For patients with Renal impairment, reduce the bisoprolol dose. Monitor creatinine clearance; dose adjustments are often necessary. Consult prescribing guidelines for specific recommendations based on eGFR.
In Patients with hepatic impairment, carefully monitor for signs of worsening liver function. Start with a low bisoprolol dose and titrate slowly. Closely observe for any adverse effects.
Patients with Asthma or COPD
Bisoprolol, a non-selective beta-blocker, may worsen bronchospasm. Use with caution in patients with asthma or chronic obstructive pulmonary disease (COPD). Consider alternative medications if respiratory symptoms arise. Careful monitoring is paramount.
Patients with Heart Failure
While bisoprolol is used in heart failure management, initiate treatment at a very low dose and titrate slowly. Closely monitor for worsening symptoms, particularly hypotension and bradycardia. Regularly assess ejection fraction.
For Elderly patients, initiate therapy with lower doses and increase gradually to minimize the risk of adverse effects. Regular monitoring of blood pressure and heart rate is recommended.
Diabetic patients should be monitored closely for changes in blood glucose levels. Bisoprolol can mask symptoms of hypoglycemia. Adjust antidiabetic medication as needed.
