<p><strong>Adult</strong>: In the treatment of mild to moderate hypertension, Bisoprolol fumarate must be individualized to the needs of the patient. The usual starting dose is 5 mg once daily either added to a diuretic or alone. If the response to 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily. An appropriate interval for dose titration is 2 weeks. Increasing the dose beyond 20 mg once daily produces only a small incremental benefit.<br />
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<strong>Children</strong>: Safety and effectiveness in children have not been established.<br />
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<strong>Patients With Renal or Hepatic Impairment</strong>: In patients with hepatic impairment (hepatitis or cirrhosis) or renal dysfunction (creatinine clearance less than 40 mL/min) as in other patients, the initial daily dose should be 5 mg. Because of the possibility of accumulation, caution must be used in dose titration. Since limited data suggest that bisoprolol fumarate is not dialysable, drug replacement is not necessary in patients undergoing dialysis.<br />
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<strong>Geriatrics</strong>: In the elderly, it is not usually necessary to adjust the dose, unless there is also significant renal or hepatic dysfunction</p>