Adult Dosing

Hypertension

• Start 2.5 mg-5 mg PO Daily
• May increase to 10 mg PO Daily if response inadequate
• MAX: 20 mg/day

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Management of hypertension, alone or in combination

• Hypersensitivity
• Overt cardiac failure
• Pulmonary edema
• Cardiogenic shock
• Marked Sinus Bradycardia
• 2nd or 3rd degree AV block

Renal Dose Adjustment (Based on CrCl)

• <40 mL/min: Start 2.5 mg PO Daily
• Hemodialysis: No supplement

Hepatic Dose Adjustment

• Cirrhosis/Hepatitis: 2.5 mg PO Daily

• Use of beta-blockers in CHF may result in further depression of myocardial contractility, and precipitate more severe failure
• Avoid use in bronchospastic disease. If used, give lower doses initially (e.g. 2.5 mg) in patients with bronchospastic disease
• Discontinue drug gradually over 2 weeks
• Beta-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease
• Beta-blockers may mask some of the manifestations of hypoglycemia, particularly tachycardia. Use cautiously in diabetes mellitus
• Warn patients against discontinuing drug without physician's supervision

Cautions: Use cautiously in

• Hepatic impairment
• Renal impairment
• Hx of anaphylactic reactions
• Bronchospastic disease
• PVD
• Recent myocardial infarction
• WPW syndrome
• Diabetes mellitus
• Thyroid disorder
• Anaesthesia and major surgery
• Concomitant calcium antagonists
• Pregnancy
• Lactation

Zebeta interacts with :

	Aricept
	Aricept ODT
	Donepezil
	Exelon
	Galantamine
	Razadyne
	Razadyne ER
	Rivastigmine

Pregnancy Category:C

Breastfeeding: Extensively excreted in breastmilk. Limited published experience with bisoprolol during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 6 May 2010). Manufacturer advises caution.

• CNS: Dizziness, headache, hypoaesthesia, vertigo, syncope, paresthesia, hyperesthesia, somnolence, sleep disturbances, insomnia decreased concentration/memory
• PSYCHIATRIC: Unsteadiness, vivid dreams, depression, anxiety/restlessness, altered sensorium, emotional lability, concentration/memory, altered sensorium, emotional lability
• CV: Bradycardia, CHF, pulmonary edema, palpitations, rhythm disturbances, claudication, cold extremities, hypotension, orthostatic hypotension, chest pain, dyspnea on exertion
• GI: Nausea, vomiting, diarrhea, gastric/epigastric/abdominal pain, gastritis, dyspepsia, constipation, peptic ulcer, mesenteric arterial thrombosis, ischemic colitis
• MUSC: Arthralgia, back/neck pain, muscle cramps, twitching, tremors
• DERM: Skin irritation, pruritus, flushing, rash, acne, eczema, psoriasis, increased sweating, alopecia, dermatitis, exfoliative dermatitis, cutaneous vasculitis
• EENT: Visual disturbances, abnormal lacrimation, ocular pain/pressure, tinnitus, decreased hearing, taste abnormalities, laryngospasm
• METABOLIC: Gout
• RESP: Bronchospasm, cough, dyspnea, pharyngitis, rhinitis, sinusitis, URTI
• GU:: Decreased libido/impotence, cystitis, Peyronie’s disease, renal colic, polyuria
• HEMA: Purpura, agranulocytosis, thrombocytopenia, thrombocytopenic purpura
• MISC: Fatigue, malaise, asthenia, chest pain, edema, weight gain, angioedema, oculomucocutaneous syndrome

• Mechanism of action: selective antagonist of beta-1 adrenergic receptors in myocardial and vascular smooth muscle
• Metabolized by liver, CYP450: unknown
• Renally excreted (50% unchanged); feces < 2%
• Half-life: 9-12 hrs

US Trade Name(s)

• Zebeta

US Availability

bisoprolol (generic)

• TABS: 5, 10 mg

Zebeta

• TABS: 5, 10 mg

Canadian Trade Name(s)

• Only generic available

Canadian Availability

bisoprolol (generic)

• TABS: 5, 10 mg

UK Trade Name(s)

• Cardicor
• Emcor
• Emcor LS

UK Availability

bisoprolol (generic)

• TABS: 1.25, 2.5, 3.75, 5, 7.5, 10 mg

Cardicor

• TABS: 1.25, 2.5, 3.75, 5, 7.5, 10 mg

Emcor

• TABS: 10 mg

Emcor LS

• TABS: 5 mg

Australian Trade Name(s)

• Bicor
• Bispro

Australian Availability

bisoprolol (generic)

• TABS: 2.5, 5, 10 mg

Bicor

• TABS: 1.25, 2.5, 5, 10 mg

Bispro

• TABS: 2.5, 5, 10 mg

[Outline]

Cardiovascular

Beta-adrenergic Blockers

Cardioselective

Pricing data from www.DrugStore.com in U.S.A.

• Zebeta 5 MG TABS [Bottle] (TEVA/WOMENS HEALTH)
  30 mg = $114.43
  90 mg = $337.86
• Zebeta 10 MG TABS [Bottle] (TEVA/WOMENS HEALTH)
  30 mg = $114.43
  90 mg = $337.86

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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