Bisoprolol is contraindicated in patients with: acute heart failure or during episodes of heart failure decompensation requiring i.v. inotropic therapy, cardiogenic shock, AV block of second or third degree (without a pacemaker), sick sinus syndrome, sinoatrial block, symptomatic bradycardia, symptomatic hypotension, severe bronchial asthma, late stages of peripheral arterial occlusive disease and Raynaud's syndrome, untreated phaeochromocytoma (see Precautions), metabolic acidosis, hypersensitivity to bisoprolol or to any of the excipients.