Beta Blockers as a Pill in the pocket

Hi

Does anybody take beta blockers (bisoprolol) as a pill in pocket for ab fib ?

Cheers

andy

[BobD Volunteer]

Not normally.

[Hidden]

As far as I know Andy, most people take a rhythm drug.

[Hidden]

Yes I do have one to try and bring the rate down ..start at 2.5mg then a further 2.5mg up to 10mg max. They don't do a great deal but if/when I have to present at A&E it saves time as they would always start me on them before dccv

Sandra

[OzLynda]

Yes, Sotalol 40mg. Twice it seemed to help when heart rate had climbed to 150+. It reduced heart rate and AF eased soon after. Once there was no noticeable change in heart rate (only about 135 that time) and the AF continued for some hours before self reverting. For reasons related to other heart issues I'm told I can't take any of the more commonly used 'pill in pocket' tablets.

[Hidden in reply to OzLynda]

I believe Sotalol is the only beta blocker used for rhythm control in AF. Obviously it also has rate control properties. I took it for 8 years and never felt it helped much.

[OzLynda in reply to Hidden]

Thanks oyster. I only ever thought of it as a rate control. I take 80mg per day (40 in morning, 40 at night), then an extra 40 if my AF still kicks in with a high heart rate. Which it does roughly every 4 to 6 weeks.

[BobD Volunteer in reply to Hidden]

Sotalol is no longer recommended by NICE.

[DGET1]

Yes, I take bisoprolol 2.5 when needed for PAF, it’s always been effective so far.

[gemsmum]

Hi Andy

Yes I take two 1.25 Bisoprolol as PIP when it starts. It slows my heart beat down but I usually stay in slow AF (not a medical term, just something I call it) until I revert to normal. It certainly helps me as it means I can get on with day to day things. EP suggested taking a rhythm drug along with Bisoprolol but so far I have refused as thankfully my AF appears about 2-3 times a year so holding off. Kind regards, Heather

[Hidden]

I was recently told by EP that as my electrocardiograph sowed all was good and my 72 hour monitor showed very little abnormal activity I could stop my beta-blocker Nebivolol and have Flecainide as a PIP. However, I have now had three episodes of AF all at night and am reluctant to start the Flecainide as I have read in several posts that it should be monitored the first time. So last night I resorted to the beta blocker and within an hour I was back in NSR.

[Brizzy5000]

I take 2x 1.25 bisiprolol plus 200mg of flecainide per day and when my episodes last a long time (I'm talking day's) I can take extra bisiprolol but to be honest they don't seem to make a lot of difference maybe slow down the rate a bit

[Finvola]

Andy - I hate the effects of Bisoprolol which I take with Flecainide.

I asked my EP if I could take my Bisoprolol as a PIP but he said it was not advisable because I take Flecainide which can start off bouts of Aflutter.

If you take an anti arrhythmic drug as well as Bisoprolol, get advice from your cardiologist.

[guitarman49]

Hi Just Flec Biso gives me problems as I have vagal PAF and when I do have an attack my heart rate remains around 80 bpm. Stay well.

[Steve01]

Hi, I take Bisoprolol 1.25mg as PIP as I didn't want to stay on it continuously and doc advised me to do this. My AF nearly always comes in the early hours and I will take a Bisoprolol tablet and an aspirin. I have also started suffering with choking in the night which I think may be sleep apnea but don't know yet. I tend to take Bisoprolol for a few days and then stop after an AF episode.

[Hidden in reply to Steve01]

Cheers sounds very similar to my case ! I did have a bit of sleep apnea but got rid of it through weight loss but I am convinced that's what gave me the AF ! I take 1.25 to take the edge of it !

[Hidden in reply to Steve01]

If you suspect you have apnea I would advise getting a home test done privately and take the results to your GP as I had a hard time convincing them I had it as I was only a stone or so overweight at the time ! The link between AF and apnea is very strong much more than people think !

[Steve01]

That's interesting to know, I have had some weird symptoms over the last couple of weeks, my tongue has been going numb on occasion also but always in the early hours. I could do with losing a bit of weight but I have been a lot heavier in the past and didn't have these symptoms. I tend to find my AF is worse if I have lacked sleep and the choking sensation is just making this a perpetual cycle. A home test might be the answer as I am caring full time for my mum and having to go into hospital just isn't an option for me.

[Hidden in reply to Steve01]

I will dig out the details of the place I used and send it over to you !

Andy

[Hidden in reply to Steve01]

Steve apologies for the delay the organisation i used to test for sleep apnea test was ukcpap.co.uk i think it was about 80 quid to rent the tester for a couple of weeks you do the test post it back and they email the results (fairly detailed) back to you ! You can then take to your GP ! andy

[Steve01 in reply to Hidden]

No worries, thanks for the reply.

[ILowe]

There are various combinations of PIP, depending on your starting point and on you. If you are aiming at avoiding attacks of AF or similar:

1/ For those on Biso, take some Flec as PIP.

2/ For those on Flec, take some Biso as PIP. Sometimes Flec creates irregularities, which the Biso helps to counteract. There can be other reasons you need it.

3/ For those on no meds, some Flec as PIP.

4/ For those on no meds, some Biso as PIP.

5/ For those on no meds. both Flec + Biso as PIP

While on no meds, I have experimented with all three options 3, 4, and 5. If in doubt option 5. If irregularities build up (hence the importance of constant self monitoring, so you remember what preceded your incident) and this is followed by tachycardia however mild, then I tackle the cause, excessive irregularities provoking correction by faster rate, hence Flec. You do not want to hit the rate control since that is working to your advantage.

Sometimes I find that my heart rate will just not settle to normal. Perhaps I am tired, and resting rate = walking rate. I take some Biso.

I actually think that taking Biso regularly for prophylaxis is counterproductive and can stimulate AF. This is because the Biso lowers the resting rate too much, and to correct it the body must increase the irregularities to stimulate a mini-tachycardia.

[pip_pip]

Yes, I do. I take bisoprolol 1.25 or more when necessary for Paroxysmal AF. Wouldn't go without it.

Phil

[Andyt36]

Started with that then moved onto Flecanide

[KathFrances]

Yes, I have 2.5mg bisoprolol plus 100mg flecainide - I take them together and they work well

[brit1]

I take 25mgs ext release Metoprolol daily and if I go into AF I take regular 25mg Metoprolol, so far has worked for me

[SMRM]

In the past I was on a beta blocker (carvedilol 1.25 bid) and was told I could take an additional when I had an episode. (Also on Xarelto) For awhile it worked, then episodes and duration and severity of sx (jaw pain, chest discomfort, SOB with activity) - all increased. This was at the same time that I started on antidepressant - bupropion - which I'd never had difficulty with in the past; and the same day the Thomas Fire started near our home in SoCal. I discontinued the bupropion and tried celexa, but episodes continued so I'm just doing the natural way of dealing with depression: talk therapy, walking in the sunshine, increasing social stuff, etc.

The episode had the acute sx for a time, then would shift to just an arrhythmia which left me lightheaded and weak feeling. Lasting from 1 to one 3-day episode.

The thrust of all that is that now I'm on flecainide 50mg bid - have had a few breakthrough episodes which have been much less symptomatic and have resolved quickly with another 5omg one time dose.

I was thinking it might be time to consider ablation, but I'm not having significant side effects with flec so that might be postponed. I have an appt with an EP to discuss. It would be great if the ablation meant I could discontinue the beta blocker and flec.

[Clarrie]

I take 80 mg Sotalol twice a day and can take extra when AF kicks in up to maximum of 320 mg a day.

[Hidden]

I have been given the lowest dosage of 1.25mg (bisoprofol) to act in this way (originally given 2.5 mg!) but last time I took one, the following day I was exhausted with a heartbeat of 50 (or lower) so am about to have another go at the doctor to prescribe something more suitable or just leave my body to sort itself out as I have paroxysmal AF and the episodes don't last very long and end themselves anyway. I have noticed as you seem to have done, that nowhere in the bumf that comes in the packet does it mention the use of beta blockers in this way. Even the cardiologist I saw said it was fine to use it as a pill in a pocket but it doesn't seem very sensible when you have a comparatively low heart beat as I do. I'd be interested to see how you do on it (and what dosage you have but you are male and dosages are calculated on the average man so they might suit you better!) Sadly medics do not seem to accept that people are different and react very differently to drugs!

[Hidden in reply to Hidden]

Hi

I am on 1.25 as 2.5 were too heavy duty as I have PAF esp if I sleep badly so tend to take 1.25 in the evening as and when needed. GP seemed ok with it !

Andy

[Hidden]

Hope it continues to work well for you.

[Toucy]

hi Andy, It just happends that I am going through this at the moment. As i understand it BISOPROLOL is a Beta B to control heart rate and you would need something else like FLECAINIDE to control PAF. In my case it is the FLECAINIDE that will be used as the PILL IN POCKET to control PAF not BISOPROLOL.

Hope this helps.