Bisoprolol

Hypertension and angina pectoris: The dosage should be individually adjusted, according to the heart frequentation and the therapeutical effect. The recommended dose is 1 film-coated tablet of 5 mg once daily. If necessary the dose can be increased to 10 mg daily with a maximum recommended dose of 20 mg per day. The whole film-coated tablet should be swallowed with a little liquid. It’s recommended to be taken in the morning during or before breakfast.

In patients with coronary heart disease (angina pectoris) treatment should not be stopped abruptly. The dosage should be diminished slowly during 1-2 weeks. No dosage adjustment is required in patients with kidney and liver impairment.

Only in patients with severe renal impairment (terminal renal insufficiency; creatinine clearance < 20 ml/min) and patients with a severe liver impairment the dose should not exceed 10 mg once dally.

Stable, chronic, moderate to severe heart failure: The following dosage scheme is recommended: – 1,25 mg bisoprolol once daily for 7 days. – When this dose is well tolerated it should be increased to 2,5 mg once daily for 7 days. In some patients, this dose may be enough as well as a sustainment dose. – The next dosage increase is up to 3,75 mg bisoprolol, once daily for 7 days. – When the previous dose is well tolerated than it’s increased to 5 mg bisoprolol, once daily for 4 weeks. – When this dose is well tolerated, the next increase is to 7,5 mg bisoprolol, once daily for 4 weeks. – The maximal sustainment dose is 10 mg bisoprolol once daily. At the beginning of the treatment with 1,25 mg bisoprolol, the patient should be monitored during the first 4 hours (blood pressure, heart frequency, a disorder of the heart conductivity as well as symptoms of heart deficiency). Earlier after a 12-week progressive increase of the dose the recommended maximal sustainment dose is achieved. The recommended maximal maintaining dose of 10 mg bisoprolol is achieved earliest after 12 weeks of progressive increase of the dose. The dose can be decreased or the treatment stopped if needed, and later it can be continued.

At patients with hepatic and renal impairment, titration of the dose should be with particular precaution. In the case of the ceasing of the therapy, the dose should be gradually decreased. The dosage should be diminished slowly by a weekly halving of the dose. Abruptly cessation of the therapy might cause temporary deterioration of heart failure.

No dosage adjustment is required.

It is not recommended the usage of bisoprolol at children’s age.