The heart-selective beta blocker — and one of the few medicines where feeling worse at the start is expected.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Bisoprolol is a cardioselective beta blocker. It blocks beta-1 receptors, which sit mainly on the heart, so it slows the heart rate and reduces the force of each beat.
Cardioselective matters practically: it acts far less on the beta-2 receptors in the airways than older beta blockers such as propranolol, which is why it can often be used cautiously in people with asthma or COPD where propranolol cannot.
In heart failure it does something counterintuitive — it makes people feel slightly worse for a few weeks and then measurably better, and it reduces mortality. Understanding that in advance is what stops people abandoning it in week two.
Tiredness and a general flatness in the first two to four weeks is common and usually settles. In heart failure, mild worsening of breathlessness during up-titration is expected rather than a sign the drug is wrong.
Do not stop because of this. Report it instead — the pace of increase can be slowed.
Diabetes is not a barrier, but bisoprolol blunts the adrenaline warning signs of hypoglycaemia — sweating and tremor — which is worth knowing if you take insulin or a sulfonylurea.
Heart rate and blood pressure at every dose change, plus kidney function and electrolytes in heart failure. A resting pulse below about 50 warrants review.
Yes, to continue established treatment where the diagnosis is clear and things are stable.
We will not start bisoprolol for heart failure remotely. That requires an echocardiogram, careful up-titration and monitoring of kidney function and blood pressure at each step — it is specialist-initiated for good reason.
Nor will we manage new or uncontrolled atrial fibrillation at a distance. That needs an ECG, a stroke risk assessment and a decision about anticoagulation, which is the part that actually prevents strokes.
Bisoprolol is a very cheap generic. A month's supply on a private prescription typically costs less than the England NHS prescription charge.
Available in several strengths, which matters because doses are titrated gradually.
Stopping a beta blocker suddenly after regular use can cause rebound rapid heart rate and raised blood pressure, and in people with heart disease it can precipitate angina or a heart attack.
Reduction is gradual, typically halving the dose every few days to weeks under supervision.
Early tiredness is expected and usually settles within a month. In heart failure, a temporary dip is part of how the drug works — the benefit comes later and is substantial.
Often yes, cautiously, because it is cardioselective — but not with severe or unstable asthma. Report any new wheeze.
A slower pulse is the drug working. Below 50, or with dizziness, blackouts or breathlessness, seek review.
Moderate alcohol is generally fine, though it adds to dizziness, especially early on.
Yes, and you should — but your maximum heart rate will be lower, so judge effort by how you feel rather than by a heart rate target.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews