Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Antihypertensive

Bisoprolol

Brand names: Cardicor, Emcor

Used in: Atrial Fibrillation Acute Coronary Syndrome & Chest Pain Heart Failure Hypertension

Bisoprolol is a cardioselective beta-blocker used in chronic heart failure, angina, hypertension and rate control.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION The dose of bisoprolol fumarate tablets 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 (see Bronchospastic Disease in WARNINGS ). 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. Patients with Renal or Hepatic Impairment In patients with hepatic impairment (hepatitis or cirrhosis) or renal dysfunction (creatinine clearance less than 40 mL/min), the initial daily dose should be 2.5 mg and caution should be used in dose-titration. Since limited data suggest that bisoprolol …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-06-26. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It selectively blocks β1-adrenoceptors, reducing heart rate, contractility and AV-node conduction and lowering myocardial oxygen demand. In heart failure, slow up-titration improves prognosis.

Prescribing in practice

  • In heart failure, start low and up-titrate slowly only when the patient is stable and euvolaemic — do not start during decompensation.
  • Do not stop abruptly in ischaemic heart disease; taper to avoid rebound.
  • Use caution in asthma — cardioselectivity is relative and is lost at higher doses.
  • It can mask the warning signs of hypoglycaemia in diabetes.

Monitoring

Monitor heart rate, blood pressure and heart-failure symptoms during titration.

Counselling the patient

  • Do not stop suddenly without advice.
  • Some tiredness, cold hands or a slower pulse can occur, especially early on.
  • Report worsening breathlessness, swelling, or a very slow pulse with dizziness.

Evidence & guidelines

Prognostic benefit in HFrEF is well established (e.g. CIBIS-II); recommended within guideline-directed therapy in NICE NG106.

Reference: NICE NG106 Chronic HF; CIBIS-II Trial Lancet 1999; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Drugs
Same class
Pathways
Same specialty