AF Association
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Coming off Bisoprolol

Hi,

I have been taking Bisoprolol 1.25mg for only 9 days and it's the worst days of my life. The breathlessness and Palpatations are so bad that I contacted my Dr today and he said to wean myself of off them. I couldn't quite hear what he said about reducing them as I had company and didn't want them to hear my private conversation. Surely after such a short time on them can't I just stop them or can anyone recommend how to wean myself of of them. I do remember my Dr saying take every other day and wean over a week but I'm confused as I would still be taking a whole tablet every other day. I just want to stop as hate these so much. Please can anyone help me as I haven't taken tonight's tablet and feeling a little anxious but I think that's due to worry. Thanks in advance for any advice.

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We shouldn't really advise on such matters but for what it is worth, when weaning myself off various things I went to half tablet one day. one the next etc and then half and next day half and so on till I was off them but it wasn't bioprolol.

That said to be honest 1.25 is about the smallest dose anyone ever had with many on 10mg! Are you sure it is the bisoprolol ? I know it can cause fatigue and breathlessness but it is supposed to stop your palpitations. If you are asthmatic then it should never have been prescribed but otherwise seems a really bad reaction on such a small dose.

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I agree 1.25mg is a tiny dose and surprising you are getting side effects on it. Although beta blockers can aggravate asthma, current thinking is that this view is overstated, especially with cardio selective betablockers like bisoprolol

pulmccm.org/main/2014/asthm...

As you say, after such a short time and on such a small dose, it is extremely unlikely you will get any problems. There is no formal advice, but I would have thought it reasonable to do half a tablet daily for 2 days, then half alt days then stop. (I am a GP in UK). Bisoprolol should also have a mild calming effect for your anxiety

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Sorry but bisoprolol is NOT cardiospecific and almost killed me because I'm a controlled asthmatic. I had to stop immediately and changed to verapamil, but am on nebivolol now which is one of the most cardiospecific beta blockers.

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Sorry but bisoprolol is classified as being cardio selective, but there are degrees of selectivity and as you say nebivolol is even more selective

en.wikipedia.org/wiki/Bisop...

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The Wikipedia article you give is mostly quoting numbers from research performed in a 1986 trial and is out of date.

Bisoprolol actually has a beta-1/beta-2 selectivity of 103 which whilst obviously far better than first generation beta blockers which were downright dangerous to anyone with lung problems, is still not really good enough to be classed as cardio-specific. Nebivolol has a selectivity of 293 and hence is significantly safer for asthmatics, but even then asthmatics should be carefully monitored when first taking it.

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I am unfamiliar with any classification for " cardio specific" as opposed to "cardio selective" beta blockers. I would be interested to read up on this if you can give me a reference

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They're the same meaning. Cardioselective was originally the American term and I sometimes lapse into English :-)

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Ongoing rant in defence of bisoprolol.

This is an excerpt from the bisoprolol data sheet.

"Bisoprolol is a highly beta1-selective-adrenoceptor blocking agent"

medicines.org.uk/emc/medici...

I can't find any reference to the term "cardio specific" in any scientific reference anywhere on the web in England or anywhere else. Not sure where you got idea that from.

However as a scotsman, I'm proud that it was a fellow scot Sir James Black, who developed the first commercial beta blocker (propranolol) non selective- and then atenolol was developed as the first cardio selective beta blocker. Improved selectivity has occurred since then as you mentioned, but I stick to my original statement that bisoprolol is classified as a cardioselective beta blocker. Also that the Brits were ahead of the Americans on this

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1.25 is a small dose but it's a horrendous drug. I was diagnosed osed at 19 and they put me on that when amiodarone and flecainide didn't work. Dropped my bloody pressure that much I could hardly get out of bed. Have you tried sotalol? I find that it has very few side effects, especially compared to the awful bisoprolol. Cut down your dose to half for 3 day then stop all together and see the GP on day 3 of the reduced dose to get a check over. Hope that helps a little, sometimes it helps knowing you're not the only one experiencing this. Hope everything works out for you!

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I was on 1.25 and felt dreadful, I could hardly move. I had onlybeen on them for a week, I was not given the weaning advice and just stopped wth no problems. That's not advice because I'm not you, it's just what I did in my case.

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Koll me too. Bisoprolol was 're introduced at half previous dose and still felt awful but maybe I was expecting it not to suit. The mind is a worrying thing! I was still on flecainide and reducing that as well

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I'm taking 7.5 mg daily and I'm not experiencing any side effects from taking it. It has not caused any drop in my blood pressure and I feel ok. Everyone reacts differently to drugs.

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Hi Mandie

Sorry to hear you are struggling with Bisperol.

I had the same issues for the first 3 weeks of taking it. But gradually my body seemed to get used to it.

I still feel breathless when faced with a hill to walk up, and at the end of the day could sleep for England! But so glad I persevered as I feel the Bisperol is now working well for me.

Hope this helps - perhaps just give yourself time to adjust? 😊

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I felt really bad when I went on them in February, I went to my doctor and she said don,t stop, I have felt a lot better now my body has got used to them. I hardly feel the palpitations now, I had a bad attack of svt in February which is why I was put on them.

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Thank you everyone for your kind replies. I was only put on these as my Troponin level was quite high and have been referred to a Rapid Heart Clinic so just waiting for an appointment. I have always suffered with breathlessness and Palpitation's as I am a Smoker but I am now going to try and quit. With the Biso tabs although only 9 days on them and I understand it takes time for your body to adjust to them but I personally found they were making me worse. I lived for 25 years with Agoraphobia so hardly ever left my house but over the past 3 years I've slowly overcome this and even started going Abroad but these tablets were making me feel so panicky that I didn't want to go out and there is no way that I want to go back to being agoraphobic just because of a tablet. I am happy that these do help a lot of people but at the same time they are also destroying other people. We are all different and our bodies tolerate things in different ways so I will now wait to see what happens at my hospital appointment and go from there. I will take there advise but not beta blockers . I don't really understand what Troponin means but when I had chest x-ray and ecg both were ok so I hadn't had an MI. I wish everyone all the best and you have all made me feel welcome and now I understand about weaning myself off of these tablets.

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Mandie4711 I didn't want to "like" your struggles but what an achievement to have come so far with controlling your agoraphobia. Amazing huge pat on the back. Xx Wendb

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Thank you Wendb it took a long time but my life changed so much for the better. I really enjoy going abroad now and was due to go to Spain this coming Sunday but with all the tablet problems and waiting to see the cardiologist I was advised to cancel our holiday. Hopefully when this is all sorted out I will be able to get away as thankfully we didn't lose any money for cancelling. xx

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I went down to half and then quarter of a tablet over a 2 week period. You could bring that down to every other day in second week. Please be aware that the breathlessness lasted for 3 weeks or so after cessation. When I say breathlessness, I mean that it was a slight out of breath feeling that lasted for an hour or so after long walks. Pulse remained in the mid to high 80's during that time.

If you are struggling for breath then, I would arrange another visit to the doctor at the earliest opportunity. 1.25 is a very low dose!

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Thank you RichMert,

As I was on a very low dose and only a short time I was going to try and just stop but if I needed to take a tablet then obviously I would. So far I have been ok as did not take one last night but am a little breathless at the moment but that maybe because I am a very anxious person at the best of times and I had a visitor who stayed for over an hour which I wasn't expecting so could be that. If still breathless in an hour or two then I will have to take one. Just that I was really hoping to never take another one as others have come off them straight away without any problems. Still best to be safe than sorry so will see how things go.

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One of the problems with anxiety (I suffer from it) the breathing and pulse monitoring whilst it is running fast tends to keep it that way longer because you are getting anxious about it.

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'''Quote =Mandie I couldn't quite hear what he said about reducing them as I had company and didn't want them to hear my private conversation.''

Hi Mandie, I would go back to your doctor for clarification . Also if you were prescribed the drug in the first place for a condition you will probably need to switch to another.

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Thanks doodle68,

I have just taken a quarter of a tablet as was a little anxious. If I need a bit more I will take another quarter. I don't really know why I was prescribed these as all happened so fast. I suffer with breathlessness as I am a smoker and just mentioned it to my Dr whom said doesn't think its my heart but to a blood test anyway. That evening she called and told me to get to A+E as my Troponin level was high and wanted to rule out a MI, At hospital I had ECG, Chest X-Ray and blood test all were fine except blood test was still a bit high. Very strange and no explanation so have been referred to Rapid heart Clinic for further testing. Apart from this everything was going well.

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I started on 12.5 mg a day . To say I was a zombie is an understatement !!

I was weaned off it for a while, halving the dose every couple of days. Be warned though when you do stop you may have horrible palpitations and/or headaches for a few days.

I'm back on 2.5mg a day now following my ablation and i'm hopeful that I can come off it again soon but I'm doubtful

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Hi Mikee69,

I an totally sympathise with you and I was only on 1.25mg a day and that knocked me out. I had to give in and I took just a third of a tablet earlier as my heart starting to feel funny. Even on only a third of my daily dose I am now extremely tired. I feel disappointed as was hoping to just come of them straight away but fingers crossed if I can manage on just a third of my tablet today them maybe tomorrow I wont need any. The sooner this stuff is out of my system the better. I really hope that you can soon come off of your 2.5mg tablets then we both might get our life's back. Good luck but I am sure you will be of them soon.

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It's not one to be messed with that's for sure. Good luck , I'm sure you will be feeling better soon

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I took that med for 5 days and quit cold turkey. HORRIBLE Med for me.

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Hi CatAnn,

I agree they are awful. Nine days of hell I suffered with these and I wanted to go cold turkey but being home alone I think I panicked so too just a third . Try cutting a small tablet into 3 pieces really hard. Within half an hour of such a tiny dose I felt tired and just like I had been all week. I am really hoping that this is it as I hate this feeling so its cold turkey for me tomorrow as well. The people who have no trouble with these tablets are so lucky as over the past week I have read so many comments where people are really suffering with this. All I want is my life back as on these I don't feel human at all. So pleased you managed to come off them without any trouble.

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I was also on the 'baby dose' of 1.25mg and had problems trying to come off them, had runs of ectopic beats which lasted continuously for 24 hours or so. Going back on Biso stopped them. This happened 3 times I tried to stop. Tried again, this time cut them in half, took this dose for 3 weeks, then went every other day for a week , stopped and so far, 3 weeks later all ok. You like me must be sensitive to this drug. In fact early on in my AF I tried 2.5mg and this slowed my heart rate to 40 ish, so I am glad to be off it.

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I am happy that you finally managed to come of off these drugs as they just don't agree with some people and totally turn our lives upside down. I have only taken a third of a tablet today and feel a little anxious and heart a little funny but blood pressure is quite low 95/59 pulse 72. Trying my hardest not to take anymore tablets as even just a third made me feel horrible. Where you on these for a while or like me just a short time. If absolutely necessary then I would take one but if I can get through tonight then hopefully that will be it. I wish I had never started these as I hate taking tablets at the best of times

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I was on them for about 2 years, had 2 ablations last year, AF free for 12 months (fingers tightly crossed), kept on them for a few months then tried to do without 6 months ago and had the problem coming off them, got more energy now. They don't 'do anything' for the AF and it's irregularity , just bring HR down.

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I had the same feelings until I was put onto Cardicor (brand name). The other mainly generic types made me feel awful. Get your doctor to prescribe it and give it a try. Pharmacists often try and fob you off with generic bisoprolol because of the costs but be persistent. Im very surprised that a doctor would just tell you to wean yourself off them!!! I would possibly also think about changing doctors too! You take bisoprolol for a life saving reason....

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I too started off with a 2.5mg and within a week reduced to 1.25mg iv been on them for three years now and in that time iv felt better for not taking them. Last year I went for mindfulness therapy and this worked a lot better for me. My Gp asked me if the CBT works then I could work to coming off bisoprolol. Anyway in the last few weeks iv felt pretty crap with bouts of NSR mostly when I'm asleep, iv been reading up on Magnesium and b12 apparently a lot of AF folk take this. Has anyone got any expiernces with magnesium.?

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I have read quite a bit about Magnesium and it is supposed to be very good for you. Sadly I cannot remember all the benefits as it was some time ago so I will have to read up again. I have now stopped taking the Bisoprolol and feel so much better and human again.

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Thanks Unome57,

I have stopped taking them now and feel so much better. I have an appointment with the Cardiologist in a few weeks time so will see what he thinks as I hate taking any drugs as I always seem to get ill on them.

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I was on Bisoprolol 1.25mg for eight months up until the start of May after an atrial fibrillation episode last September.While taking them I had huge breathing difficulties and also general malaise and disinterest in most things.My cardiologist advised me to wean off by taking a tablet every second day for three weeks and then a tablet every third day for three weeks.I have done this and now feel that my breathing is mostly very good.It was not easy during those weeks as I had regular palpitations and racing heartbeat.Also my breathing was very bad during the weaning period.There are sources on the net which advise that these are normal withdrawal symptoms when going off this drug.I now feel better most days but am still getting occasional bouts of palpitations and fast heart rate but I have decided to stick it out as I would never take Bisoprolol again.It seems it may take from two to six months to completely purge the body of this drug(if you have been taking it for quite a while).Withdrawel symtoms may occur intermittently during this period.So....a powerful drug even in low doses.Best of luck....

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Hi patton,

I had only been on these tablets for 9 days and was also advised to wean myself of them but I hated them that much as felt so ill that I took a quarter of a tablet one day and then none. I do still get palpatations and breathlessness but im not seeing a Cardiologist until 2nd August. I was told I had a high Troponin level that's what started all this off and was told at A+E that I would be seen within a week. I was due to go to Spain so cancelled that holiday and lost a lot of money but the annoying thing is I was given false information about my appointment. I have no idea now if and what is wrong with my Heart. Its like having a black cloud hanging over my head but im so glad im off the tablets and will never take them again.

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Hi Mandie....I can sympatise completely.I had an AF episode back in 2004 and had a successful electric cardioversion.I was on a calcium channel blocker(Amlodipine) since then which kept it at bay up until July last year.Probably my own fault as I was in Kerry in July last year on holidays and was running low on tablets.Decided to take a tablet only every other day(not clever!)....and when I returned to my doctor on coming home...AF active again.Another electric cardioversion in September last year and put on Bisoprolol and Diltiazem(calcium channel blocker) and also Xarelto(blood thinner).Since coming off the Bisoprolol I feel generally better.The other two I am still taking and am due to have a 24 hour heart monitor in September.I am getting occasional bouts of palpitations/fast heart rate and at this stage don't know if its intermittent AF or withdrawal symptoms of Bisoprolol.I intend to stick with it anyway as I can definitely feel better each week.When you see your cardiologist you can chat about what medicine suits you.Bisoprolol seemingly suits some people and causes problems for others just like most drugs I'd imagine.Best wishes...

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Hi patton

I am of the Bisoprolol now but yesterday and today ive had terrible breathing problems and to be honest thought I was going to die. I have phoned the Doctor and seeing her later on. I don't want to be put back on these tablets so just wondered what the Amiodipine was like. I am dreading my appointment but if I have to take tablets then I have no choice as cant live like this until I see the cardiologist in August.

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Hi Mandie

sorry to hear of your problems but I felt much the same after stopping the Bisoprolol.For me it has taken two months so far for me to feel my breathing has improved.The Amlodipine(Istin) was fine for me when I was on it from 2004-2016.However medicines seem to be different for different people so probably best to chat it over with your doctor.Best wishes...

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