The Basics
What is Bisoprolol?
A beta blocker medication most commonly used for heart diseases.
Brand names for Bisoprolol
Zebeta
How Bisoprolol is classified
Antihypertensive Agents, Adrenergic Beta-Antagonists, Antiarrhythmics
Bisoprolol During Pregnancy
Bisoprolol pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Bisoprolol while pregnant
In rats, bisoprolol fumarate was not teratogenic at doses up to 150 mg/kg/day which is 375 and 77 times the MRHD on the basis of body weight and body surface area, respectively. Bisoprolol fumarate was fetotoxic (increased late resorptions) at 50 mg/kg/day and maternotoxic (decreased food intake and body weight gain) at 150 mg/kg/day. The fetotoxicity in rats occurred at 125 times the MRHD on a body weight basis and 26 times the MRHD on the basis of body surface area. The maternotoxicity occurred at 375 times the MRHD on a body weight basis and 77 times the MRHD on the basis of body surface area. In rabbits, bisoprolol fumarate was not teratogenic at doses up to 12.5 mg/kg/day, which is 31 and 12 times the MRHD based on body weight and body surface area, respectively, but was embryolethal (increased early resorptions) at 12.5 mg/kg/day. There are no adequate and well-controlled studies in pregnant women. ZEBETA (bisoprolol fumarate) should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Taking Bisoprolol While Breastfeeding
What are recommendations for lactation if you're taking Bisoprolol?
Because there is little published experience with bisoprolol during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
Maternal / infant drug levels
Because there is little published experience with bisoprolol during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
Possible effects of Bisoprolol on milk supply
A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[5] Relevant published information on the effects of beta-blockade or bisoprolol during normal lactation was not found as of the revision date.
Possible alternatives to Bisoprolol
Propranolol, Labetalol, Metoprolol.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID: 2878668
2. Khurana R, Bin Jardan YA, Wilkie J, Brocks DR. Breast milk concentrations of amiodarone, desethylamiodarone, and bisoprolol following short-term drug exposure: Two case reports. J Clin Pharmacol. 2014;54:828-31. PMID: 24482268
3. Ho TK, Moretti ME, Schaeffer JK et al. Maternal beta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
4. Duke ME, Britten FL, Pretorius CJ et al. Maternal metyrapone use during breastfeeding: Safe for the breastfed infant. J Endocr Soc. 2019;3 :973-8. PMID: 31041428
5. Board JA, Fierro RJ, Wasserman AJ et al. Effects of alpha- and beta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID: 556882
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
