Bilocor contains bisoprolol, a beta-blocker used for high blood pressure, angina and heart failure. It slows the heart and reduces how hard it has to work. Bilocor Co adds a diuretic, hydrochlorothiazide, for blood pressure. It is a long-term medicine that should never be stopped suddenly.
What is Bilocor?
Bilocor contains bisoprolol fumarate and is registered in South Africa as Schedule 3:
| Product | Contains |
|---|---|
| Bilocor 5 mg | Bisoprolol fumarate 5 mg |
| Bilocor 10 mg | Bisoprolol fumarate 10 mg |
| Bilocor Co 2.5/6.25 | Bisoprolol 2.5 mg + hydrochlorothiazide 6.25 mg |
| Bilocor Co 5/6.25 | Bisoprolol 5 mg + hydrochlorothiazide 6.25 mg |
| Bilocor Co 10/6.25 | Bisoprolol 10 mg + hydrochlorothiazide 6.25 mg |
Check which one you have. Plain Bilocor and Bilocor Co are different medicines — “Co” contains a second active ingredient, a thiazide diuretic (water tablet), and brings its own considerations.
Bisoprolol is a beta-blocker. Adrenaline and related hormones act on beta receptors to speed the heart and make it contract harder. Bisoprolol blocks those receptors, so the heart beats more slowly and with less force. That lowers blood pressure and reduces the heart’s oxygen demand.
Bisoprolol is described as cardioselective, meaning it acts mainly on beta-1 receptors in the heart rather than the beta-2 receptors in the airways. That makes it better tolerated than older non-selective beta-blockers by people with breathing problems — but selectivity is relative, not absolute, and caution in asthma still applies.
Hydrochlorothiazide, in the Co versions, makes the kidneys excrete more salt and water, reducing blood volume and further lowering pressure. It is the same ingredient found in Ridaq.
What is Bilocor commonly used for?
- High blood pressure (hypertension) — the most common reason it is prescribed.
- Angina, reducing how often chest pain occurs on exertion by lowering the heart’s workload.
- Chronic heart failure, where bisoprolol is one of a small group of beta-blockers shown to improve outcomes. Here it is started at a very low dose and increased slowly.
- After a heart attack, to protect the heart.
- Certain fast or irregular heart rhythms, to control heart rate.
High blood pressure usually has no symptoms. That is the central thing to understand about this medicine: you will probably not feel any different on it, and feeling well is not evidence you no longer need it. It is treating a risk — of stroke, heart attack, kidney damage and heart failure — rather than a sensation.
In heart failure the approach is counterintuitive. A beta-blocker briefly makes symptoms feel worse before it helps, which is why it is introduced at a small dose and increased gradually over weeks. Feeling slightly worse early is expected and is not a reason to stop on your own.
How Bilocor fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Beta-blockers | Bisoprolol (Bilocor), carvedilol, atenolol | Slow the heart, reduce its workload |
| ACE inhibitors | Enalapril, perindopril | Relax vessels; protect heart and kidneys |
| ARBs | Losartan, valsartan | Similar to ACE inhibitors, without the cough |
| Calcium channel blockers | Amlodipine | Relax and widen blood vessels |
| Thiazide diuretics | Hydrochlorothiazide (Ridaq) | Remove salt and water |
| Statins | Simvastatin | Lower cholesterol; not blood pressure |
Blood pressure is often treated with two or more of these together, at modest doses, rather than one at a high dose — combining mechanisms works better and causes fewer side effects. See the blood pressure, heart and circulation medicines hub.
What to check before using Bilocor
Never stop a beta-blocker abruptly. This is the most important point on this page. Stopping suddenly can cause a rebound — a sharp rise in heart rate and blood pressure, worsening angina, and in people with heart disease a risk of heart attack or dangerous rhythm disturbance. If it needs to stop, a doctor reduces it gradually.
Tell your doctor or pharmacist if you:
- Have asthma or COPD. Beta-blockers can trigger bronchospasm. Bisoprolol is often used cautiously in mild disease, but this must be a considered decision.
- Have a slow heart rate or heart block.
- Have diabetes. Beta-blockers can mask the warning signs of a hypo — particularly the trembling and rapid heartbeat — leaving sweating as the main clue. Check your glucose more carefully.
- Have peripheral arterial disease or Raynaud’s, which may worsen.
- Have thyroid disease. Beta-blockers can mask overactive thyroid symptoms.
- Have kidney or liver disease.
- Have gout, or low potassium or sodium — relevant to the Co versions, as thiazides can worsen all three.
- Are pregnant, planning pregnancy or breastfeeding.
- Take verapamil or diltiazem, other blood pressure medicines, insulin or diabetes tablets, or anti-inflammatories such as ibuprofen, which raise blood pressure and blunt these medicines.
Take it at the same time each day, and keep appointments for blood pressure checks. The Co versions usually need periodic blood tests for kidney function, potassium and sodium.
Possible cautions and when to ask a pharmacist or doctor
Common effects are tiredness, dizziness — especially standing up quickly — cold hands and feet, slow pulse, headache, and sometimes vivid dreams or disturbed sleep. Tiredness often eases after the first weeks. With the Co versions, passing more urine is expected early on.
Seek medical advice promptly if you develop:
- A very slow pulse, or fainting.
- Increasing breathlessness, or waking at night short of breath.
- Marked swelling of the ankles or sudden weight gain, which may indicate worsening heart failure.
- Wheezing or chest tightness.
- Chest pain that is new, more frequent, or occurring at rest — seek emergency care.
- Severe dizziness or repeated fainting.
- Muscle cramps, weakness, marked thirst or confusion — possible salt imbalance from the diuretic.
- A rash, or with the Co versions, unusual sunburn.
Stand up slowly, particularly when starting or after an increase, and take care in hot weather or after alcohol, both of which lower blood pressure further.
Contact your doctor if you become pregnant, before starting any new medicine including over-the-counter anti-inflammatories, or if you are unwell with vomiting or diarrhoea — dehydration on a diuretic can affect the kidneys and may mean pausing it temporarily on advice.
Related medicine guides
- Browse Blood Pressure, Heart & Circulation Medicines guides
- Read: Ciplavasc used for
- Read: Ridaq used for
Frequently asked questions
What is Bilocor used for? High blood pressure, angina, chronic heart failure, protection after a heart attack, and control of some fast heart rhythms. It contains bisoprolol, a beta-blocker.
What is Bilocor 5 mg used for? A common maintenance strength for blood pressure or angina. In heart failure, treatment usually starts lower and builds up to it.
What is the difference between Bilocor and Bilocor Co? Bilocor Co also contains hydrochlorothiazide, a diuretic, for additional blood pressure lowering. Check your pack.
Can I stop taking it if my blood pressure is normal? No. Normal readings usually mean the medicine is working. Stopping abruptly is dangerous — speak to your doctor first.
Will I feel different on it? Often not, since high blood pressure has no symptoms. Some tiredness or cold hands early on is common and usually settles.
Can I take it with asthma? Only on medical advice. Beta-blockers can cause airway narrowing; bisoprolol is more selective but the caution still applies.
Does it affect diabetes? It can mask the early warning signs of a low blood sugar. Monitor more carefully and tell your doctor you are diabetic.
Can I take ibuprofen with it? Anti-inflammatories raise blood pressure and reduce the effect of these medicines, and combine badly with diuretics. Ask a pharmacist before using them regularly.