I have decided to ween myself off Sotalol I take 360mg per day, I have a pacemaker inserted. I have been taking this beta blocker for the past seven years in different doses. I spoke to my GP and asked if I could try a pill in the pocket, which he has agreed for me to try. It will take me three weeks to completely come off the drug.
He has suggested Bisaroyl as the pip. I am concerned about all of this because it is my suggestion. I have PAF. Also coronary heart condition. When in AF it triggers off angina. But I feel I need to try it.
Has anyone on here experienced this.
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Junoesque
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Can you please confirm the name of the drug you are proposing to take as PIP? Do you mean bisoprolol? I do not recognise the drug with the spelling you gave.
Why not just take a larger dose of sotalol as a PiP as it obviously does work on you. Anyone with problems with it would have stopped taking it about 6.5 years ago.
I asked the doctor if I could take Sotalol as a PIP but he said they do not use this drug as a PIP. Sotalol makes me feel so tired and breathless especially at the high dose I was on. A lower dose doesn’t do anything. Even the higher dose does not keep AF in control. I have just tolerated. But my thoughts lately have been that perhaps I should tolerate the episodes of AF without the side effects of the drug. But need something to take if it gets too bad.
They don't normally use Verapamil as a PiP either, but that's what I use since I can't take Fleciamide. Everyone is different and if Sotalol in a quick maximum dosage kicks you out of AF then I think a good cardiologist would recommend it to your GP. And of course as a PiP, even if used every few weeks, won't have so many side effects.
Yes you are right Mike. Thanks for the reply. I am at last going to see a EP in December after a years wait. So will discuss this with him. I also cannot have Flecainide because of underlying heart decease. Did your GP say it was ok to take the verapamil?
I was on this high dose of Sotalol two years ago and had taken it for two years. It kept the AF under control but then it started to stop working and my cardiologist, after giving me a heart echo test, told me it was prolonging my Q R time (not sure what this is). Anyway he took me off it immediately and put me on 10mg of Bisoprolol a day plus a high dose of digoxin as a pip if I went into AF. The Bisoprolol took a little time to get used to but it is worth it as it worked fine and I have had only 2 episodes a year for the last two years. Worth a try!
Thanks Kington 38. I tried Bisoprolol several years ago and it worked a treat but after three years started to send me into bradycardia. That’s when the pacemaker was put in as an emergency. But as a pip it should be ok I should think. It is such a trial and error situation.
I agree, a variety of meds can be used as PIP including Sotalol and Verapamil. The key is that they are quick acting. The idea is that you kick start the heart by giving it a wave of highish dose.
I was even told by a British Cardiologist that Bisoprolol was worth the risk with mild asthmatics. Loads of people are using Bisoprolol as PIP. Try it. If you have asthma related problems, ask to try Nebivolol which has the least effect on the lungs. I hope you find a solution that works for you.
Be aware when talking to your doctor, that there are two problems to deal with. Increased heart rate (hence beta blockers and Verapamil/Diltiazem) and increased irregularities (hence Flecainide). Which problem you tackle is debatable and depends so much on the individual. But, my cardiologist said that PIP was usually both. And if you were already taking one type, you took only the other type as PIP.
Thank you for that advice. Will go ahead with this and hope I get some luck. As it is all I want to do is sleep and every chore I do is such an effort and it is all very exhausting.
If you are doing this under guidance from your GP then all should be well, having a pacemaker is reassuring as I know myself, if you start to get 'episodes' take the P/P and if that doesn't do the trick then contact your GP. Good luck
Yes thank you. I am getting episodes taking the Sotalol so hopefully when I am weened off the Sotalol I can control it with the PIP. At present I have to go through it without any help.
I am also on 180mgs of Sotalol twice a day; same dose as you. There is no way I would come off Sotalol without consulting with an EP cardiologist and it would be supervised in hospital in Australia. Maybe you should discuss it with a specialist first.
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