Bisoprolol and Bisoprolol / HCTZ Dosages for Adults: Your GoodRx Guide

Bisoprolol is a medication that treats high blood pressure (hypertension) and heart failure. It belongs to a class of medications called beta blockers. Bisoprolol is available on its own, as well as in a combination pill with hydrochlorothiazide (HCTZ), a diuretic ("water pill").

Bisoprolol comes in 5 mg and 10 mg tablets. Bisoprolol / HCTZ (Ziac) comes in 2.5 mg/6.25 mg, 5 mg/6.25 mg, and 10 mg/6.25 mg tablets. Understanding your recommended bisoprolol dosage and which tablet to take can help you get the most from your medication.

Here, we'll cover the typical bisoprolol dosages for adults. Keep in mind that the information below may differ from your prescriber's directions, so be sure to follow their instructions. The FDA hasn't approved bisoprolol or bisoprolol / HCTZ for use in children, so this article won't cover children's dosages. If this medication has been prescribed off-label for your child, reach out to your healthcare team about any dosage questions or concerns.

What's the typical bisoprolol dosage for adults?

Bisoprolol and bisoprolol / HCTZ have one FDA-approved use: treating high blood pressure in adults. But bisoprolol is also prescribed off-label for heart failure.

Bisoprolol

For high blood pressure, the typical bisoprolol dosage starts at 5 mg daily. From there, your prescriber may increase your dosage to 10 mg daily, then 20 mg daily, depending on how your blood pressure responds to the medication. The maximum recommended dosage is 20 mg daily. Your healthcare team may have you check your blood pressure regularly at home or return to the office for blood pressure checks to see how well it's working.

You'll typically take bisoprolol once daily, around the same time each day. Beta blockers can sometimes cause strange dreams, so taking bisoprolol in the morning may help lessen this side effect.

For heart failure, it's recommended to start with a bisoprolol dosage of 1.25 mg and work up to a target dosage of 10 mg daily. Your prescriber will determine the right dosage for you based on your symptoms. Keep in mind that the lowest dose of bisoprolol is a 5 mg tablet, so you'll need to cut it into quarters for a 1.25 mg dose.

Bisoprolol HCTZ

Bisoprolol may not lower your blood pressure enough by itself. In that case, your prescriber may switch you to bisoprolol / HCTZ to see if adding a diuretic makes a difference. In some cases, your prescriber may have you start taking bisoprolol / HCTZ even if you haven't tried bisoprolol alone.

The recommended starting dosage of bisoprolol / HCTZ for adults with hypertension is one 2.5 mg/6.25 mg tablet once daily. From there, your prescriber may increase your dose gradually (about every 2 weeks) as needed. The maximum recommended dosage is 20 mg/12.5 mg once daily (two 10 mg/6.25 mg tablets).

Diuretics such as HCTZ are nicknamed "water pills" because they help your body get rid of extra fluid. But they do this by making you pee more often. To help avoid having to get up throughout the night to use the bathroom, it's best to take bisoprolol / HCTZ in the morning.

Are there any dosage adjustments for medical conditions?

People with certain medical conditions may need a different dosage of bisoprolol or bisoprolol / HCTZ than what's described above.

Dosage for people with breathing problems

A lower starting bisoprolol dosage (2.5 mg daily) is recommended when it's being used to treat high blood pressure in people with asthma or other conditions that affect breathing. This is because beta blockers can worsen breathing problems in some cases. Bisoprolol has a lower risk of this side effect than some other beta blockers. But it's still best to use caution.

Keep in mind that the lowest available dose of bisoprolol is a 5 mg tablet. So you'll need to split it in half to get a 2.5 mg dose.

Dosage for people with liver or kidney problems

If you have liver or kidney problems, it can be harder for your body to clear bisoprolol. This can increase bisoprolol levels and raise your risk of side effects. So, you may need a lower bisoprolol dosage if you're living with these health conditions. It's recommended to start with a bisoprolol dosage of 2.5 mg once daily. Your prescriber will increase it slowly from there as needed, keeping an eye out for any side effects.

What happens if you miss a dose of bisoprolol?

If you forget to take a dose of bisoprolol or bisoprolol / HCTZ, take it as soon as you remember. However, if it's almost time for your next dose, just skip the missed one and stick to your regular schedule. Don't take two doses to make up for the one you missed.

It's important to take bisoprolol consistently. Stopping a beta blocker suddenly (or forgetting to take it for a few days in a row) could cause your blood pressure to go up. It may also cause serious heart problems, such as chest pain or heart attack. Try a medication reminder app or phone alarm to help you remember your medication. And let your prescriber know if you're missing bisoprolol doses often.

What should you do if you take too much bisoprolol?

If you take an extra dose of bisoprolol or bisoprolol / HCTZ by mistake, it's not likely to cause a major problem. You may feel tired or dizzy if your blood pressure drops lower than usual, but this should go away as the extra dose wears off.

But large amounts of bisoprolol can slow your heart rate and lower your blood pressure to a point that's dangerous or even life-threatening. Too much bisoprolol / HCTZ has the same risks, along with dehydration and electrolyte issues.

If you think you've taken too much bisoprolol or bisoprolol / HCTZ, contact a healthcare professional or reach out to Poison Control at 1-800-222-1222. If any of your symptoms seem life-threatening, call 911 or seek emergency care right away.

How to save on bisoprolol

There are ways to save on bisoprolol and bisoprolol / HCTZ. Both are available as lower-cost generics. GoodRx can also help you navigate ways to save on your prescription.

GoodRx can help you save over 50% off the average retail price of the generic versions. Generic bisoprolol's price at certain pharmacies is as low as $9.00with a free GoodRx discount. Generic bisoprolol / HCTZ's price at certain pharmacies is as low as $14.00with a free GoodRx discount.