Bisoprolol oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.
Examples of drugs that can cause interactions with bisoprolol are listed below.
Heart rhythm drugs
These heart rhythm drugs may cause a lower heart rate or more side effects. If you take these drugs with bisoprolol, you’ll be monitored closely. Your doctor might change the dosage of your heart rhythm drugs. Examples of these drugs include:
- sotalol
- amiodarone
- bretylium
- quinidine
- disopyramide
- encainide
- flecainide
- propafenone
- procainamide
- digoxin
Beta-blockers
Bisoprolol should not be used with another beta-blocker because your heart rate can be lowered too much. Examples of these drugs include:
- acebutolol
- atenolol
- carvedilol
- metoprolol
- propranolol
- Dihydropyridine calcium channel blockers: Using these drugs with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This raises your risk of falls. Examples of these drugs include:
- amlodipine
- felodipine
- nifedipine
- Non-dihydropyridine calcium channel blockers: Using verapamil with bisoprolol can cause severe heart block, low heart rate, changes in how your heart works, heart failure, and low blood pressure. If you have poor function of your heart ventricles, you should not use these drugs together.
- Bisoprolol and diltiazem have a similar action on the heart. Using one of these drugs with bisoprolol can cause heart failure, a heart rate that’s lower than average, low blood pressure, problems with how the heart works, and heart block.
- Clonidine: If you’re starting bisoprolol and stopping clonidine, your blood pressure can severely increase. If you’re on both medications and are going to stop taking clonidine, your doctor should stop bisoprolol several days before stopping clonidine.
- Reserpine: Using this drug with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This can increase your risk of falls.
Anti-infective drug
Using rifampin with bisoprolol can speed up the rate at which bisoprolol leaves your body. This can prevent bisoprolol from working as well as it should.
Alpha-blockers
Using these drugs with bisoprolol may cause a drop in your blood pressure when you change position from sitting to standing or from lying down to sitting. This raises your risk of falls. Examples of these drugs include:
- doxazosin
- prazosin
- terazosin
Anesthetic
Bisoprolol might affect how lidocaine is cleared from your body. This can cause lidocaine toxicity. Your doctor may check your blood levels if you use these drugs together.
Malaria drug
Using mefloquine with bisoprolol can cause heart rhythm abnormalities, and your heart may stop working.
Stimulants
Do not use these drugs with bisoprolol. If you take them together, they will cancel out the action of each other and will not work. Examples of these drugs include:
- norepinephrine
- phenylephrine
Over-the-counter cough, cold, allergy, and pain drugs
Do not take these drugs without talking with your doctor or pharmacist. Some over-the-counter drugs contain ingredients that can increase your blood pressure. Other drugs may cancel out the action of bisoprolol. Examples of these drugs include:
- products containing phenylephrine, such as:
- Sudafed PE
- Mucinex Sinus-Max
- Advil Congestion Relief
- Tylenol Cold Multi-Symptom
- products containing pseudoephedrine, such as:
- Sudafed Congestion
- Sudafed 12 Hour
- Sudafed 24 Hours
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs may decrease the blood pressure-lowering effects of bisoprolol. If you take them with bisoprolol, your doctor will likely monitor your blood pressure and change your bisoprolol dosage if needed. Examples of these drugs include:
- indomethacin
- naproxen
- piroxicam
- sulindac
- nabumetone
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
