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The first initiated treatment, ie, an ACE inhibitor, is more likely to be uptitrated to its target dose, whereas the second agent, ie, a β-blocker, is often given in suboptimal doses, if given at all.
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Bisoprolol is eliminated by two equally effective routes, that is, about half of the dose is metabolized to three inactive polar metabolites in the liver that are then eliminated by the kidneys.
In one embodiment, the administration of enriched (S)-bisoprolol or pharmaceutically acceptable salt thereof reduces one or more side effects relative to those observed following administration of a racemic mixture of bisoprolol.
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