It can be dangerous to administer bisoprolol concomitantly with the following medicines:
Hypoglycaemic agents, phenothiazines and various antiarrhythmic agents.
N.B. – Such medicine interactions can have life-threatening consequences. It may enhance the effects of hypoglycaemic agents in patients with diabetes mellitus as well as the effects of myocardial depressants such as lignocaine, procainamide and quinidine.
The effects may be antagonised by beta-adrenoceptor stimulating agents (e.g. isoprenaline). The hypotensive effects may be dangerously reversed by alpha-adrenoceptor stimulants. The vasoconstrictor effects may be dangerously enhanced by alpha-adrenoceptor stimulants. The effects may be enhanced by adrenergic neurone blocking agents such as guanethidine and reserpine.
The anaesthetist should be informed of bisoprolol therapy prior to any operation.
The half-life of bisoprolol can be slightly shortened by the simultaneous administration of rifampicin. An increase in the dose is generally unnecessary. The pharmacokinetics of bisoprolol are not significantly influenced by cimetidine.
KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT:
Overdosage may produce bradycardia and severe hypotension. Bronchospasm and heart failure may be produced in certain individuals.
Bradycardia associated with severe hypotension should be treated with intravenous atropine (1 – 2 mg). If necessary this should be followed up by a slow intravenous infusion of 25 micrograms isoprenaline. Bronchospasm should be treated with intravenous aminophylline, and heart failure with digitalis and diuretics.
CONCOR* 5 tablets: Light yellow, heart-shaped biconvex film-coated tablets, scored on both sides.
CONCOR* 10 tablets: Light orange, heart-shaped biconvex film-coated tablets, scored on both sides.
Blister packs containing 30 tablets.
Store below 25°C in airtight containers and protect from light.
Keep all medicines out of reach of children.