Bisoprolol Fumarate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jun 28, 2024

Warnings

Bisoprolol Fumarate Risks, Warnings, and Complications

Bisoprolol fumarate can cause or worsen health problems in some people. Talk to your doctor or pharmacist about taking other medications to treat hypertension (high blood pressure) if you are at increased risk of complications from this drug.

HEART FAILURE: Taking a beta-blocking agent such as bisoprolol fumarate can decrease the contraction of the heart muscle and trigger more severe heart failure in patients with this condition. Beta-blockers are generally avoided in patients with overt congestive failure due to this potential risk. These drugs are, however, sometimes used with caution in people with compensated heart failure. You may need to stop taking bisoprolol fumarate at the first signs of cardiac failure. Tell your doctor if you develop swelling in the arms and legs or unusual weight gain.
ABRUPTLY STOPPING TREATMENT: There are reports of angina pectoris (chest pain), heart attack, and irregular heartbeat in people with coronary heart disease who abruptly stopped taking beta-blocking drugs. Do not stop treatment with bisoprolol fumarate unless your doctor tells you. Your provider will tell you how to lower the dose gradually and also advise you to avoid physical activity during this time. They will monitor you carefully for any withdrawal symptoms.
PERIPHERAL VASCULAR DISEASE: Taking beta blocker medications can trigger or worsen symptoms of arterial insufficiency (narrowed blood vessels). Before starting treatment with bisoprolol fumarate, tell your doctor if you have a history of circulation problems.
LUNG DISEASE: Patients with bronchospastic disease (tightening of the airways) should not take beta blocker drugs in general. Before starting treatment with bisoprolol fumarate, tell your doctor if you have a history of asthma, COPD, emphysema, or lung infections. If you have lung conditions and cannot take other antihypertensive drugs, your doctor will start you on the lowest dose of bisoprolol fumarate (2.5 mg) and make a bronchodilator available.
MAJOR SURGERY: People taking beta blocker drugs like bisoprolol fumarate may not need to stop taking this medication before major surgery. However, the impaired ability of the heart to respond to reflex adrenergic stimuli may increase the risk of complications associated with surgical procedures done using general anesthesia.
HYPOGLYCEMIA: Beta blocker medications can mask the symptoms of hypoglycemia (low blood sugar) such as a fast heartbeat. Taking beta blockers can trigger insulin-associated hypoglycemia and slow down the recovery of blood sugar levels. Bisoprolol fumarate is beta1 selective (cardioselective) and less likely to cause hypoglycemia (low blood sugar) compared to nonselective beta-blocking agents. However, if you have diabetes and take medications to treat it, you should be aware of this risk.
THYROTOXICOSIS: Beta blocker medicines like bisoprolol fumarate can mask the symptoms of hyperthyroidism (overactive thyroid gland). Abruptly stopping beta blockade can make the condition worse and trigger a thyroid storm (thyrotoxicosis). Tell your doctor if you have a history of thyroid conditions before starting bisoprolol fumarate treatment.

Precautions Before Starting Bisoprolol Fumarate

Tell your doctor if you have ever had an allergic reaction to bisoprolol fumarate, any of the active or inactive ingredients in bisoprolol fumarate tablets, other beta blockers, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between bisoprolol fumarate and your other drugs.

Give your doctor a complete medical history. Bisoprolol fumarate may not be right for people with certain medical conditions such as an irregular or slow heartbeat, congestive heart failure, heart disease, asthma or other lung diseases, kidney disease, liver disease, circulatory conditions, diabetes, or overactive thyroid gland (hyperthyroidism).

Tell your doctor if you are pregnant, could be pregnant, or plan to get pregnant—this medication may cause harm to the unborn baby. Also, tell your doctor if you are breast-feeding, as bisoprolol passes into breast milk.

Precautions During Use of Bisoprolol Fumarate

Keep all your medical and laboratory appointments while on this medication. Your blood pressure may need to be checked regularly, and the dose may be adjusted based on your response. Keep a log of your blood pressure readings at home and tell your doctor how you feel on this medicine.

Bisoprolol fumarate can cause dizziness and drowsiness. Do not drive, operate machinery, or do any other hazardous activity until you know how it affects you. Get up slowly from a sitting or lying position to avoid lightheadedness. Avoid drinking alcohol, as it can make side effects worse.

You should know that if you have an allergic reaction to any substance while taking bisoprolol fumarate, the reaction may be worse than usual, and you may not respond to the typical doses of epinephrine for allergic reactions.

Tell your doctor if you become pregnant while on bisoprolol fumarate.

Tell all your healthcare providers you are on bisoprolol fumarate before any surgery, including dental procedures.

Bisoprolol Fumarate Drug Interactions

Certain other drugs can affect how bisoprolol fumarate works. Possible interactions with other medicines can increase the risk of severe adverse effects such as slow heartbeat and AV block.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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