When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to bisoprolol or any type of beta blocker medicine (such as atenolol, metoprolol, propranolol, Corgard®, Inderal®, Lopressor®, Tenormin®, or Toprol®), or if you have certain heart problems. Talk with your doctor about what these heart problems are.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• You may take this medicine with or without food.
• Carefully follow your doctor's instructions about any special diet.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using clonidine (Catapres®), digoxin (Lanoxin®), diltiazem (Cardizem®), guanethidine (Ismelin®), reserpine, rifampin (Rifadin®, Rimactane®), verapamil (Calan®, Isoptin®, Verelan®), other blood pressure medicines (such as atenolol, metoprolol, propranolol, timolol, Inderal®, or Toprol®), medicines for heart rhythm problem (such as disopyramide, Norpace®), or diabetes medicines (such as glyburide, insulin, metformin, Actos®, or Glucotrol®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, angina (severe chest pain), blood vessel or circulation problems, diabetes, heart disease, heart failure, lung or breathing problems (such as asthma, bronchitis, or emphysema), or an overactive thyroid.
• This medicine may cause or worsen heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may raise or lower your blood sugar level.
• This medicine may make you less alert than you are normally. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Many patients who have high blood pressure will not notice any symptoms of the condition. In fact, many patients feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• This medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life.
• If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain (may be related to your disease and not a side effect).
• Fainting or severe dizziness.
• Fast, slow, or uneven heartbeat.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Shortness of breath, cold sweat, and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Wheezing or trouble breathing.

If you notice these less serious side effects, talk with your doctor:

• Cold hands and feet.
• Diarrhea, nausea, or vomiting.
• Feeling dizzy, drowsy, or depressed.
• Joint or muscle pain.
• Stuffy or runny nose.
• Trouble having sex.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088