Bisoprolol withdrawal

[Becksagogo]

Hello. I'm new to this having only recently been diagnosed with AF. I was taking Bisoprolol but because I am having the op to put my heart back into it rhythm my cardiologist has suggested I come off them and start taking Amiodarone instead. Am I likely to get withdrawal symptoms from Bisoprolol.

[BobD Volunteer]

I guess you mean cardioversion which is not an operation but a quick go to sleep. zap with the paddles and wake up feeling better. Ten minutes max on average. The only puncture will be the cannula to send you to sleep. I guess you must be in persistent AF to be sent for CV. I have never taken bisoprolol so can't comment other than there is no reason why you should have any problems stopping it. With any luck you might even feel human. How long does he suggest taking the amiodarone which is a rhythm control drug? Bisoprolol only controls rate.

[Becksagogo in reply to BobD]

Hello Bob. I go for pre op tomorrow so will ask the consultant then how long I will be taking it for. This is all very new to me and quite scarey.

[BobD Volunteer in reply to Becksagogo]

I am surprised that you haven't already been started on it if your CV is tomorrow. Don't worry it is a simple procedure.

[seasider18 in reply to Becksagogo]

Each time I had a cardioversion they wanted me on Amiodarone for twelve weeks prior and for some time after.

I rather suspected that the twelve weeks was actually to suit their waiting lists

[ILowe in reply to BobD]

Strange that you should say amiodarone is a rhythm control drug. Yet it is used in acute situations, intravenous, for bringing down to a safe level a fast tachycardia.

The 2014 "Guidelines" say "Oral amiodarone may be useful for ventricular rate control when other measures are unsuccessful. Agreed, bisoprolol only controls rate.

[CaroleF]

I was taking a small dose of bisoprolol (1.25) and then stopped under different circumstances from yours. I experienced no problems doing that. As BobD has indicated in his message the 'effect' was beneficial rather than otherwise - in that I no longer felt 'zombified'. If you have been taking a large dose I suppose it might be wise to cut down the dose gradually over a period of time but since you are seeing the consultant tomorrow you can ask him/her tomorrow.

[Becksagogo in reply to CaroleF]

Thank you Carole. There are so many questions which seem important to me but not to the Consultant so it is good to know I am not alone with this. It seems that everyone reacts differently too.

[RobertELee]

I continued on bisoprolol after my successful ablation for the irrational reason that if my heart went faster I might go back into AF - nonsense of course but it seemed best to leave well alone. After a few months I made myself a concession and reduced daily dose from 5mg to 2.5g with little obvious effect. Finally, two years after the ablation, I stopped taking it completely after reducing to 1.25mg for a week. For a couple of nights I was awoken to a 100+ heartbeat and, I confess, I very nearly popped one! But it didn't last and I now consider myself fully withdrawn. I've noticed that my resting heart rate is now in the low 70s compared to high 50s but there is no doubt I do feel better overall for not having the drug.

Now, statins.......

[adriatico in reply to RobertELee]

You were taking Biso for two years after the ablation? I am stopping both Fleca and Metopropol one month after ablation. I am scared a bit. Why EP's are so different?

[Hidden]

I was on a very high dose (12.5 mg daily)

The dose was reduced gradually and I did have some withdrawal symptoms, mainly migraine like headache and some palpitations. This lasted 10 days or so, then I felt so much better and less zombie like.

Unfortunately I'm back on the Bisoprolol again but hopefully after ablation I will be rid of it again.

Keep on the lookout for side effects from the amiodorone, I reacted terribly to that.

[Becksagogo in reply to Hidden]

Oh bless you Mike. It seems that you give up taking one tablet and then take on a whole new set of " problems" with the new drug. I made the mistake of reading the leaflet for Amiodarone and see I am destined to spend the rest of my life hiding from the sun!

[Hidden in reply to Becksagogo]

I didn't want to come over as a scaremonger but you have done the right thing reading up on amiodorone. It's a "dirty" drug and you do need to be very aware of some of the potential side effects.

I doubt you'll be on it for more than 3 to 6 months. I started taking it a month before my cardioversion and the plan was to take it for 6 months after. However I was feeling worse and worse following my successful cardioversion and it got to the point after 4 months of taking it that I was getting sunburn wearing factor 50 whilst being inside the house. My EP told me to stop taking it immediately. Tests showed that it had also made my thyroid go overactive. Thankfully 12 months on the thyroid function is back to normal and I can drive to work in the daylight.

Of course everyone is different and many will tell you that they have no side effects from amiodorone.

I am also in no doubt that it kept me in NSR for 6 months following my CV, but I have refused to take it again

[Hidden in reply to Hidden]

Oh, and I was on bisoprolol and amiodorone at the same time, one controls rate, the other rhythm

[ILowe in reply to Hidden]

Again I am surprised by that. As I understand it, Amiodarone, like Sotalex, touches both rate and rhythm. Therefore, any combination therapy is potentially dangerous.

[Hidden in reply to Becksagogo]

Don't over worry about the sun and Amiodarone. Just be sensible. Use a high protection sun cream and don't deliberately expose yourself to the sun's rays.

I've taken this a few times..the longest being a period of 18 months. Prior to that I had always been a ' sun worshipper '.I made sure I had a sunhat available for prolonged periods in the sun and a voile-y type shirt to hand for covering up.

The cardioversion is nothing to worry about...a great relief to get back into a normal rhythm ( I've had 16 of these over the years)

Best wishes

Sandra

[Becksagogo in reply to Hidden]

Thanks for your comments Sandra. I too love the sun and hate to think that I can't enjoy it any more! I gather the cardioversion is not a fix and may not last.

[Hidden in reply to Becksagogo]

Becks, you are correct in thinking that cardioversion is not a fix as such. Think positive. I've had two which kept me in normal ( sinus ) rhythm for 3/5 years but normally averaging 12 months. ( I'm 8+ months since my last )

Let us know how you get on

By the way..I didn't get any withdrawal symptoms coming off Bisoprolol...just a blessed relief.

Sandra

[Mike-tyson]

Understand you should come off Bisoprolol gradually but depends how much you are taking per day. Your Doctor will know the best way. I would question it with your Doctor.

[Becksagogo in reply to Mike-tyson]

Thank you Mike

[Alibalibea]

I have been coming of Bisoprolol since 6th December reducing from 2.5mg to nil 2 weeks ago. I was on the tablet 24 years and have had withdrawals but they have been manageable the main problem being the release ogbadrenaline causing a faster heart rate and me being jittery and speeded up. On the advice of members of another forum I have been drinking more water which has helped. I have also been raking Magnesium tabletsv200mg morning and evening. I am sleeping better than ever, and feel more clear headed. Good luck I hope you feel better soon.

[Prancer]

I appreciate each patient is unique and different in terms of type of AF/symptoms/reactions etc.etc. but to quote Adriatico above I really do wonder “Why EP's are so different?" My experience is:

I started Amiodarone, 200mg daily, in mid October, so as to comply with the 6 weeks my EP required pre-ablation, and assuming it might be continued for the 2nd ablation he thought likely. At that time my Bisoprolol had just been increased to 5 mg per day.

I continued on both these in fact for 5 months right up to the very delayed ablation 2 weeks ago.

I was lucky enough to have no obvious side-effects (at least physical – I do wonder about mental ones though?). The Amiodarone did put me in NSR, however, which my EP seemed pleased about pre-ablation.

Immediately post-ablation my Amiodarone dosage has been cut to 100mg and will be discontinued after 6 weeks. In the absence of any other information, I have to assume I am still in NSR – for now but what will happen when I come off it? My Bisoprolol dosage has been cut, "given brachycardia", to 2.5mg per day as well.

[michou]

same story - am having my ablation in a couple of weeks and I was taken off Bisoprolol also because I was completely knackered. What they did not tell me is that it takes a week or so to kick in and as soon as I went on Amiodarone my fatigue stopped but my heart beat went into overdrive - I thought it was withdrawal symptoms but it was not and it took a while for my HB to settle - fine now. The consultant at the hospital said it was a fantastic drug!

[Becksagogo in reply to michou]

I don't seem to be having withdrawal symptoms from Bisoprolol however like you my heart palpitations on Amiodarone seem to be more noticeable! I guess it is a small price to pay to feel " normal " again. Like you I was tired on Bisoprolol caused by weird dreams and waking up at two every night! Let's hope this procedure is a success for both of us!

[audi1]

don't go on amiadrone it made me I'll my liver was in a right mess make sure thay give you regularly blood tests

[Becksagogo in reply to audi1]

Thank you Audi1. My post was from two years ago. Unfortunately I did go down the Amiodarone route and wish I hadn't. I took myself off after 6 months but in that time it affected my thyroid, liver and kidneys. I understand that it is no longer the drug of choice. Thank goodness.