Generally, bisoprolol is prescribed at a lower dose than metoprolol because of its greater beta-1 selectivity and longer half-life. A common starting dose of bisoprolol is 2.5-5 mg daily.
Begin by carefully reviewing the patient’s medical history and current metoprolol dosage. Consider factors like age, renal function, and other medications.
- Metoprolol Succinate (extended-release): Convert to bisoprolol at approximately the same total daily dose. For example, a patient on 100 mg Metoprolol Succinate daily might start with 5 mg Bisoprolol daily, then adjust based on clinical response and blood pressure monitoring. Metoprolol Tartrate (immediate-release): Conversion is more complex due to the shorter half-life. Careful titration is needed. Consider a slightly lower bisoprolol starting dose than the equivalent total daily dose of metoprolol tartrate. Close monitoring is vital.
Monitor blood pressure and heart rate regularly during the conversion process. Adjust bisoprolol dosage based on clinical response. Increase gradually, if necessary, in 2.5-5 mg increments at intervals of at least one week.
Typical adjustments are made every 1-2 weeks. Target blood pressure and heart rate should guide dosage adjustments. Always prioritize patient safety; sudden changes can cause adverse events.
Be aware of potential side effects, including bradycardia, hypotension, and fatigue. These are more common during the initial conversion phase. Discuss these potential side effects with the patient.
Regular follow-up appointments are crucial for monitoring response and making appropriate adjustments. Close communication between the physician and the patient is key for successful conversion.
