What dosage can you tolerate?? (Bisoprolol and Ramipril)

I'm titrating up my dosages of Bisoprolol and Ramipril. My cardiologist wants me to get as high as possible (e.g. 10mg of each). However, I don't suffer from high blood pressure and I only weigh 63kg.

I'm interested to know if anyone else with a similar weight and blood pressure level has been able to tolerate such high doses.

I'm currently on 2.5mg of each and it's not completely wiping me out but I'm certainly operating at a reduced function.

All advice/suggestions are gratefully received. Many thanks.

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Hi there

I am a it over your weight and I take Bisopropol 5mg, I started om 2.5mg 3 1/2 years ago. I seem reasonable okay on 5 mg but if I take over that I become zombie like, feeling terrible. May of last year my cardio wanted to increase to 7.5mg but I refused (its all very well telling us that can go upto 10 mg but it impairs my QOL so I refused). After much ado I was given Diltiazem 180mg to take with the 5 mg of Biso which works fine, I used to get some breathlessness with biso but the Dilitiazem seem to reduced that greatly.

I am also on Ramipril, this I am told is to make th heart stronger, started on 2.5 then 5 and recently now on 7.5. This is because I also have heart failure which has been playing up receently.

Bassically I am saying its all very well the medics saying we can increase to higher levels but this often causes problems, some will just not try you on different drugs that might suit better.

Try and talk to your GP, Cardi or EP about your side effects. I met an elderly lady (80) ten years older than me. She was prescribed AF drugs which made her feel alwful, Bisoprolol, she ws under the impression that she had to put up with the side effects, so did not complain. I eventually helped her with this and she is now on drugs that suit her and she is almost her old self again.

Sorry for long post - Over the last 3 1/2 years I just got fed up with the stock line that we can increase the dosage, and donn't seem to want to know the side effects that some of them have.

Cassie

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I couldn't even take the lowest dose of that med...I stopped taking it. Made me feel horrible and I think I was on 1.25mg.

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Hi Pikaia , I weigh 68 kg and am currently on 12.5 mg Bisoprolol. I was on ramipril 2.5 per day but was changed to 4mg candesartan although I can't remember the reasoning for that change. It was some time ago.

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12.5mg?!?! That's a lot. Hopefully I'll have no trouble increasing. I'm starting 3.75mg tonight.

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Isn't it strange how different we all are? I had a successful ablation over two years ago and came off bisoprolol. I had experienced no side effects with my 2.5mg dosage but as I no longer had AF it seemed to be the right thing to do even though I missed the gentle, low heart rate. However, almost certainly as a direct result of that, I experienced a slight increase in blood pressure. GP initially prescribed Indapamide, a water tablet, to supplement my standard BP med. That was awful - erratic BP, sometimes high, sometimes very low, palpitations and dizzy spells for much of the day. After a couple of weeks of that, GP suggested binning the water tablet and to go back on bisoprolol. How wonderful it was to be back on it. Blood pressure is back to the low side of normal, no more palpitations or dizziness and, most reassuringly for me, heartbeat is back down to 55/60 bpm,

I love bisoprolol!

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From what I've read on here you appear to be the only person who actually likes taking bisoprolol! I've been a little more tired than usual, but I can't work out if that's all in my head or not.

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Is bisoprolol and metoprolol tarts are the same drug? I recently started metoprolol and I haven't felt this "normal" heart beat in years. I'm in the US.

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Hi. Assuming you have persistent AF, which is the only way you could tolerate 10mg of Bisoprolol per day. If you are in paroxysmal AF its unlikey your heart rate would tolerate such a high dose. If in persistent AF be aware that the highest dose in this country is in fact 20mg per day. I was unfortunate enough to be in this position some years ago, altho the dose only reached 17.5mg per day. i have to admit after a couple of weeks of this appalling situation, not being able to barely stand it was reduced to 12.5mg .

Ramipril made me dizzy on the smallest dose.

Forunately after my third ablation three years ago, I no longer need either of these meds.

Phil

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I have paroxysmal AF. My cardiologist has just said to get as close as I can to 10mg. Good to hear your ablations reduced the need for your meds. That sounds like success to me!

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I've been in a similar position. My cardiologist wanted me on the standard 10mg of Bisoprolol and 10mg of Ramipril. But already having a fairly low BP I just couldn't tolerate it; I kept getting dizzy and nearly passing out when standing up. But after discussions with both my cardiologist and a prescribing heart failure nurse we tried some changes out and I've ended up taking 5mg Bisoprolol and splitting the Ramipril into 5mg, twice a day.

I do think prsonalised medicine is the way forwards, so have a chat to your consultant and see what they can suggest to suit you better.

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Thanks. Hopefully I can tolerate it, and hopefully it does me some good.

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I am a lot heavier but I have been on 10mg for many years and I do not think it has made a great deal of difference to me? However I was put on Dilitiazem and taken off Bisoporol which put me into hospital. and then 3 months of ambulatory care to get me in order again. I do have multi conditions which complicates most of what I can and cannot take? Total of 16 prescriptions at present! :( It does depend so much each of us though?

Be Well

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I think you've hit the nail on the head. We're all so different in our genetics, lifestyle and ability to cope and respond to these meds that its impossible to know whether we'll cope or not. Hopefully I can keep increasing my dose and they'll do me some good.

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My heart failure nurse and the doctor almost literally came to blows over my Bisoprolol as she was adamant that 10mg was the maximum advised for AF patients with HF, and the doctor was in favour of 20mg for me. Happily they came to the 12.5 mg agreement before the cleaners were called in anticipation of the bloody outcome 😀

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I weigh slightly less than you and have tolerated 10 mg Bisoprolol for 5 years. I have not suffered any side effects and can swim 500 metres 3x each week and walk miles. I also take Digoxin.

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Thanks for your reply Mrspat, good to hear that you can still be pretty sporty without side effects.

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I’m new to all this and take 2.5ml Ramipril twice a day and Bisoprolol 2.5ml once in morning with no noticeable effect.

I don’t understand why they want to increase the doses?

They are waiting for my CRT-D to be fitted

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Hi STA4

Out of context your post is difficult to interpret. I can see you are currently posting on the BHF site.

Did you mean to post here, do you have AF?

Suggest you start a new thread with full information on relevant background. Have you had a look at the Information link top right for the CRT-D ? What is the indication for it?

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