily.
- In patients with renal or hepatic impairment: start with 2.5 mg once daily then increase, if necessary, according to clinical response, maximum 10 mg daily.
Heart failure
- Adult: start with 1.25 mg once daily and increase according to tolerance.
- Week 1: 1.25 mg once daily, 1/2 of a 2.5 mg tablet daily.
- Week 2: 2.5 mg once daily, 1 tablet of 2.5 mg daily or 1/4 of a 10 mg tablet daily.
- Week 3: 3.75 mg once daily, 1 1/2 tablets of 2.5 mg daily.
- Week 4 to 8: 5 mg once daily, 1/2 of a 10 mg tablet daily.
- Week 9 to 12: 7.5 mg once daily, 1 tablet of 2.5 mg plus 1/2 of a 10 mg tablet daily, or 3/4 of a 10 mg tablet daily.
- From week 13: 10 mg once daily, maximum 10 mg daily.
Duration
According to clinical response. Do not stop treatment abruptly; decrease doses gradually.
Contra-indications, adverse effects, precautions
- Do not administer to patients with asthma, chronic obstructive bronchopneumonia, acute heart failure, severe hypotension, bradycardia under 50 per minute, atrio-ventricular heart blocks, or Raynaud's syndrome.
- May cause bradycardia, hypotension, and worsening of heart failure; reduce dose if needed.
- May cause bronchospasm in patients with obstructive respiratory disease.
- May cause hypoglycaemia, gastrointestinal disturbances, headache, fatigue, muscle weakness, and erectile dysfunction.
- Administer with caution to patients with diabetes because of the risk of hypoglycaemia.
- In the event of anaphylactic shock, there is a risk of resistance to epinephrine.
- Avoid or monitor combination with mefloquine, digoxin, amiodarone, diltiazem, or verapamil because of the risk of bradycardia.
- Avoid or monitor combination with tricyclic antidepressants, antipsychotics, or anti-hypertensive drugs because of the risk of hypotension.
- Pregnancy and breast-feeding: use labetalol, particularly for the management of hypertension in pregnancy.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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