How quick does Bisopralol work - Atrial Fibrillati...

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How quick does Bisopralol work

higgy52 profile image
19 Replies

Sorry just put post on but only half of it went not to good on net.

I take 2.5 mg Bisoprolol in morning to slow heart rate down 9 months post Ablation, check pulse in morning 90 ish, check it at night its 60 ish. i do have thyroid trouble as been on Amiodarone so long, just wondered how quick Bisoprolol starts working and stays in your body. or is my over active thyroid the problem

Thank you

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higgy52
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19 Replies
CaroleF profile image
CaroleF

I am not competent to comment on your lower heart rate in the evening, nor on your medication for thyroid problems, but bisoprolol starts working within a couple of hours.

I don't know how long it stays in the body, I'm afraid.

higgy52 profile image
higgy52 in reply toCaroleF

Thank you

CaroleF profile image
CaroleF in reply tohiggy52

Just a thought .... the quickest, and best, way of getting an authoritative answer to your questions is to ask the pharmacist who dispenses your prescription. [They are the experts on things like this - and an under-used resource in my opinion.] I find mine extremely helpful and you can just go in (or phone) and get an answer there and then rather than waiting for weeks for a GP non-emergency appointment.

higgy52 profile image
higgy52 in reply toCaroleF

good idea thanks

Barry24 profile image
Barry24 in reply tohiggy52

Hi Higgy,

I think Carole has hit the nail on the head, best suggestion. I use my Pharmacist a lot for any questions about medication.

Be well.

Barry

higgy52 profile image
higgy52 in reply toBarry24

Thanks Barry,

Going in today to see Pharmacist

When I've been given Bisoprolol in A&E they expect it to start working within half an hour.

CaroleF profile image
CaroleF in reply to

Do they? (genuine question). Last time I was in A&E with a high HR (200+) I was told a couple of hours. Maybe they meant that they anticipated a observable/significant reduction in HR after a couple of hours. I was keeping an eye on the monitor and HR only dropped significantly after 2 hours or so.

higgy52 profile image
higgy52 in reply toCaroleF

Thank you, The more info the better

Maybe it continues to work to its optimum level in 2 hrs ? .....if that makes sense ! I'm only going by my experience. It doesn't work much for me now but in days of yore I used to get a reduction in rate in half an hour.

If you taking all the time and one a day presumably it's working continuously

cuore profile image
cuore

As I am on Amiodarone, I am most concerned about my thyroid. How long were you on Amiodarone to cause you your thyroid problem?

higgy52 profile image
higgy52 in reply tocuore

Hi,

Been on Amiodarone for 1 year 9 months and they wont let me come off it yet, as its to soon after Ablation 9 months ago, might have to have a Ablation for Atrial flutter next so might be on it for 6 more months. thyroid started playing up after 4 months ofter going on Amiodarone

cuore profile image
cuore in reply tohiggy52

It sounds as if this was your first ablation nine months ago, but prior to the ablation, you were on Amioderone for a whole year. Do you mean that you will have to be on Amiodarone for six more months to possibly get you to the Atrial Flutter ablation date?

Nine months post ablation to still continue to take Amiodarone appears long since your thyroid acted up 4 months from initially taking it? A member on this site quoted that 30g is the danger zone for Amiodarone, and that can be reached at 6 months taking 200 mg per day. You got there in 4 months. Did "they" explain why they won't let you come off it?

I am now at 4 months post ablation, and mineral deposits were found in my eyes 3 months post ablation. I have requested my EP take me off it, and should expect some reply soon. Now I am wondering, Higgy52, whether my thyroid has also acted up, granted we are all different?

higgy52 profile image
higgy52 in reply tocuore

yes when e p put me on 200 mg of amiodarone he said give you a cardiovertion, as you know how long the waiting lists are to get any thing done, 3 months later had cardiovertion sent me home said it worked back in normal rhythm till next day back in A F,

So waited few months for follow up Appointment, and said i would like a Ablation so was on waiting list for 5 moths then had Ablation,

In meantime under Endocronolagist who wrote to E P and recemend i come off Amiodarone but E P said no its to early,

cuore profile image
cuore in reply tohiggy52

If I have read your comments correctly, you were in persistent atrial fibrillation for one year during which you were on 200 mg Amiodarone pre-ablation. But, were you in persistent AF prior to that year, by which the total would be one year plus, and you would be in long-standing AF?

Now you are 9 months post ablation and still taking 200 mg of Amiodarone. did you ask you EP what he/she mean by too soon in light of the fact that you will have a probable ablation in 6 months for Atrial Flutter. If my analysis is correct, by Atrial Flutter ablation time you will have been on Amiodarone 2 years and 3 months (12 months + 9 months + 6 months =27 months). So, post atrial flutter ablation, will you still be on Amiodarone especially since you endocrinologist wants you to come off it?

Different EP's have different mindsets regarding Amiodarone. There must be a rationale why your EP wants you to remain on it for so long especially, as you say, your thyroid is being compromised.

higgy52 profile image
higgy52 in reply tocuore

Hi Cuore,

Yes think ive had A F for years, nearly 3 years ago i was diagnosed With persistent A F,

The E P thinks if i come off it i might go back in A F, Ive asked him 3 times if i can come off it and told him its destroying me Thyroid and lot of other thing , but he just says stay on it, What do you do.

cuore profile image
cuore in reply tohiggy52

You evaluate what your EP wants relative to how another EP would prescribe in a similar situation. (Getting similar situation is difficult unless perhaps you ask some people on this forum what their EP did) Then, if there is a different process, you might present it to your EP whether it would be satisfactory to him/her.

For example, my EP wrote in my report (as I had my ablation in Bordeaux) "We recommend that the patient continues with Amiodarone for a few months and anticoagulation. Amiodarone may be replaced by FLECAINIDE." During the "loading period" I had a vomiting reaction to Amiodarone which is perhaps why Flecainide could be replaced as it is also an anti-rhythmic drug . But, now I am able to tolerate Amiodarone. My optometrist did say that I do have mineral deposits in my eyes which is a side-effect.

Now, my Bordeaux EP, when I asked to be taken off of it after three months, stated that it will be discontinued until everything is fixed. My local EP would discontinue it now so as to be in arrythmia for the ablation as to better see the rogue electrical impulses. There appear to be two different approaches.

The bottom line is seek a different approach, present it to you EP, and ask how long after your next ablation do you still have to remain on Amiodarone.

Obviously, I speak from experience with no medical background.

Japaholic profile image
Japaholic

Binding to serum proteins is approximately 30%. Peak plasma concentrations occur within 2-4 hours of dosing with 5 to 20 mg, and mean peak values range from 16 ng/mL at 5 mg to 70 ng/mL at 20 mg. Once daily dosing with Bisoprolol fumarate results in less than twofold intersubject variation in peak plasma levels. The plasma elimination half-life is 9-12 hours and is slightly longer in elderly patients, in part because of decreased renal function in that population. Steady state is attained within 5 days of once daily dosing. In both young and elderly populations, plasma accumulation is low; the accumulation factor ranges from 1.1 to 1.3, and is what would be expected from the first order kinetics and once daily dosing. Plasma concentrations are proportional to the administered dose in the range of 5 to 20 mg

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