Bisoprolol (Concor, Bisotrol)

Bisoprolol (Concor, bisotrol) is a selective Beta-1 receptor inhibitor that selectively and competitively blocks the Beta-1 receptors without affecting the Beta-2 receptors especially at doses of less than 20 mg per day. It is one of the WHO's lists of essential medicine and is used to treat the following conditions:

Management of hypertension (Not recommended as first-line of therapy)
Off Label Use of Bisoprolol in Adults include:
- Acute Myocardial infarction
- For rate control in atrial fibrillation
- Heart failure with a reduced ejection fraction
- Ventricular arrhythmias
- Chronic stable angina
- Supraventricular arrhythmias.

Bisoprolol dose in adults:

Bisoprolol as off-label use in the treatment of Atrial fibrillation (for rate control):
- 2.5 - 10 mg once a day.

Off-label use in the treatment of Heart failure with a reduced ejection fraction:
- 1.25 mg orally once a day.
- The dose may be doubled every 2 weeks or more to the maximum tolerated dose (the maximum dose should not exceed 10 mg/day.
- Bisoprolol therapy should be initiated only once the patient is stable, the volume status is optimized, inotropes, vasopressors, and intravenous diuretics have been discontinued.

Use as an alternative agent in Hypertension:
- 2.5 - 5 mg orally once a day.
- The dose may be titrated to a maximum dose of 20 mg once a day.
- The usual dose ranges between 2.5 - 10 mg once a day.

Off label use in the treatment of Ventricular arrhythmias:
- 5 - 10 mg orally once a day.

Bisoprolol for anxiety:

2.5 - 5 mg once daily

Bisoprolol Dose in Childrens

Not recommended for use in children.

Pregnancy Risk Factor C

Bisoprolol has been linked to fetal bradycardia, hypoglycemia and a decreased birth weight.
However, maternal hypertension can also lead to adverse maternal and fetal outcomes.
Like other beta-blockers such as bisoprolol in pregnancy, it can be used to treat hypertension and heart failure. However, you should first consider other agents.

Bisoprolol use during breastfeeding:

It is unknown if bisoprolol can be absorbed into breastmilk.
You should be cautious when using it in nursing women.
Patients with peripartum cardiomyopathy should not breastfeed.

Bisoprolol Dose in Renal Disease:

For the treatment of hypertension:
- CrCl of 40 mL/minute or more:
  - No dose adjustment is required as per the manufacturer's labeling.
- CrCl of less than 40 mL/minute:
  - 2.5 mg once a day.
  - Increase the drug with caution.
For the treatment of Heart failure as off-label use:
- Data is limited. However, may initiate at a dose of 1.25 mg once a day to a maximum dose of 2.5 mg once a day.
Hemodialysis:
- It is not dialyzable.

Bisoprolol Dose in Liver Disease:

Bisoprolol Dose in Chronic liver disease:
- 2.5 mg once a day.
- The dose may be increased cautiously.

Common Bisoprolol Side Effects Include:

Cardiovascular:
- Chest Pain
Central Nervous System:
- Fatigue
- Hypoesthesia
Gastrointestinal:
- Diarrhea
- Vomiting
Hepatic:
- Increased Serum Alanine Aminotransferase
- Increased Serum Aspartate Aminotransferase
Respiratory:
- Upper Respiratory Tract Infection
- Dyspnea

Bisoprolol side effects (rare):

Cardiovascular:
- Cardiac Arrhythmia
- Cardiac Failure
- Claudication
- Cold Extremities
- Edema
- Flushing
- Hypersensitivity Angiitis
- Hypotension
- Orthostatic Hypotension
- Palpitations
Central Nervous System:
- Anxiety
- Depression
- Dizziness
- Drowsiness
- Headache
- Hyperesthesia
- Insomnia
- Lack Of Concentration
- Malaise
- Memory Impairment
- Paresthesia
- Restlessness
- Sensation Of Eye Pressure
- Twitching
- Vertigo
- Vivid Dream
Dermatologic:
- Acne Vulgaris
- Alopecia
- Diaphoresis
- Eczema
- Pruritus
- Skin Irritation
- Skin Rash
Endocrine & Metabolic:
- Decreased Libido
- Gout
- Increased Serum Glucose
- Increased Serum Phosphate
- Increased Serum Potassium
- Increased Serum Triglycerides
- Increased Uric Acid
- Weight Gain
Gastrointestinal:
- Abdominal Pain
- Constipation
- Dysgeusia
- Dyspepsia
- Epigastric Pain
- Gastric Pain
- Gastritis
- Nausea
- Peptic Ulcer
- Xerostomia
Genitourinary:
- Cystitis
- Impotence
Hematologic & Oncologic:
- Decreased White Blood Cell Count
- Positive ANA Titer
- Purpuric Rash
- Thrombocytopenia
Neuromuscular & Skeletal:
- Back Pain
- Muscle Cramps
- Myalgia
- Neck Pain
- Tremor
Ophthalmic:
- Abnormal Lacrimation
- Eye Pain
- Visual Disturbance
Otic:
- Otalgia
- Tinnitus
Renal:
- Increased Blood Urea Nitrogen
- Increased Serum Creatinine
- Polyuria
- Renal Colic
Respiratory:
- Asthma
- Bronchitis
- Bronchospasm
- Cough
- Dyspnea On Exertion
- Pharyngitis
- Rhinitis
- Sinusitis

Contraindication to Bisoprolol include:

Cardiogenic shock
Overt heart failure
Sinus bradycardia marked
Heart block of second or third degree
Allergic reaction to the drug

Warnings and Precautions

Anaphylactic reactions
- It has been associated with severe allergic reactions, including anaphylaxis.
- Patients being treated for anaphylaxis might not respond to epinephrine while on beta-blocker therapy.
Bronchospastic disease
- Patients with an allergic airway disease should not use Beta-blockers.
- If used, the lowest possible dose should be advised and an inhaled Beta-1 agonist therapy should be available for immediate relief if the condition worsens.
- Asthmatics should not take more than 20 mg of bisoprolol daily.
Conductive abnormality
- Patients suffering from sick sinus syndrome should not receive beta-blockers.
Diabetes:
- It can increase hypoglycemia and mask hypoglycemia symptoms in diabetic patients.
Heart failure:
- Patients with compensated cardiac failure should use it with caution.
- Low doses of therapy should be used and patients should be closely monitored.
Hepatic impairment
- Patients with severe liver disease should be cautious.
- Patients with severe hepatic impairment may need to adjust their dose.
Myasthenia gravis:
- Patients with myasthenia gravis should be careful when using bisoprolol.
Raynaud and peripheral vascular disease (PVD).
- It can worsen the symptoms of arterial impairment in patients with Raynaud and peripheral vascular disease.
- Monitor your patient for any worsening symptoms while on beta-blocker therapy.
Pheochromocytoma:
- A sufficient amount of alpha-blockade must be achieved before you can start therapy with a beta blocker.
Angina Prinzmetal version:
- Patients with Prinzmetal variant Angina should not be treated with beta-blockers that do not block alpha1adrenergic receptor activity.
- This could cause coronary vasoconstriction, and worsen anginal symptoms.
Psoriasis:
- Beta-blockers can cause psoriasis patients to experience worsening symptoms.
Renal impairment
- Patients with impaired renal function should be cautious when taking the drug.
- If the CrCl level is below 40 ml/min, adjustments may be necessary in the dosage.
Thyroid disease:
- It can mask hyperthyroidism symptoms.
- Patients with hyperthyroidism should not abruptly stop taking beta-blockers as this could lead to a thyroid storm.

Bisoprolol: Drug Interaction

Risk Factor C (Monitor therapy)
Acetylcholinesterase Inhibitors	May enhance the bradycardic effect of Beta-Blockers.
Alfuzosin	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Alpha1-Blockers	Beta-Blockers may enhance the orthostatic hypotensive effect of Alpha1Blockers. The risk associated with ophthalmic products is probably less than systemic products.
Aminoquinolines (Antimalarial)	May decrease the metabolism of Beta-Blockers.
Amiodarone	May enhance the bradycardic effect of Beta-Blockers. Possibly to the point of cardiac arrest. Amiodarone may increase the serum concentration of Beta-Blockers.
Amphetamines	May diminish the antihypertensive effect of Antihypertensive Agents.
Antipsychotic Agents (Phenothiazines)	May enhance the hypotensive effect of Beta-Blockers. Beta-Blockers may decrease the metabolism of Antipsychotic Agents (Phenothiazines). Antipsychotic Agents (Phenothiazines) may decrease the metabolism of Beta-Blockers.
Antipsychotic Agents (Second Generation [Atypical])	Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]).
Barbiturates	May decrease the serum concentration of Beta-Blockers.
Barbiturates	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Benperidol	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Beta2-Agonists	Beta-Blockers (Beta1 Selective) may diminish the bronchodilatory effect of Beta2-Agonists. Of particular concern with nonselective beta-blockers or higher doses of the beta1 selective beta-blockers.
Bosentan	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Bradycardia-Causing Agents	May enhance the bradycardic effect of other Bradycardia-Causing Agents.
Bretylium	May enhance the bradycardic effect of Bradycardia-Causing Agents. Bretylium may also enhance atrioventricular (AV) blockade in patients receiving AV blocking agents.
Brigatinib	May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents.
Brimonidine (Topical)	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Bupivacaine	Beta-Blockers may increase the serum concentration of Bupivacaine.
Calcium Channel Blockers (Nondihydropyridine)	May enhance the hypotensive effect of BetaBlockers. Bradycardia and signs of heart failure have also been reported. Calcium Channel Blockers (Nondihydropyridine) may increase the serum concentration of Beta-Blockers. Exceptions: Bepridil.
Cardiac Glycosides	Beta-Blockers may enhance the bradycardic effect of Cardiac Glycosides.
Cholinergic Agonists	Beta-Blockers may enhance the adverse/toxic effect of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Management: Administer these agents in combination with caution, and monitor for conduction disturbances. Avoid methacholine with any beta blocker due to the potential for additive bronchoconstriction.
CYP3A4 Inducers (Moderate)	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Deferasirox	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Dexmethylphenidate	May diminish the therapeutic effect of Antihypertensive Agents.
Diazoxide	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Dipyridamole	May enhance the bradycardic effect of Beta-Blockers.
Disopyramide	May enhance the bradycardic effect of Beta-Blockers. Beta-Blockers may enhance the negative inotropic effect of Disopyramide.
DULoxetine	Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine.
EPINEPHrine (Nasal)	Beta-Blockers (Beta1 Selective) may diminish the therapeutic effect of EPINEPHrine (Nasal).
EPINEPHrine (Oral Inhalation)	Beta-Blockers (Beta1 Selective) may diminish the therapeutic effect of EPINEPHrine (Oral Inhalation).
Epinephrine (Racemic)	Beta-Blockers (Beta1 Selective) may diminish the therapeutic effect of Epinephrine (Racemic).
EPINEPHrine (Systemic)	Beta-Blockers (Beta1 Selective) may diminish the therapeutic effect of EPINEPHrine (Systemic).
Herbs (Hypertensive Properties)	May diminish the antihypertensive effect of Antihypertensive Agents.
Herbs (Hypotensive Properties)	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Hypotension-Associated Agents	Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents.
Insulins	Beta-Blockers may enhance the hypoglycemic effect of Insulins.
Ivabradine	Bradycardia-Causing Agents may enhance the bradycardic effect of Ivabradine.
Ivosidenib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Lacosamide	Bradycardia-Causing Agents may enhance the AV-blocking effect of Lacosamide.
Levodopa-Containing Products	Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products.
Lidocaine (Systemic)	Beta-Blockers may increase the serum concentration of Lidocaine (Systemic).
Lidocaine (Topical)	Beta-Blockers may increase the serum concentration of Lidocaine (Topical).
Lormetazepam	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Mepivacaine	Beta-Blockers may increase the serum concentration of Mepivacaine.
Methoxyﬂurane	May enhance the hypotensive effect of Beta-Blockers.
Methylphenidate	May diminish the antihypertensive effect of Antihypertensive Agents.
Midodrine	May enhance the bradycardic effect of Bradycardia-Causing Agents.
Molsidomine	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Naftopidil	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Nicergoline	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Nicorandil	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
NIFEdipine	May enhance the hypotensive effect of Beta-Blockers. NIFEdipine may enhance the negative inotropic effect of Beta-Blockers.
Nitroprusside	Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside.
Nonsteroidal Anti-Inﬂammatory Agents	May diminish the antihypertensive effect of BetaBlockers.
Opioids (Anilidopiperidine)	May enhance the bradycardic effect of Beta-Blockers. Opioids (Anilidopiperidine) may enhance the hypotensive effect of Beta-Blockers.
Pentoxifylline	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Pholcodine	Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine.
Phosphodiesterase 5 Inhibitors	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Propafenone	May increase the serum concentration of Beta-Blockers. Propafenone possesses some independent beta blocking activity.
Prostacyclin Analogues	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Quinagolide	May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Regorafenib	May enhance the bradycardic effect of Beta-Blockers.
Reserpine	May enhance the hypotensive effect of Beta-Blockers.
Rifamycin Derivatives	May decrease the serum concentration of Beta-Blockers. Exceptions: Rifabutin.
Ruxolitinib	May enhance the bradycardic effect of Bradycardia-Causing Agents. Management: Ruxolitinib Canadian product labeling recommends avoiding use with bradycardia-causing agents to the extent possible.
Sarilumab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Siltuximab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Sulfonylureas	Beta-Blockers may enhance the hypoglycemic effect of Sulfonylureas. Cardioselective beta-blockers (eg, acebutolol, atenolol, metoprolol, and penbutolol) may be safer than nonselective beta-blockers. All beta-blockers appear to mask tachycardia as an initial symptom of hypoglycemia. Ophthalmic beta-blockers are probably associated with lower risk than systemic agents.
Terlipressin	May enhance the bradycardic effect of Bradycardia-Causing Agents.
Theophylline Derivatives	Beta-Blockers (Beta1 Selective) may diminish the bronchodilatory effect of Theophylline Derivatives. Management: Monitor for reduced theophylline eﬃcacy during concomitant use with any beta-blocker. Beta-1 selective agents are less likely to antagonize theophylline than nonselective agents, but selectivity may be lost at higher doses.
Tocilizumab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Tofacitinib	May enhance the bradycardic effect of Bradycardia-Causing Agents.
Yohimbine	May diminish the antihypertensive effect of Antihypertensive Agents.
Risk Factor D (Consider therapy modification)
Alpha2-Agonists	May enhance the AV-blocking effect of Beta-Blockers. Sinus node dysfunction may also be enhanced. Beta-Blockers may enhance the rebound hypertensive effect of Alpha2Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Exceptions: Apraclonidine.
Amifostine	Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. If blood pressure lowering therapy cannot be withheld, amifostine should not be administered.
Ceritinib	Bradycardia-Causing Agents may enhance the bradycardic effect of Ceritinib. Management: If this combination cannot be avoided, monitor patients for evidence of symptomatic bradycardia, and closely monitor blood pressure and heart rate during therapy. Exceptions are discussed in separate monographs.
CYP3A4 Inducers (Strong)	May increase the metabolism of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be speciﬁcally contraindicated. Consult appropriate manufacturer labeling.
Dabrafenib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects).
Dronedarone	May enhance the bradycardic effect of Beta-Blockers. Dronedarone may increase the serum concentration of Beta-Blockers. This likely applies only to those agents that are metabolized by CYP2D6. Management: Use lower initial beta-blocker doses; adequate tolerance of the combination, based on ECG ﬁndings, should be conﬁrmed prior to any increase in betablocker dose.
Enzalutamide	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP3A4 substrate should be performed with caution and close monitoring.
Ergot Derivatives	Beta-Blockers may enhance the vasoconstricting effect of Ergot Derivatives. Exceptions: Nicergoline.
Fingolimod	Beta-Blockers may enhance the bradycardic effect of Fingolimod. Management: Avoid the concomitant use of ﬁngolimod and beta-blockers if possible. If coadministration is necessary, patients should have overnight continuous ECG monitoring conducted after the ﬁrst dose of ﬁngolimod. Monitor patients for bradycardia.
Grass Pollen Allergen Extract (5 Grass Extract)	Beta-Blockers may enhance the adverse/toxic effect of Grass Pollen Allergen Extract (5 Grass Extract). More speciﬁcally, Beta-Blockers may inhibit the ability to effectively treat severe allergic reactions to Grass Pollen Allergen Extract (5 Grass Extract) with epinephrine. Some other effects of epinephrine may be unaffected or even enhanced (e.g., vasoconstriction) during treatment with Beta-Blockers.
Lorlatinib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Avoid concurrent use of lorlatinib with any CYP3A4 substrates for which a minimal decrease in serum concentrations of the CYP3A4 substrate could lead to therapeutic failure and serious clinical consequences.
Mitotane	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Doses of CYP3A4 substrates may need to be adjusted substantially when used in patients being treated with mitotane.
Obinutuzumab	May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion.
Pitolisant	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Combined use of pitolisant with a CYP3A4 substrate that has a narrow therapeutic index should be avoided. Other CYP3A4 substrates should be monitored more closely when used with pitolisant.
Siponimod	Bradycardia-Causing Agents may enhance the bradycardic effect of Siponimod. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia.
St John's Wort	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be speciﬁcally contraindicated. Consult appropriate manufacturer labeling.
Risk Factor X (Avoid combination)
Bromperidol	Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Bromperidol may diminish the hypotensive effect of Blood Pressure Lowering Agents.
Floctafenine	May enhance the adverse/toxic effect of Beta-Blockers.
Methacholine	Beta-Blockers may enhance the adverse/toxic effect of Methacholine.
Rivastigmine	May enhance the bradycardic effect of Beta-Blockers.

Monitor:

Blood pressure
Heart rate
ECG
Serum glucose in patients with diabetes.

Target Blood pressure:

Target blood pressure of less than 130/80 mmHg in patients with hypertension and known cardiovascular disease or the 10-year ASCVD risk is greater than 10%.
The target blood pressure of less than 130/80 mmHg may be reasonable in patients with ASCVD risk.
Target blood pressure of less than 140/90 mmHg in patients aged 18 – 65 years with Diabetes and hypertension without cardiovascular disease and the 10-year ASCVD risk is less than 15%.
Target blood pressure of less than 130/80 mmHg in patients aged 18 – 65 years with Diabetes, hypertension, cardiovascular disease, or the 10-year ASCVD risk is greater than 15%.
Target blood pressure of less than 140/90 mmHg in patients aged more than 65 years and without major comorbid conditions.
Target blood pressure of less than 150/90 mmHg in patients aged more than 65 years and poor health or comorbid conditions.

How to take Bisoprolol (Bisotrol)?

It may be taken orally with or without regard to meals.

Mechanism of action of Bisoprolol (Bisotrol):

It selectively inhibits Beta-1 receptors.
It blocks Beta-1 receptors competitively, but has little to no effect on Beta-2 receptors when taken less than 20mg/day.

It is capable of initiating action at the rate ofIt takes between 1 and 2 hours. It is quickly absorbed completely and widely distributed throughout the body.

Concentrations higher than that are found in the liver, heart, lungs, saliva, and saliva. It crosses theBlood-brain barrierProtein-bound drugs account for 30% of drug's total weight. It is widely used.

Metabolized20% of the drug is first passed through the liver. It has been abioavailabilityOf 80%.

Bisoprololhalf-life eliminationPatients with normal renal function have a waiting time of 9-12 hours, patients with CrCl less than 40ml/min and patients with cirrhosis 8-22 hours.

TheTime to achieve peak effectIt can be seen in between 2 and 4 hours.excretedPrimarily in the urine

Bisoprolol brand names (International):

APO-Bisoprolol
MINT-Bisoprolol
MYLAN-Bisoprolol
PHL-Bisoprolol
PMS-Bisoprolol
PRO-Bisoprolol-10
PRO-Bisoprolol-5
RIntravenousA-Bisoprolol
SANDOZ Bisoprolol
TEVA-Bisoprolol
Adroten
Ancor
B-Beta
B-Cor
Beprol
Beta-One
Betabis
Betapro
Bicard
Bicor
Bilocor
Biol
Bipro
Biprolol
Biscor
Bisloc
Biso
Biso 5
Bisoblock
Bisocard
Bisocor
Bisohexal
Bisol
Bisolock
Bisomerck
Bisono Tape
Bisop
Bisopine
Bisostad
Bisosten
Bisoten
Bisotrol
Bispro
Biteven
Bosvate
Caprol
Carbisol
Cardensiel
Cardex
Cardiloc
Cardiosafe
Cobis
Colber
Concor
Concor COR
Concor-Cor
Concore
Corbis
Corbloc
Cordinorm
Corentel
Emconcor
Euradal
Hapsen
Hypercor
Isoten
Jutabis
Kenco
Maintate
Monocor
Novacor
Pactens
Probis
Sopalol
Soprol
Soprol-5
Vasoten
Zabesta

Bisoprolol Brand Names in Pakistan:

Bisoprolol (Fumarate) [Tabs 5 mg]
Actintramuscular	SAMI PHARMACEUTICALS (PVT) LTD.
Barilol	Barrett Hodgson Pakistan (Pvt) Ltd.
Biscord	Selmore Agencies
Biscot	Scotmann Pharmaceuticals
Bison	Siza International (Pvt) Ltd.
Bisprol	Kuratintravenouse Pak (Pvt) Ltd
Byso	Medizan Labs (Pvt) Ltd
Concor	Merck Printravenousate Ltd.
Corbis	Efroze Chemical Industries (Pvt) Ltd.
Monitor	Werrick Pharmaceuticals
Monocor	Standpharm Pakistan (Pvt) Ltd.
Probase	Mass Pharma (Printravenousate) Lintramuscularited
Safcor	Saffron Pharmaceutical Company
Sopral	Bryon Pharmaceuticals (Pvt) Ltd.
Valvozid	Pacific Pharmaceuticals Ltd.

Bisoprolol (Fumarate) [Tabs 10 mg]
Actintramuscular	SAMI PHARMACEUTICALS (PVT) LTD.
Barilol	Barrett Hodgson Pakistan (Pvt) Ltd.
Biscord	Selmore Agencies
Biscot	Scotmann Pharmaceuticals
Bisprol	Kuratintravenouse Pak (Pvt) Ltd
Byso	Medizan Labs (Pvt) Ltd
Concor	Merck Printravenousate Ltd.
Corbis	Efroze Chemical Industries (Pvt) Ltd.
Monitor	Werrick Pharmaceuticals
Monocor	Standpharm Pakistan (Pvt) Ltd.
Probase	Mass Pharma (Printravenousate) Lintramuscularited
Safcor	Saffron Pharmaceutical Company
Sopral	Bryon Pharmaceuticals (Pvt) Ltd.
Valvozid	Pacific Pharmaceuticals Ltd.

Bisoprolol (Fumarate) [Tabs 2.5 mg]
Actintramuscular	SAMI PHARMACEUTICALS (PVT) LTD.
Barilol	Barrett Hodgson Pakistan (Pvt) Ltd.
Concor	Merck Printravenousate Ltd.
Corbis	Efroze Chemical Industries (Pvt) Ltd.
Corbis	Efroze Chemical Industries (Pvt) Ltd.
Monitor	Werrick Pharmaceuticals
Safcor	Saffron Pharmaceutical Company
Sopral	Bryon Pharmaceuticals (Pvt) Ltd.