Zebeta Side Effects

Generic Name: bisoprolol

Note: This document contains side effect information about bisoprolol. Some of the dosage forms listed on this page may not apply to the brand name Zebeta.

Some side effects of Zebeta may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to bisoprolol: oral tablet

Along with its needed effects, bisoprolol (the active ingredient contained in Zebeta) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking bisoprolol:

Less common
  • Body aches or pain
  • chest pain
  • chills
  • cough
  • difficult or labored breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • pain or tenderness around eyes and cheekbones
  • shortness of breath or troubled breathing
  • sneezing
  • sore throat
  • stuffy or runny nose
  • tightness in chest
  • unusual tiredness or weakness
  • wheezing
Rare
  • Chest discomfort
  • lightheadedness, dizziness, or fainting
  • slow or irregular heartbeat

Get emergency help immediately if any of the following symptoms of overdose occur while taking bisoprolol:

Symptoms of overdose
  • Anxiety
  • blurred vision
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • decreased urine output
  • depression
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • extreme fatigue
  • fast heartbeat
  • increased hunger
  • irregular breathing
  • nausea
  • nervousness
  • nightmares
  • noisy breathing
  • seizures
  • shakiness
  • slurred speech
  • sweating
  • swelling of face, fingers, feet, or lower legs
  • weight gain

Some side effects of bisoprolol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Abnormal or decreased touch sensation
  • diarrhea
  • difficulty in moving
  • lack or loss of strength
  • muscle pain or stiffness
  • pain in joints
  • sleeplessness
  • trouble sleeping
  • unable to sleep
  • vomiting

For Healthcare Professionals

Applies to bisoprolol: oral tablet

General

Bisoprolol is generally well-tolerated. In one placebo-controlled trial, the withdrawal rate associated with bisoprolol (the active ingredient contained in Zebeta) and placebo were 3.3% and 6.8%, respectively.

In a review of heart failure trials, beta-blockers (i.e., carvedilol, metoprolol, bisoprolol) were associated with increased risks of hypotension, dizziness, and bradycardia, but not fatigue compared with placebo. In addition, beta-blocker therapy was associated with fewer overall all-cause withdrawals and less heart failure deterioration than placebo.

Cardiovascular

Cardiovascular side effects include bradycardia, dizziness, and dyspnea. Like other beta-blockers, bisoprolol (the active ingredient contained in Zebeta) may decrease myocardial contractility, which may be important in some patients with poor left ventricular systolic function. Unusual side effects include palpitations, mild heart rhythm disturbances, and orthostatic hypotension. Claudication is reported, and may be more likely in patients with peripheral vascular disease.

Nervous system

More common nervous system side effects include fatigue (4% to 25%), dizziness (3% to 10%), and headache (2% to 10%). Paresthesias, somnolence, decreased concentration or memory, anxiety, and vertigo have been reported in 1% to 10% of patients. Abnormal dreams have been reported rarely.

Respiratory

Wheezing is a rare respiratory system side effect that is associated with beta-blockers. This is due to beta-blockade of bronchial dilation, and may be important in patients with reactive airways disease.

Dermatologic

Dermatologic problems associated with bisoprolol (the active ingredient contained in Zebeta) include rash, acne, eczema, skin irritation, pruritus, flushing, sweating, alopecia, angioedema, and exfoliative dermatitis.

Endocrine

Endocrinologic changes are unusual, and include hyperglycemia and hypercholesterolemia. Sporadic reports of elevated serum triglycerides are found. While rare and often clinically insignificant, these problems may be important in patients with or at risk of diabetes or coronary artery disease. Thyroid function tests are unaffected by bisoprolol (the active ingredient contained in Zebeta) This may be relevant if bisoprolol is used to treat the symptoms of hyperthyroidism.

Hepatic

The incidence of elevated liver function tests (SGOT and SGPT) of between one and two times normal is approximately 6%, of greater than two times normal is approximately 2%.

Genitourinary

Genitourinary problems include decreased libido, impotence, Peyronie's disease, cystitis, and renal colic.

Psychiatric

Psychiatric problems associated with bisoprolol (the active ingredient contained in Zebeta) include vivid dreams, hallucinations, and insomnia. Rare cases of catatonia are reported. Depression is reported, as with some other beta-blockers.

Hematologic

Hematologic side effects are rare. Purpura, agranulocytosis, and thrombocytopenia are reported.

Musculoskeletal

Musculoskeletal side effects have included rare reports of musculoskeletal pain and acute quadriplegic myopathy.

Acute quadriplegic myopathy was reported in an anephric patient receiving bisoprolol 2.5 mg daily. Muscle function and strength returned to normal following discontinuation of bisoprolol. Symptoms recurred when the patient was started on carvedilol and resolved within 3 days after discontinuation of carvedilol.

Immunologic

Approximately 15% of patients on long-term bisoprolol (the active ingredient contained in Zebeta) therapy develop a positive ANA titer. Other immunologic changes are not reported.

Other

Other side effects including dry mouth have been reported.

Metabolic

Metabolic side effects have included gout. Gout and elevated serum uric acid levels are reported in at least 1% of patients.

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