What is the difference between Propranolol Hydrochloride Tablets and Bisoprolol Fumarate Tablets?
Disease description:
Last year, the medicine prescribed by the doctor for angina was Propranolol Hydrochloride Tablets. However, when I went back to the hospital for a follow-up and to get more medication, the doctor switched it to Bisoprolol Fumarate Tablets. What is the difference between Propranolol Hydrochloride Tablets and Bisoprolol Fumarate Tablets?
Doctor's answer (1)
Dr. Tian Hongbo
Propranolol Hydrochloride Tablets and Bisoprolol Fumarate Tablets differ specifically as follows:
1. Pharmacological Characteristics: Propranolol Hydrochloride is a non-selective beta-blocker that blocks both beta-1 receptors in the heart and beta-2 receptors in vascular smooth muscle, potentially causing bronchial constriction and abnormalities in glucose and lipid metabolism. In contrast, Bisoprolol Fumarate is a highly selective beta-1 receptor blocker that primarily acts on the heart and has minimal effects on beta-2 receptors.
2. Mechanism of Action: Both medications slow heart rate and treat angina. Bisoprolol Fumarate, however, also inhibits beta-2 receptors at higher doses (≥20 mg), so maintaining selectivity requires using the lowest effective dose.
3. Metabolic Pathway: Propranolol Hydrochloride is primarily metabolized by the liver, whereas Bisoprolol Fumarate is partially metabolized by the liver and partially excreted via the kidneys. Dose adjustment is required for patients with hepatic impairment when using Propranolol Hydrochloride.
4. Indications and Contraindications: Both medications should be taken under a physician's guidance with regular monitoring of heart rate and related tests. Contraindications include bronchial asthma and cardiogenic shock, although there may be slight differences between the two drugs.
