Bisoprolol is indicatedin-

• Hypertension
• Angina
• Moderate to severe heart failure

Bisoprolol Hemifumarate is the most selective ß1 blocker. It displays highest level of affinity for the ß1 receptor than any other beta-blocker available up to now. Selectively blocks ß1 adrenergic receptor in the heart and vascular smooth muscle and reduces heart rate and cardiac output resulting in decrease of arterial hypertension. Lipid metabolism can be adversely affected by ß-blockers, in patients with non-ß1 selective ß1-blocker, but Bisoprolol does not cause any change in the cholesterol fraction including the cardioprotective HDL-cholesterol, in long-term therapy.

Hypertension: The dose of Bisoprolol must be individualized to the needs of the patient. The usual starting dose is 5 mg once daily. In some patients, 2.5 mg may be an appropriate starting dose. If the antihypertensive effect of 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily.

Angina: Usually 10 mg once daily (5 mg may be adequate in some patients) max 20 mg daily.

Heart Failure: Initially 1.25 mg once daily (in the morning) for 1 week then, if well tolerated, increased to 2.5 mg once daily for 1 week, then 3.75 mg once daily for 1 week, then 5 mg once daily for 4 weeks, then- 7.5 mg once daily for 4 weeks, then 10 mg once daily maximum 10 mg daily.

Bisoprolol should not be combined with other ß-blocking agents.

In patients with cardiogenic shock, overt heart failure, second or third degree A-V block, right ventricular failure secondary to pulmonary hypertension and sinus bradycardia.

Gastro-intestinal disturbances, bradycardia, hypotension, headache, fatigue, sleep disturbances, dizziness, vertigo, thrombocytopenia, visual disturbances, alopecia may be occurred.

The safety of bisoprolol during pregnancy has not been established. No data is available for lactation.

Monitoring of renal, hepatic and hematopoietic function should be performed at regular intervals during long-term treatment with bisoprolol.

Anti adrenergic agent (Beta blockers), Beta-adrenoceptor blocking drugs, Beta-blockers

Keep in a dry place away from light and heat. Keep out of the reach of children.