What side effects can bisoprolol have?
Below you will find the most important information about possible known side effects of bisoprolol.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Common side effects:
tiredness, dizziness, headache, depressive moods, confusion, nightmares, increased dream activity, sleep disorders, delusions, nervous abnormalities, feeling of cold on legs and arms, increased drop in blood pressure (even when moving from lying to standing), too slow heartbeat, AV block, increase of heart failure with fluid retention and / or difficulty breathing, enhancement of local circulatory disorders (eg Raynaud’s syndrome), loss of appetite, nausea and vomiting, constipation, diarrhea, abdominal pain, abdominal cramps, muscle weakness, muscle spasms, allergic skin reactions ( redness, itching, rash, hives), sweating, disorders of the fat metabolism.
Uncommon side effects:
blurred vision, conjunctivitis, dry eyes (this is important when wearing contact lenses).
Very rare side effects:
joint inflammation (with involvement of one or more joints), disorders of libido, impotence, increase of transaminases (GOT, GPT) in the blood, hepatitis, development of psoriasis, exacerbation of psoriasis, hair loss, hearing impairment , Tinnitus, weight gain, emotional changes, short-term memory loss, hay fever, penile stiffening, increased tendency to allergic reactions.
Adverse events of unknown incidence:
Diabetes, diabetes mellitus, in patients with hyperthyroidism, signs of thyroid toxicity (such as palpitations and tremors) may be obscured.
After a sudden end of therapy with the active ingredient, there is often a rapid increase in high blood pressure (rebound phenomenon).
Prolonged fasting and heavy physical exertion may result in hypoglycaemia or concealment of the warnings of an onset hypoglycaemia.
Increased sensitivity to allergens may occur. In this context, severe hypersensitivity reactions are especially possible during the desensitization phase (therapy for the reduction of allergic reactions).
What interactions does bisoprolol show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
The hypotensive effect of bisoprolol can be massively increased by the concomitant use of other means of lowering blood pressure such as ACE inhibitors), vasodilators (such as dihydralazine and hydralazine), dehydrating agents (diuretics) or calcium channel blockers of the nifedipine type be.
This is also the case when sedatives (barbiturates), neuroleptics, H1 antihistamines, anesthetics, tricyclic antidepressants or alcohol are consumed at the same time. Such an (excessive) drop in blood pressure can lead to the development of myocardial insufficiency.
Calcium channel blockers of the verapamil or diltiazem type and agents that make the heart beat more regularly (antiarrhythmic drugs), lead to a reduction in cardiac output (cardiodepressive effect). Lower blood pressure, slower heart rate, cardiac arrhythmia, heart failure can all be the result. Intravenous administration of these agents should be withheld, except for intensive care, during use. Verapamil must not be administered to the veins until 48 hours after the drug combination has been discontinued.
Special blood pressure medications such as reserpine, alpha-methyldopa, guanethidine, guanfacine, cardiac glycosides or clonidine result in a greater decrease in heart rate and delay in cardiac conduction. In particular, after the discontinuation of clonidine, there may be a strong increase in blood pressure. The application of the drug combination may therefore only begin several days after the discontinuation of clonidine.
Blood pressure-increasing agents such as norepinephrine, adrenaline or MAO inhibitors (except MAO-B inhibitors) weaken the blood pressure-lowering effect and there is an excessive increase in blood pressure.
Coagulation of hypoglycaemic agents such as insulin or oral antidiabetics may increase hypoglycaemia. The symptoms of hypoglycaemia, but especially the rapid pulse (tachycardia) and tremor (tremor) can be obscured or mitigated. In diabetics, therefore, regular blood sugar checks are required.
In addition, there may be increased circulatory problems with bisoprolol and migraine (ergot alkaloids).
Alpha-sympathomimetics (including tacrine), when given concomitantly, may extend the conduction time in the atrioventricular node of the heart and induce cardiac arrhythmias.
If digoxin is used to boost cardiac strength at the same time, digoxin secretion in the blood will be delayed. Therefore, medical supervision and monitoring of the amount of digoxin in the blood is necessary. If necessary, a reduction in the dose of digoxin is required.
There is an increased risk of heartbeat reduction (bradycardia) when co-administered with the antimalarial mefloquine agent.
Rheumatoid and analgesics such as indomethacin or ibuprofen weaken the hypotensive effect of bisoprolol. Tuberculosis drugs (such as rifampicin) also reduce the efficacy of bisoprolol and should not be given concomitantly.
Stomach acid inhibitors (antacids) such as cimetidine or ranitidine also increase the blood pressure lowering effect.