Zebeta (Bisoprolol)

Zebeta (also known as bisoprolol fumarate) can be prescribed solely or combined with other excessive blood pressure medicines. It is commonly recommended for the treatment of hypertension (i.e. high blood pressure). Being a beta blocker, the principle of its effect is decreasing heart rate as well as diastolic and systolic pressure by means of suspending a particular kind of beta receptor in the human organism. This medicine is sold in a form of tablets and is commonly prescribed to be taken one time a day. Note that dizziness, fatigue, and diarrhea are among possible side effects.

Zebeta is just a share of a comprehensive course of curing hypertension that typically also comprise exercise, diet, and weight regulation. Take the medication as prescribed, observe your diet, and exercise on a regular basis for successful and fast treatment.

In order to decrease high blood pressure, a treatment course enduring for a few weeks will be sufficient for the complete effect. It is advised to remain on regular doses of this medication until the full course is complete, regardless of how you feel. On average, patients with hypertension do not feel sick.

Zebeta is manufactured by Duramed Pharmaceuticals, Inc. Other manufacturers produce the standard version of this medicine as well. Zebeta pills are retailed in sizes of 5 mg and 10 mg.


Hypertension treatment
Hypertension treatment
Zebeta (bisoprolol fumarate in chemical terms) is a medicament having purpose of beta-blocking sanctioned for the treatment of hypertension (high blood pressure).

At the time patient's blood pressure is determined, the values read as a grouping of a pair of numbers (for instance, 140/90, pronounced "140 over 90"). The first number is identified as the systolic pressure, and the second one represents the diastolic pressure. Excessive blood pressure is stated when the blood pressure measured multiple times is constantly higher than 140/90. Series of measurements (preferably taken on different days) is required due to the fact that blood pressure normally ranges quite widely, so there is no problem with pressure, if high values don't appear consistently.

In medical research, Zebeta had been proved to considerably lower both diastolic and systolic pressure. Thus, the medicine is capable of reducing the risks that arise along with durable hypertension; on the other hand, long-term research on Zebeta has not yet been accomplished. Note that this medicine is not capable of curing high blood pressure permanently and makes temporary effect on the pressure.

Zebeta can be taken exclusively or combined with supplementary medications. Children or teens shouldn't use Zebeta, as it is not generally approved for younger ages. Consult your child's doctor regarding the cautions of prescribing Zebeta to children.

Complimentary uses of Zebeta

Heart attack
Heart attack
In some cases, your doctor may consider prescribing Zebeta against diseases other than excessive pressure. Among possible off-label uses are:
  • Treatment of arrhythmias (heart's irregular electrical activity)
  • Chest pain (angina) treatment
  • Suppressing negative consequences after a heart attack
  • Prevention of migraines
  • Alcohol withdrawal symptoms mitigation
  • For patients with cirrhosis of the liver in order to inhibit bleeding in stomach or the esophagus
  • Treatment of nervousness, such as performance anxiety and social phobia
  • Heart failure prevention and treatment


Zebeta 10mg
Zebeta 10mg
Zebeta dosage should always be personalized and correspond to the patient's exact case. The typical initial dosage equals 5 mg per day. An appropriate initial dose may be 2.5 g daily for a portion of patients. On the other hand, should the antihypertensive action of 5 mg prove to be insufficient, the doctor may add the dose up to 10 mg and, in extreme cases, to 20 mg per day.

Renal or hepatic suffering patients

Patients suffering from cirrhosis, hepatitis or renal dysfunction (creatinine flow lower than 40 mL/min), the starting dosage should not exceed 2.5 mg per day, and added with caution only if absolutely necessary. Bisoprolol fumarate is not dialyzable according to studies, so medicine substitution is not required for patients on dialysis.

Elderly patients

Adjustment of the dose for geriatric patients is not required, except if they suffer from hepatic or renal dysfunction.

Pediatric patients

Documented pediatric practice using Zebeta (bisoprolol fumarate) is non-existent.

Warnings and Precautions

Talk to doctor
Talk to doctor
Before undergoing treatment course with Zebeta (bisoprolol fumarate), make sure the doctor familiarized himself with the history of your diseases. It is especially important to make note of:
Along with that, inform your doctor if you are:
  • Breastfeeding
  • Pregnant or planning pregnancy

Do not omit telling your doctor about all other medications you are currently taking, mentioning prescription and nonprescription ones, herbal additives, and vitamins.

Precautions and notices specific to Zebeta

Minimize physical activity
Minimize physical activity
Below are a few notices and precautions to be alert about before undergoing Zebeta treatment:
  • Similar to the rest of beta blockers, sudden discontinuing of taking Zebeta may lead to heart attacks or other serious problems. You will be instructed by your doctor on how to drop off the treatment course without harm. Typically, the dosage is reduced gradually over 7 to 14 days duration, along with cautious monitoring. Patients are advised to minimize physical activity as this period goes by. Should any pain or problems arise while stopping Zebeta course, you must consult your doctor immediately.
  • Zebeta is potentially capable of provoking more severe heart failures in some circumstances. Still, Zebeta along with similar beta blockers are effective for heart failure treatment. Patients with heart failure are advised to go to the hospital to be closely monitored while taking Zebeta. Immediately inform your doctor if you notice worsening of heart failure symptoms.
  • Beta blockers can provoke breathing problems (including COPD or asthma) to get worse. Patients with breathing problems are advised to consult the doctor prior to taking Zebeta. Despite of the fact that this beta blocker is "cardioselective" (meaning the probability of causing breathing problems is minimal), problems of breathing can still occur, particularly when a high dosage of Zebeta is prescribed.
  • Should you have a surgery scheduled, validate the fact that both your anesthesiologist and surgeon are informed that you are on Zebeta, as the selection of medicines used during the surgery depends on it.
  • Beta blockers have an effect of masking particular symptoms of hypoglycemia (insufficient blood sugar), for example giving feel of the "racing heart". This can introduce potential complications for people having diabetes, who rely on sensing decreased blood sugar for correcting it on time to prevent worsening of their condition.
  • Beta blockers have an effect of masking particular symptoms of hyperthyroidism (an excessively active thyroid). Stopping Zebeta abruptly can potentially cause symptoms of a "thyroid storm" (a rapid and severe deteriorating of hyperthyroidism symptoms).
  • Zebeta's effect can potentially be altered by many other prescriptions.
  • Liver and the kidneys are responsible for removing this medicine from the organism. For this reason, if the patient is having liver or kidney disease, the doctor will insist on close monitoring of patient's response to Zebeta and adjusting dosage accordingly.
  • In case you suffer from anaphylactic allergy (the kind of allergy that affects the whole organism and usually introduces breathing problems), Zebeta can potentially provoke increased sensitivity to the allergen as well as reduce the effectiveness of the usual treatments, for instance EpiPen or epinephrine.
  • Zebeta is classified as a pregnancy Category C medicine. This implies that using Zebeta may be dangerous during pregnancy; however, the exact risks have not been estimated so far.
  • From researches accomplished by now it can't be derived whether Zebeta can be transferred with breast milk from mother to child. So, in case you plan to start breastfeeding or do it already, consult your doctor in regard to safety of taking Zebeta.

Contraindications of Zebeta

You should keep yourself from taking this medicine if you:
  • Have shown an allergic reaction to bisoprolol fumarate, Zebeta, or one or more of the auxiliary components used in manufacturing of the medicine. Your doctor or pharmacist can provide a list of the auxiliary ingredients
  • Are in severe heart failure condition
  • Are diagnosed with a heart block of second- or third-degree (a decreased conductivity of electrical signal within the heart)
  • Have a decreased heart rate (bradycardia)
  • Suffer from a cardiogenic shock (an emergency heart failure)

Side Effects

Documented side effects

Zebeta side effects
Zebeta side effects
Zebeta medicine has undergone thorough clinical research. In this research, there were two clusters of people: the first took Zebeta pills, the second one took placebos. The side effects that were noticed in the first cluster were documented and compared to effects shown by the second cluster. Owing to such method, researchers were able to detect occurring problems, rate of occurrence, as well as difference from the cluster which didn't take the medicine.

In the mentioned studies on Zebeta, the noticed shared side effects (happening more frequently to those who took Zebeta) were as follows:
  • The common cold (upper respiratory infection) - not more than 5 percent
  • Fatigue - 8.2 percent or less
  • Diarrhea - 3.5 percent or less
  • Stuffy or runny nose - up to 4 percent
  • Dizziness - 3.5 percent or less

Among minor side effects (noticed in 1 to 2.7 percent of persons being tested) are:
  • Nausea
  • Joint pain
  • Insomnia
  • Irritation or sinus infection
  • Decreased sensation (for example, touch sensation)
  • General weakness
  • Vomiting

Side effects that should not be neglected

There are also potentially serious side effects, which occur very rarely. Should you start to notice one of the effects in the list above, never neglect them and let your doctor be informed on your condition.
  • Lightheadedness or black out, which can mean that blood pressure has been lowered too much (hypotension)
  • Pain in the chest
  • A slow heart rate (bradycardia)
  • Asthma becoming more severe
  • Downheartedness
  • Symptoms of heart failure, for instance: inflammation of limbs, getting excessive weight, increase in breath rate
  • Manifestations of allergic reaction, for instance: hives, suddenly appearing rash, itching, quickly formed swelling, complications while swallowing or breathing, wheezing

Undocumented potential side effects

A number of minor Zebeta side effects have been reported in medical studies or practices in different countries; however, such effects have not been noticed while conducting clinical researches in the territory of United States. In fact, it cannot be guaranteed that those reported side effects were caused by Zebeta exclusively. Here is the list of such effects:
  • Decreased salivation
  • Vertigo (a revolving sensation)
  • Dyspepsia or heartburn
  • Eczema
  • Difficulties with memorizing
  • Sweating
  • Sleepiness
  • Squeaking in the ears (tinnitus)
  • Hearing getting worse
  • Nervousness
  • Muscle contraction or shuddering
  • Acne
  • Constipation
  • Hair loss

Mechanism of action

Zebeta is classified as a medicine from beta-adrenergic blocking agents group, publicly known as beta blockers. Corresponding to the name, medicines from this group are meant to block beta receptors in human organism. There are many locations of beta receptors in the body, for the most part they are found in blood vessels and the heart. Anxiety hormones (for example, adrenaline) are detected by beta receptors, and as a result the body answers with specific reactions:
  • Greater force of heart pumping
  • Greater heart contraction frequency
  • Contracted blood vessels
  • Increased blood pressure (both diastolic and systolic)

Zebeta in small doses is capable of blocking the response of one type of beta receptors known as beta-1 receptors (it can also block beta-2 receptors if doses are greater). The effect of suspending beta-1 receptors is reverse to the effect caused by anxiety hormones. The heart contraction frequency goes lower thus decreasing diastolic and systolic pressure.

Generic Zebeta

Generic Zebeta
Generic Zebeta
Duramed Pharmaceuticals, Inc is the owner manufacturer of brand-name Zebeta. However, due to the fact that the patents for proprietary medicine have expired, unbranded Zebeta is also sold at the mrket now. Nonproprietary Zebeta pills come in the sizes ranging from 5 mg to 10 mg.

A number of competing companies manufacture a generic version of Zebeta. Among them are: Mylan Pharmaceuticals, Aurobindo Pharma, Teva Pharmaceuticals, Sandoz.

All nonproprietary medicines are required to be tested for compatibility and compliance with original brand-name ones. The U.S. Food and Drug Administration (FDA) analyzes test results and makes a decision on the equivalency of the tested medication to the brand-name one, then the tested medication receives a corresponding rating. An "AB" rating implies that the FDA concluded that a nonproprietary medicine in question is indeed equivalent to the original patented medicine. All bisoporol-based medications currently seen at the market carry an "AB" rating, thus all of them are identical to Zebeta.

Note that nonproprietary medicines are not guaranteed to share the same auxiliary ingredients as the original medicine. The differences can be found in dyes and fillers, but there can also be other inactive ingredients which may be unwanted for some patients with related sensitiveness or allergies.

Drug Interactions

Calcium channel blockers, NSAIDs (non-steroidal anti-inflammatory drugs), alpha-blockers and many other drugs if taken with beta-blocker Zebeta can cause serious health hazards. To prevent such scenario, please, do not avoid consultations with your healthcare provider on any medication you are going to use with this drug. Especially avoid the following drug interactions with Zebeta (aka Bisoprolol Fumarate after the active component):
  • Alpha blockers (drugs with alpha-blocking activity):
    Zebeta vs alpha blockers
    Zebeta vs alpha blockers
    • Alfuzosin (Uroxatral)
    • Carvedilol (Coreg)
    • Doxazosin (Cardura)
    • Labetalol (Trandate)
    • Phenoxybenzamine (Dibenzyline)
    • Phentolamine (Regitine)
    • Prazosin (Minipress)
    • Tamsulosin (Flomax)
    • Terazosin (Hytrin)
  • Calcium channel blockers:
    Zebeta vs calcium channel blockers
    Zebeta vs calcium channel blockers
    • Amlodipine (Norvasc)
    • Diltiazem (Cardizem, Cardizem LA, Cardizem CD, Cartia XT, Dilacor XR, Diltia XT, Dilt-XR, Dilt-CD, Tiazac, Taztia XT)
    • Felodipine (Plendil)
    • Isradipine (Dynacirc CR, Dynacirc)
    • Nisoldipine (Sular)
    • Nicardipine (Cardene SR, Cardene)
    • Nifedipine (Afeditab CR, Adalat CC, Procardia, Procardia XL, Nifediac CC, Nifedical XL)
    • Nimodipine (Nimotop)
    • Verapamil (Calan SR, Calan, Covera-HS, Isoptin SR, Verelan PM, Verelan)
  • Some arrhythmia drugs:
    Zebeta vs arrhythmia drugs
    Zebeta vs arrhythmia drugs
    • Amiodarone (Cordarone)
    • Disopyramide (Norpace CR, Norpace)
    • Lidocaine (Xylocaine)
    • Propafenone (Rythmol)
    • Quinidine
    • Sotalol (Betapace)
  • Clonidine (Catapres, Duraclon)
  • Digoxin (Digitek, Lanoxin)
  • Nonsteroidal anti-inflammatory drugs:
    Zebeta vs NSAIDs
    Zebeta vs NSAIDs
    • Diclofenac (Cataflam, Voltaren)
    • Etodolac (Lodine)
    • Ibuprofen (Advil, Motrin)
    • Indomethacin (Indocin)
    • Ketoprofen (Orudis)
    • Ketorolac (Toradol)
    • Nabumetone (Relafen)
    • Naproxen (Anaprox, Aleve, Naprosyn, Naprelan)
    • Oxaprozin (Daypro)
    • Celecoxib (Celebrex)
    • Meloxicam (Mobic)
  • Other beta blockers:
    Zebeta vs beta blockers
    Zebeta vs beta blockers
    • Atenolol (Tenormin)
    • Carvedilol (Coreg)
    • Labetalol (Trandate)
    • Metoprolol (Toprol XL, Lopressor)
    • Nadolol (Corgard)
    • Nebivolol (Bystolic)
    • Propranolol (Inderal LA, Inderal, InnoPran XL)
    • Sotalol (Betapace)
    • Timolol (Blocadren)
  • Reserpine
  • Rifampin (Rifadin)

Combination with alpha-blockers and calcium channel blockers
To avoid hypotension (decreased blood pressure) you are not allowed to take this beta-blocker with drugs that belong to calcium channel blockers or alpha-blockers. Also keep in mind that Bisoprolol Fumarate mixed with such calcium channel blockers as Diltiazem or Verapamil can lead to bradycardia (aka a very slow heart rate) and eventually can become a trigger for a heart failure.

NSAIDs intake
As well as the previous drug groups, NSAIDs when used along with this beta-blocker may trigger decrease of blood pressure.

Arrhythmia meds and Digoxin
These separate groups of medical preparations when used along with Zebeta may lead to negative consequences to health like bradycardia and heart failure.

Rifampin combination
The simultaneous use of these two drugs can speed up the half-life (process of clearing a preparation from a body) of Bisoprolol Fumarate in such way leading to its inefficiency. Consult a therapist and discuss the dosage adjustment before swallowing these pills together.

Reserpine impact
Serious adverse reactions of Zebeta can occur if to use it along with Reserpine pills. It is possible to take these medications simultaneously if to adjust doses properly under the medical supervision.

If you start using these medical preparations together and then abruptly you will cease taking Clonidine while sticking to regular intakes of Zebeta pills you should beware hypertension, heart strokes risk and other serious health hazards. If you need to use these medications together, it is recommended reducing the daily doses of Clonidine at least during few days before cessation of Bisoprolol Fumarate treatment.

Similar beta-blockers
Since Zebeta belongs to the drug family of beta-blockers, no wonder this preparation is forbidden for the use with similar by content and effects meds. The combination with other beta-blockers may lead to overdose.

The bottom line
There is a high possibility that Bisoprolol Fumarate can interact in a negative way with a number of other medications. Before starting to take Zebeta pills on a regular basis along with any medical preparations, supplements or vitamins, please consult your therapist.

General keywords

User discussion about Zebeta

06 August 2012
One year I was taking 2.5 mg of this drug to keep my high blood and palpitations pressure in order. It helped me to solve both problems. I was very upset when I needed to decrease the dosage of the drug because of lower strength. And also it really helped against dizziness and tiredness at bedtime.
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20 September 2012
I used it about a month. I had terrible side effects, my legs, waist and feet began to swell. That is why I stopped to use it. Soon everything was fine. The swelling was away (likely).
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05 December 2012
The drug has helped me with my blood pressure and heart rate. For me didn't work generic so I had to change back - and of course the price was higher. The tingling in my toes and hands bothered me at times.
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24 September 2014
One year I was taking 2.5 mg of this drug to keep my high blood and palpitations pressure in order. It helped me to solve both problems. I was very upset when I needed to decrease the dosage of the drug because of lower strength. And also it really helped against dizziness and tiredness at bedtime.
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24 September 2014
The blood preassure is normal but bisoprolol 0,25 I am taking on regular basic for occasional arrythmia..It doesn't always stop those episode. Than I take another 0.25.The arrythmia could not stop sometimes for an hours.iIt became prolong period of time than was before. Still reluctant to take Amiadorone,which helps initially,than arrythmia return.
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