Drug Interaction Report

Beta-blockers such as bisoprolol may increase the risk, severity, and/or duration of hypoglycemia (low blood sugar) in patients receiving repaglinide and certain other antidiabetic medications. In addition, beta-blockers may mask some of the symptoms of hypoglycemia such as tremor, palpitation and rapid heartbeat, making it more difficult to recognize an oncoming episode. Other symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, nausea, hunger, weakness, and perspiration are not affected. Talk to your doctor if you have any questions or concerns. You may need to monitor your blood glucose levels more frequently, especially if you are prone to developing hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Grapefruit juice may increase the blood levels of certain medications such as repaglinide. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with repaglinide. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

Bisoprolol and ethanol (alcohol) may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using bisoprolol together with multivitamin with minerals may decrease the effects of bisoprolol. Separate the administration times of bisoprolol and multivitamin with minerals by at least 2 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.