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Active substance(s): BISOPROLOL FUMARATE

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Bisoprolol Fumarate

Read all of this leaflet carefully before you start taking this medicine because it
contains important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, please ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may
harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Bisoprolol Fumarate is and what it is used for
2. What you need to know before you take Bisoprolol Fumarate
3. How to take Bisoprolol Fumarate
4. Possible side effects
5. How to store Bisoprolol Fumarate
6. Contents of the pack and other information
1. What Bisoprolol Fumarate is and what it is used for

The active substance in this medicine is bisoprolol fumarate. Bisoprolol fumarate belongs
to a group of medicines called beta-blockers. These medicines work by affecting the
body's response to some nerve impulses especially in the heart. As a result, bisoprolol
slows down the heart rate and makes the heart more efficient at pumping blood around
the body. Heart failure occurs when the heart muscle is weak and unable to pump
enough blood to supply the body's needs.
Bisoprolol is used:
To treat stable chronic heart failure. It is used in combination with other medicines
suitable for this condition (such as ACE-inhibitors, diuretics, and heart glycosides)
In treatment of coronary heart disease and chest pain (angina pectoris) caused by
shortage of oxygen in the heart muscle
In treatment of high blood pressure (hypertension).
2. What you need to know before you take Bisoprolol Fumarate

Do not take Bisoprolol Fumarate:
Do not take Bisoprolol Fumarate if one of the following conditions applies to you:
Allergic to bisoprolol fumarate or any of the other ingredients of this medicine (listed in
section 6)
Severe asthma
Severe blood circulation problems in your limbs (such as Raynaud's syndrome), which
may cause your fingers and toes to tingle or turn pale or blue
Untreated phaeochromocytoma, which is a rare tumour of the adrenal gland
Metabolic acidosis, which is a condition when there is too much acid in the blood.

Do not take Bisoprolol Fumarate if you have one of the following heart problems:
Acute heart failure
Worsening heart failure requiring injection of medicines into a vein, that increase the
force of contraction of the heart
Slow heart rate
Very low blood pressure
Certain heart conditions causing a very slow heart rate or irregular heartbeat
Cardiogenic shock, which is an acute serious heart condition causing low blood
pressure and circulatory failure.

Warnings and precautions
If you have any of the following conditions tell your doctor before taking this medicine; he
or she may want to take special care (for example give additional treatment or perform
more frequent checks):
Strict fasting
Certain heart diseases such as disturbances in heart rhythm, or severe chest pain at
rest (Prinzmetal's angina)
Kidney or liver problems
Less severe blood circulation problems in your limbs
Less severe asthma or chronic lung disease (see section 4)
Previously had or currently have a scaly skin rash (psoriasis) (see section 4)
A tumor of the adrenal gland (phaeochromacytoma) or if you are currently under
going treatment for a tumor of the adrenal gland
Thyroid disorder
Thyroid problems.

During Treatment
Talk to your doctor or pharmacist if you:
Are going to have desensitization therapy (for example for the prevention of hay
fever), because Bisoprolol may make it more likely that you experience an allergic
reaction, or such reaction may be more severe
Are going to have anaesthesia (for example for surgery), because this medicine may
influence how your body reacts to this situation
Have chronic lung disease or less severe asthma please inform your doctor
immediately if you start to experience new difficulties in breathing, cough, wheezing
after exercise, etc. when using bisoprolol.
Other medicines and Bisoprolol Fumarate
Tell your doctor or pharmacist if you are taking, have recently taken or might take any
other medicines.

Do not take the following medicines with Bisoprolol Fumarate without special
advice from your doctor:
If you have chronic heart failure certain medicines used to treat irregular or abnormal
heartbeat (e.g. Class I antiarrhythmic medicines such as quinidine, disopyramide,
lidocaine, phenytoin; flecainide, propafenone)
Certain medicines used to treat high blood pressure, angina pectoris or irregular
heartbeat (e.g. calcium antagonists such as verapamil and diltiazem)
Certain medicines used to treat high blood pressure (e.g. clonidine, methyldopa,
moxonidine, rilmenidine).
However, do not stop taking these medicines without checking with your doctor

Check with your doctor before taking the following medicines with Bisoprolol
Fumarate; your doctor may need to check your condition more frequently:
Certain medicines used to treat high blood pressure or angina pectoris (e.g.
dihydropyridine-type calcium antagonists such as nifedipine, felodipine and
Certain medicines to treat clinical shock (e.g. adrenaline, dobutamine, noradrenaline)
Certain medicines used to treat irregular or abnormal heartbeat (Class III
antiarrhythmic medicines such as amiodarone)
Beta-blocking agents applied locally (such as timolol eye drops for glaucoma
Certain medicines used to treat for example Alzheimer's disease or glaucoma
(parasympathomimetics such as tacrine or carbachol) or medicines that are used to
treat acute heart problems (sympathomimetics such as isoprenaline and dobutamine)
Antidiabetic medicines including insulin
Anaesthetic agents (for example during surgery)
Digitalis glycosides, used to treat heart failure
Non-steroidal anti-inflammatory medicines (NSAIDs) used to treat arthritis, pain or
inflammation (for example ibuprofen or diclofenac)
Medicines for asthma or medicines used for a blocked nose
Mefloquine, used for prevention or treatment of malaria
Any medicine which can lower blood pressure as a desired effect such as
antihypertensives, certain medicines for depression (tricyclic antidepressants such as
imipramine or amitriptyline), certain medicines used to treat epilepsy or during
anaesthesia (barbiturates such as phenobarbital), or certain medicines to treat mental
illness characterised by a loss of contact with reality (phenothiazines such as
Depression treatment medicines called monoamine oxidase inhibitors (except MAO-B
inhibitors) such as moclobemide.
Pregnancy and breast-feeding
Bisoprolol Fumarate is not recommended during pregnancy. There is a risk that use of
bisoprolol during pregnancy may harm the baby. If you are pregnant or planning to
become pregnant, tell your doctor. He or she will decide whether you can take this
medicine during pregnancy.
It is not known whether bisoprolol passes into human breast milk. Therefore, breastfeeding is not recommended during therapy with Bisoprolol Fumarate.
Driving and using machines
Your ability to drive or use machinery may be affected depending on how well you
tolerate the medicine.
Please be especially cautious at the start of treatment, when the dose is increased or the
medication is changed, as well as in combination with alcohol.
3. How to take Bisoprolol Fumarate
Always take this medicine exactly as your doctor has told you. Check with your doctor or
your pharmacist if you are not sure.
This treatment should be initiated by a specialist in cardiology or internal medicine.
Adults and the Elderly:
Hypertension or angina pectoris
The maximum daily dose is 20 mg once a day.

Stable chronic heart failure
The treatment should be managed by a doctor experienced in treating chronic heart

Treatment with bisoprolol must be started at a low dose and increased gradually. Your
doctor will decide how to increase the dose, and this will normally be done in the following
1.25 mg bisoprolol once daily for one week
2.5 mg bisoprolol once daily for one week
3.75 mg bisoprolol once daily for one week
5 mg bisoprolol once daily for four weeks
7.5 mg bisoprolol once daily for four weeks
10 mg bisoprolol once daily for maintenance (on-going) therapy.
The maximum recommended dose is 10 mg once daily.
Depending on how well you tolerate the medicine, your doctor may also decide to
lengthen the time between dose increases. If your condition gets worse or you no longer
tolerate the drug, it may be necessary to reduce the dose again or to interrupt treatment.
In some patients a maintenance dose lower than 10 mg bisoprolol may be sufficient.
Your doctor will tell you what to do.
Kidney or liver disease
Patients with hypertension or angina pectoris: The dosage should not exceed 10 mg once
daily in patients with severe kidney or liver problems.
Use in children and adolescents
Bisoprolol Fumarate is not recommended for use in children and adolescents.
Taking your medicine
Bisoprolol Fumarate Tablets should be taken in the morning, before, with or after
breakfast. Swallow the tablet/s whole with some water and do not chew or crush them.
The 2.5 mg, 5 mg and 10 mg tablets can be divided into equal doses. The 1.25 mg and
3.75 mg tablets should not be broken.
If you take more Bisoprolol Fumarate than you should
Contact your doctor or local emergency ward immediately. Take this leaflet and any
tablets you still have with you. Your doctor will decide what measures are necessary.
The most common signs of an overdose may include slowed heart rate, severe difficulty
in breathing, feeling dizzy, or trembling (due to decreased blood sugar).
If you forget to take Bisoprolol Fumarate
If you forget to take a dose, take it as soon as you remember it unless it is nearly time for
your next dose.
Do not take a double dose to make up for a forgotten dose.
If you stop taking Bisoprolol Fumarate
Do not stop treatment suddenly or change the recommended dose without talking to your
doctor first. If you need to stop treatment, it must be done gradually, to avoid side effects.
If you have any further questions on the use of this medicine, ask your doctor or
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets
To prevent serious reactions, speak to a doctor immediately if a side effect is
severe, occurred suddenly or gets worse rapidly.

The most serious side effects are related to the heart function:
Slowing of heart rate (may affect more than 1 person in 10 people)
Worsening of heart failure (may affect up to1 in 10 people)
Slow or irregular heartbeat (may affect up to 1 in 100 people).
If you feel dizzy or weak, or have breathing difficulties please contact your doctor as soon
as possible.

Other serious side effects are:
Uncommon (may affect up to 1 in 100 people):
Breathing problems in patients with asthma or chronic lung disease.

Rare (may affect up to 1 in 1,000 people):
Inflammation of the liver which can cause yellowing of the skin or whites of the eyes.
Further side effects are listed below according to how frequently they may occur:

Common (may affect up to 1 in 10 people):
Feeling of coldness or numbness in hands or feet
Low blood pressure
Stomach or intestine problems such as nausea, vomiting, diarrhoea, or constipation.
* These symptoms occur at the beginning of therapy in patients with hypertension or
angina pectoris.
They are usually mild and disappear within 1-2 weeks.

Uncommon (may affect up to 1 in 100 people):
Sleep disturbances
Muscle weakness and muscle cramps
Changes in the normal heart rate
Dizziness when standing up.

Rare (may affect up to 1 in 1,000 people):
Hearing problems
Allergic runny nose
Reduced tear flow
Certain blood test results for liver function or fat levels differing from normal
Allergy-like reactions such as itching, flush, rash
Impaired erection
Nightmares, hallucinations

Very rare (may affect up to 1 in 10,000 people):
Irritation and redness of the eye (conjunctivitis)
Hair loss
Appearance or worsening of scaly skin rash (psoriasis); psoriasis-like rash.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any
possible side effects not listed in this leaflet. You can also report side effects directly via
the Yellow Card Scheme at:
By reporting side effects you can help provide more information on the safety of this
5. How to store Bisoprolol Fumarate
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister and the
carton. The expiry date refers to the last day of that month.
This medicine does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures will help
protect the environment.
6. Contents of the pack and other information
What Bisoprolol Fumarate contains:
The active substance is bisoprolol fumarate.
Each 7.5 mg tablet contains 7.5 mg bisoprolol fumarate.
The other ingredients are microcrystalline cellulose, colloidal anhydrous silica,
croscarmellose sodium, sodium starch glycolate (type A) and magnesium stearate.
What Bisoprolol Fumarate Tablets look like and contents of the pack:
Bisoprolol Fumarate 7.5 mg Tablets are white to off white round biconvex tablets with a
break line on one side.
They come in packs of 28 tablets.
Marketing Authorisation Holder:
Chanelle Medical UK Limited, The Lodge, Stanford Bridge Farm, Station Road, Pluckley,
Ashford, Kent, TN27 ORU, United Kingdom.
Chanelle Medical, Loughrea, Co Galway, Ireland.
This leaflet was last revised in 06/2016

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.