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Bisoprolol is a beta blocker, specifically a selective adrenergic receptor blocker, belonging to a class of drugs which work directly on the heart and blood circulation. It is mainly used to treat cardiovascular diseases like hypertension (high blood pressure), coronary heart disease, arrhythmias (irregular heartbeat), ischemic heart disease (restricted blood supply to the heart), and myocardial infarction (necrosis of the heart muscle leading to heart attack).

Bisoprolol works by blocking the heart's beta-adrenergic receptors, which are found in the body's sympathetic nervous system. This reduces the heart rate and prevents abnormal rapid heartbeat, while relaxing the blood vessels so the heart does not need to pump too hard.

This drug is also used to treat patients with congestive heart failure by to reducing the heart muscle's oxygen consumption. It decreases the heart's contraction force while lowering blood pressure, and in doing so lessens the heart's need for oxygen. When the heart's need for oxygen exceeds the amount supplied to it, heart pain or angina occurs. This makes Bisoprolol ideal in the treatment of angina.

Other illnesses indicated include dysautonomia (disorder of the autonomic nervous system), anxiety, and hyperthyroidism (an overactive thyroid gland).

Before taking Bisoprolol, patients should inform their doctor if they are allergic to the drug or to any other medications. The doctor should be aware if the patient is currently taking any prescription or over-the-counter medications, including vitamin, mineral or herbal supplements. The doctor will need to change the Bisoprolol dosage in patients taking calcium channel blockers like diltiazem, verapamil, clonidine, or guanethidine; drugs indicated for irregular heartbeat like disopyramide, other beta blockers like reserpine, and other contraindicated drugs such as rifampin and digoxin. In these cases close monitoring during Bisoprolol therapy is needed.

The doctor will also need to know if the patient has asthma or other bronchial diseases; a slow heart rate; a history of heart failure; any existing liver, kidney or heart disease; diabetes; allergies; circulation disorders, or hyperthyroidism. Bisoprolol use is contraindicated for these ailments.

The FDA has classified Bisoprolol under pregnancy category C, which means it is yet unknown whether the drug can harm an unborn child. Female patients need to inform their medical practitioner if they are pregnant, plan to get pregnant, or become pregnant during the course of treatment. This holds true for breastfeeding patients, as well, since Bisoprolol can be secreted into breastmilk and may harm a nursing infant.

Patients also need to disclose their existing Bisoprolol therapy prior to any type of surgery, including dental procedures. Bisoprolol medication will have to be temporarily ceased under medical supervision before undergoing a surgical procedure.

As Bisoprolol can cause drowsiness and reduce alertness, patients are advised not to drive a vehicle or operate any kind of machinery while on medication. Drinking alcoholic beverages may also exacerbate the effect of dizziness that Bisoprolol may cause.

Bisoprolol may cause side effects which are mild and easily tolerated. In rare instances, it may result in headaches, nausea, abdominal cramping, diarrhea, impotence, slow heart rate, unexplained weight gain, low blood pressure, numbness and tingling, sore throats, clamminess and swelling of the hands and feet, fainting, and wheezing or shortness of breath. If these symptoms continue, patients are advised to consult their doctor immediately.

Diabetics should inform their doctor if they are taking Bisoprolol, as the drug can alter the results of blood tests for diabetes, particularly that for hypoglycemia, or low blood sugar.

Distributed under the brand names Concor, Zebeta, Concore and Monocor, it is available by prescription in 5mg and 10mg pink, heart-shaped, film-coated tablets. Bisoprolol should be taken orally according to the doctor's directions, once daily with water, at the same time each day. The doctor may also prescribe a low-salt diet to complement treatment.

Because Bisoprolol may only form a part of a comprehensive treatment program for hypertension, it cannot get rid of the disease altogether. Patients are encouraged to stick to a healthy diet, regular exercise and their prescribed medication to control hypertension.

Bisoprolol is considered a preventive maintenance drug that a patient may need to take for the rest of their lives, even in the absence of hypertensive symptoms. Suddenly stopping Bisoprolol therapy without prior medical advice may cause the patient's condition to worsen.

Bisoprolol has the following structural formula:

Chemical structure of bisoprolol

• Molecular formula of bisoprolol is C18H31NO4
• Chemical IUPAC Name is 1-[4-[2-(1-methylethoxy)ethoxymethyl]phenoxy]-3-(1-methylethylamino)propan-2-ol
• Molecular weight is 325.443 g/mol
Bisoprolol available : 5mg tablets, 10mg tablets

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