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Bisoprolol Side Effects

In Summary

More frequently reported side effects include: fatigue. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to bisoprolol: oral tablet

In addition to its needed effects, some unwanted effects may be caused by bisoprolol. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when 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
  • Chest discomfort
  • lightheadedness, dizziness, or fainting
  • slow or irregular heartbeat

If any of the following symptoms of overdose occur while taking bisoprolol, get emergency help immediately:

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

Minor Side Effects

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

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


The more commonly reported side effects observed with this drug are bradycardia, dizziness, and hypotension.[Ref]


Bradycardia occurred as a dose-related event.

Cardiac failure occurred in 18.4% of patients (n=1328) compared with 22.8% of placebo-treated patients (n=1321).[Ref]

Very common (10% or more): Bradycardia (up to 15.2%)
Common (1% to 10%): Chest pain, heart failure aggravation, hypotension, cold extremities, peripheral edema, ischemia, conduction disorder, left cardiac failure, palpitation, vein disorder
Uncommon (0.1% to 1%): Atrioventricular (AV) disturbances, orthostatic hypotension
Frequency not reported: Other rhythm disturbances, claudication[Ref]

Nervous system

Very common (10% or more): Dizziness (up to 13.3%)
Common (1% to 10%): Headache, extremity numbness, cerebrovascular disorder, syncope, hypoesthesia
Frequency not reported: Vertigo, paresthesia, hypoesthesia, hyperesthesia, somnolence, decreased concentration/memory, tremor, taste abnormalities
Postmarketing reports: Unsteadiness[Ref]


Very common (10% or more): Dyspnea (up to 13.8%)
Common (1% to 10%): Pneumonia, bronchitis, coughing, exertional dyspnea, upper respiratory tract infection, respiratory distress, stridor, respiratory tract edema, respiratory tract hemorrhage, sinusitis
Uncommon (0.1% to 1%): Bronchospasm
Rare (0.01% to 0.1%): Allergic rhinitis[Ref]

Sinusitis occurred as a dose-related event.[Ref]


Very common: Antinuclear antibody (ANA) conversions (up to 15%)
Common (1% to 10%): Viral infection[Ref]


Common (1% to 10%): Pruritus
Uncommon (0.1% to 1%): Sweating
Rare (0.01% to 0.1%): Itching, flushing, rash
Very rare (less than 0.01%): Alopecia, psoriasis-like rash, psoriasis exacerbation
Frequency not reported: Acne, eczema, skin irritation, cutaneous vasculitis
Postmarketing reports: Dermatitis, exfoliative dermatitis[Ref]


Diarrhea occurred as a dose-related event.[Ref]

Common (1% to 10%): Nausea, vomiting, diarrhea, constipation, dyspepsia, epigastric pain (not food related), abdominal pain, gastritis, dry mouth
Frequency not reported: Gastric pain, peptic ulcer[Ref]


Common (1% to 10%): Purine metabolism disorder, carbohydrate metabolism disturbed, weight changes, cholesterol changes, potassium levels altered, blood lipid changes
Rare (0.01% to 0.1%): Increased triglycerides
Frequency not reported: Gout
Postmarketing reports: Increased uric acid and glucose[Ref]

Uric acid, serum potassium, glucose, and phosphorus increases associated with use of this drug were not of clinical importance and rarely resulted in discontinuation.[Ref]


Common (1% to 10%): Limb pain, myalgia, arthropathy, arthralgia
Uncommon (0.1% to 1%): Muscular weakness, cramps
Frequency not reported: Back pain, neck pain, twitching[Ref]


Common (1% to 10%): Asthenia, fatigue, body pain, fever, malaise
Rare (0.01% to 0.1%): Hearing disorders
Frequency not reported: Earache, tinnitus[Ref]

Fatigue and asthenia occurred as dose-related events.[Ref]


Common (1% to 10%): Insomnia, anxiety
Uncommon (0.1% to 1%): Sleep disorders, depression
Rare (0.01% to 0.1%): Nightmares, hallucinations
Frequency not reported: Restlessness[Ref]


Common (1% to 10%): Urinary tract infection
Rare (0.01% to 0.1%): Potency disorders
Frequency not reported: Decreased libido, Peyronie's disease, polyuria[Ref]


Common (1% to 10%): Hepatomegaly
Rare (0.01% to 0.1%): Increased liver enzymes (ALT, AST), hepatitis[Ref]

Transaminase elevations of 1 to 2 times the upper limit of normal were reported in 6.2% of patients, with a multiple occurrence rate of 1.9%. Generally, this increase was the result of underlying disorders or resolved with continued use of this drug.[Ref]


Rare (0.01% to 0.1%): Hypersensitivity
Postmarketing reports: Angioedema[Ref]

Of the 15% of patients who developed positive ANA status, one-third of patients converted back to a negative titer with continued use.[Ref]


Rare (0.01% to 0.1%): Reduced tear flow
Very rare (less than 0.01%): Conjunctivitis
Frequency not reported: Visual disturbances, ocular pain, ocular pressure[Ref]


Creatinine and BUN were associated with slightly increased levels, but these effects were generally not of clinical importance and rarely resulted in discontinuation.[Ref]

Frequency not reported: Cystitis, renal colic
Postmarketing reports: Increased creatinine and BUN[Ref]


During treatment with this drug, decreased levels of WBCs and platelets were not of clinical importance and rarely resulted in discontinuation.[Ref]

Postmarketing reports: Purpura, decreases in WBC and platelets[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.

Not all side effects for bisoprolol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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