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Specific Safety Concerns With Bisoprolol

Specific Bisoprolol Warnings and Precautions

Some precautions and warnings to be aware of prior to taking bisoprolol include the following:
  • As with all beta blockers, you should not abruptly stop taking bisoprolol, as serious problems (including heart attacks) may result. Your healthcare provider will advise you about how to safely stop taking this medication. It is usually recommended to slowly reduce the dose over a period of one to two weeks, with careful monitoring. Physical activity should be minimized during this time. Let your healthcare provider know if you develop chest pain or any other problems while stopping bisoprolol.
  • Bisoprolol can worsen heart failure in some situations. However, beta blockers are also useful for the treatment of heart failure. If you have heart failure, your healthcare provider may need to monitor you closely while you take this drug. Let your healthcare provider know immediately if your heart failure symptoms seem to worsen during treatment.
  • Beta blockers can make breathing problems like asthma or COPD worse. If you have breathing problems, check with your healthcare provider before taking bisoprolol. Even though it is a "cardioselective" beta blocker, which makes it less likely to cause breathing problems, such problems are still possible, especially with a high bisoprolol dosage.
  • If you will be having surgery, make sure your surgeon and anesthesiologist know you take bisoprolol, as it may affect the choice of medications used during surgery.
  • Beta blockers can mask some of the symptoms of low blood sugar (hypoglycemia), particularly the "racing heart" feeling. This can cause serious problems for people with diabetes, who need to be able to sense that they have low blood sugar in order to correct it before it becomes life-threatening.
  • Beta blockers can mask some of the symptoms of an overactive thyroid (hyperthyroidism). Stopping bisoprolol suddenly could cause symptoms of a "thyroid storm" (a sudden and severe worsening of hyperthyroidism symptoms).
  • Bisoprolol can potentially interact with many other medications (see Drug Interactions With Bisoprolol).
  • The kidneys and liver help remove bisoprolol from the body. Therefore, if you have kidney or liver disease, your healthcare provider may need to monitor your response to this medication more closely and a lower dosage may be recommended.
  • If you have an anaphylactic allergy (the type that affects the entire body and often interferes with breathing), bisoprolol may make you more sensitive to the allergen and may make the usual treatments (such as epinephrine or an EpiPen®) less effective.
  • Bisoprolol is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see Bisoprolol and Pregnancy).
  • At this time, it is unknown if bisoprolol passes through breast milk in humans. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Bisoprolol and Breastfeeding).
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