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Beta Blocker·Cardiovascular - Beta Blockers
Stable chronic HFrEF, hypertension, angina
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Max Dose
10 mg/day
Half-life
10–12 h
Cardioselective
YES
Heart Failure
INDICATED
Avoid / Cautions
Acute decompensated heart failure, cardiogenic shock, 2nd/3rd degree heart block, severe asthma. Pregnancy Category C.
Overview
Highly cardioselective (Beta-1) beta-blocker. Exceptional evidence base for reducing mortality in chronic heart failure with reduced ejection fraction (HFrEF).
Clinical Focus
Titration in heart failure must be 'start low, go slow' to prevent acute decompensation.
Bottom Line
Bisoprolol is the most cardioselective beta-blocker with strong heart failure mortality evidence, but must be up-titrated slowly and never stopped abruptly.
Brand Names
Bicor, Bisoprolol Sandoz
Oral Routes
Tablets (1.25 mg, 2.5 mg, 5 mg, 10 mg).
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Stable chronic HFrEF, hypertension, angina.
Clinical Place
One of the three core beta-blockers (alongside carvedilol and metoprolol succinate) with proven mortality benefit in HFrEF.
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