High blood pressure, angina, heart failure and certain fast or irregular heart rhythms such as atrial fibrillation. In heart failure the dose is started low and raised slowly over weeks.

Adrenaline speeds the heart and makes it beat harder by acting on beta-1 receptors. Bisoprolol blocks those receptors, so the heart beats more slowly and with less force. It needs less oxygen, which relieves angina, and blood pressure falls.

Tiredness, cold hands and feet, dizziness, headache, slow heartbeat and sometimes nausea or vivid dreams. Tiredness is usually worst in the first weeks and then eases.

Never stop bisoprolol suddenly: the heart can rebound and angina or blood pressure can worsen dangerously, so any stop is tapered by a doctor. Tell your doctor about asthma or other lung disease, a very slow heart rate, heart block, poor circulation or diabetes, since a beta blocker can mask the warning signs of a low blood sugar. It is a prescription medicine in Pakistan.