Bisoprolol

[Andrea_1s]

Just looking for others experience. Last year my dad (80) was taken into hospital and had to have a triple heart bypass, ablation and defibrillator. He was then put on bisoprolol. Since then he has no energy. Can only walk a few steps, his legs give way. He stopped taking them and his cardiologist advised him to go back on them but on a lower dose. He just feels as bad now. He has low blood pressure and my understanding that this medication lowers his blood pressure. We are as a family stuck as what to do. We don’t think this tablet is right for him. What alternative to this medication is there?

[Hidden]

Hello Andrea, as I'm sure you will appreciate, we are not medically trained therefore we cannot recommend medication but we can make people aware of the alternatives. Bisoprolol is a very effective betablocker and it works well for many, however you can find many posts from members who express concerns about the side effects. There are a number of alternative betablockers and I'm sure that others here will share their knowledge and experience. In my case, I asked if I could try a calcium channel blocker which is also an alternative to betablockers and for, that was aa good move.

The point you raise about blood pressure is very valid and I would suggest that you ask if your father could see an Electrophysiologist (EP) because, as I understand it, only a consultant can recommend an alternative to Bosoprolol which is the only betablocker a GP can prescribe. To move things a bit quicker, maybe a private consultation with an EP would make a great 80th birthday present!......hope this helps.......

[Andrea_1s in reply to Hidden]

Thank you for the reply. We are thinking about going private but wasn’t sure who the best person to see. I will certainly now go down that route.

[Hidden]

My understanding is that Bisoprolol is used mainly to control heart rate. However, it has some characteristics which some healthcare professionals like to use it to lower blood pressure.

My view is to ask which of these it was prescribed for and if you are still unhappy, ask for a second and independent opinion.

I have been on 5 mg of Bisoprolol, taken at night, for the last 8 years. It successfully keeps my heart rate at around 65 BPM. Prior to AF my heart rate was usually around 88.

I am on separate meds for blood pressure, namely, Ramipril and Felodopine.

John

[Hidden]

Bisoprolol is mainly used to treat angina, hypertension and heart failure. It is also used as a rate control drug in AF. If your father has a low blood pressure, particularly on standing, then he is at risk of falling.

Bisoprolol is a powerful drug and elderly people are often very sensitive to it. Your father’s GP may feel it sensible to stop or reduce the dose, or try an alternative beta blocker, in the first instance. It really depends why it was prescribed.

If your father has a reasonable relationship with his GP, I think you should encourage him to see his GP initially. Involving too many doctors is often counterproductive, and puts the new doctor in a difficult position. A private doctor will not usually have the NHS notes.

[Mazza23]

I take 10 mg of bisoprolol a day and have done so for 4years with no sideffects bu t I know many people do talk to your GP

[Hidden]

Some good points raised by others and certainly worth discussing with your GP. However, I’m not sure he will want to make changes to medication which has been abvised by his cardiologist. May be a return visit to see him might be a way forward.

[Bazillion]

nice.org.uk/guidance/cg180/...

NICE guidelines give advice to healthcare professionals on the care and support that should be offered to people who use health and care services. You have the right to be involved in discussions and make informed decisions about your treatment and care with your healthcare team. You should be given relevant information that explains the options in a way you can understand. For more information see About care in the NHS on the NICE website.

About this decision aid

This information is intended to help you reach a decision about whether to take an anticoagulant to reduce your risk of stroke, and which one to take if you decide to do so. Your decision depends on several things that this decision aid will help explain. Different people will feel that some of these things are more important to them than others, so it’s important that you make a decision that is right for you personally.

You may have just been diagnosed with atrial fibrillation (AF for short) or may be considering changing anticoagulant treatment. This decision aid is designed for you to work through with the healthcare professional who is helping you make this decision. You might also find it helpful if you want to talk your decision over with your family or friends.

The information is based on the recommendations on anticoagulants in NICE’s guideline on atrial fibrillation. The guideline covers all the care and treatment that you can expect, and is explained in our information for the public about the guideline.

The above link is to the advise guidelines for patients with AF on anti coagulation. All patients are meant to be given this information but very few are. It’s only because my wife is a retired nurse and keeps up to date on these things.

This guide is 36 pages long and it gives you in depth information on choices you should be given before making a decision.

These bodies cost a lot of money and are there for our benefit. Drs May be the experts but we ultimately have to be given informed choices to make an informed decision not be told what is best for us.

[Hidden in reply to Bazillion]

Very helpful post Bazillion......thanks

[42boston]

My GP has just taken me off Bisoprolol and I feel 90% better as a result. I am left with Perindopril, an ace inhibitor, to control my high bood pressure and Warfarin to control my AF. There is a mass of information available to the public on the internet about alternative beta blockers to bisoprolol. Their generic names mostly end with the letters ...lol.

[Buffafly]

It certainly sounds as if the medication is not helping but may I make a lateral suggestion? Elderly people can lose muscle tone very quickly so unless your father is already having physiotherapy it might be good if he did some gentle strengthening exercises. The British Heart Foundation website has a set of seated exercises, exercises with bands, and another option is a seated exercise cycle.

I used to take Diltiazem instead of Bisoprolol because I am asthmatic and I am sure there must be other alternatives, best wishes.

[Hidden]

I am a 74 year old woman recently diagnosed with paroxysmal atrial fibrillation and have found that I can't take the lowest dose of bisoprolol regularly as it caused tiredness (and brings my heart beat down to 50 or less) . They still tell me I should use it as a "pill in a pocket" when I have an episode but I am then fairly exhausted for the next day. We are all different but sadly docs don't seem to appreciate this and tend to treat all patients the same! Good luck with finding what might be suitable for your father.

[goldie67]

Hi i am only on 5mg of bisopralol im constant tiered and feel dizzy at times my heart rate only sits at 40-48bpm i have doctor tomorrow to get a double appointment as i want my health and tablets reviewedhope you get to the bottom of it

[Adiepie]

Hi. Was put on bisoprolol boat cardiac “incident “ and diagnosis of PAF, however it left me exhausted. Switched to ACE inhibitors and calcium channel blockers and felt much better. Talk to your cardiologist, they are the experts!

[Hidden in reply to Adiepie]

Thanks for this Adiepie, I mentioned the calcium channel blockers to a doc at the surgery and he is going to leave a prescription for me to try but I forgot the ACE inhbitors? Do you have to take them together? And more importantly do they work - have they stopped the episodes and the exhaustion?

[Adiepie in reply to Hidden]

1) no

2) yes

3) mostly, but the ablation improved it much more!

[Hidden]

So, I'll see how the calcium channel blockers work and if not might mention the ACE inhibitors. I've only had the diagnosis for seven months and don't have many episodes and ablation has not been mentioned. I've decided against another test that I've been invited to have as it doesn't sound too good at all! Thanks for replying and hope things go well for you.