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AF Association
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Bisoprolol replaced by Nebivolol

I posted about my experiences of the effects of Bisoprolol and my hope that something with fewer side effects could be prescribed:

healthunlocked.com/afassoci...

I saw my GP and described the symptoms which I have had for the four years I have been taking Bisoprolol (initially at 2.5mg and lately at 1.25mg). I explained the negative effects on my life and my inability sometimes to walk and talk.

He suggested I switch to Nebivolol - 2.5mg.

The effect was almost immediate - no breathlessness, walk and talk, perform a series of normal tasks one after the other without having to stop every 15 minutes to gasp for breath. In fact, in the first week I was exhausted from doing so much!!

The only thing I noticed was a slight headache in the first few days on Nebivolol.

I know some members are interested in this change and hope you find this report useful.

I feel better than I have done in quite a while. Long may it last.

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Oh finvola, that’s WONDERFUL to hear!! I’m so happy for you how it’s worked out. Thank you so much for letting us know. Long may it last indeed! Xx

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Thank you Jane - big smile on my face!

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Hi Finvola - As you may remember I was changed to Nebivolol nearly 3 months ago now. Biso did not effect me quite as badly as yourself - but yes I have noticed a big difference since I started it. Breathlessness is much improved and I feel less tired and more alert. Hope you see even more of an improvement over the next few weeks.

Cassie

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Now that you say it, my alertness is better too and I don’t feel tight chested and tired from the start of the day.

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Oddly i asked my gp today if he could consider an alternative for Bisoprolol and he stated categorically that there was no option than to take Bisoprolol. I shall go armed with your post to ask him to reconsider as i experience the same adverse effects as you describe. Thank you for posting this, it provides hope.

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Similar to me, jonjub - only in my case it was my EP who stated categorically the only alternative to bisoprolol he would consider is Sotolol - and that as it would be worse for my asthma, he wouldn’t recommend it. I hope your GP rethinks when you’re armed with this new information :)

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I changed to Sotolol and it gave me bad headaches although the breathlessness etc was better than bisoprolol but I have come off them both now. I have high blood pressure so I'm on BP meds but no beta blockers they just don't agree with me.

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I have mentioned my symptoms a few times to my cardiologist but he felt that other factors such as my fitness and dehydration were to blame.

With my GP, I decided to explain the effects more than the symptoms. Just a note of caution - my GP said that if I had palpitations, I should stop Nebivolol and return to Bisoprolol. I’ve due for a review with him in 10 days and I’ll ask him why Bisoprolol seems to be preferred and why I might have had palpitations. In fact, my heart rate is slightly down from low 70’s to high 60’s.

I’ve just had my evening walk and totally forgot about being breathless and so walked about 100 yards up a steep hill where I would have had to stop at least 3 times in the past.

Best wishes with your GP - I believe Nebivolol is more expensive than Bisop.

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That’s interesting - and when you ask, I’d love to hear your GPs responses if you don’t mind :) x

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Will post anything I learn Jane.

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Hi Finvola :-) I am delighted you are getting on well with Nebivolol .When I first started taking it and Apixaban at the same time I had a strange headache a sort of pressure in my head but I didn't know which if any med was responsible. It went away gradually.

AF symptoms accepted (eg tiredness /breathlessness during/after episodes ) I don't seem to get the permanent side effects many seem to get on Bisoprolol.

I hope the benefits of taking Nebivolol continue for you.

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Thank you doodle - the headache was slight and over the top of my head for a while each day at the start.

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So pleased you have found ( and been prescribed) an alternative that suits you better

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Interesting about the palpitations, I will bear that in mind. After I got my 1st lot of Nebivolol the pharmacist phoned me about a week later to see all was okay, then again a few weeks later. I was in a rush both times I should have asked him why!!! You will see from one of my previous post that I first asked at a cardio appointment to change to Nebivolol and I explained the reasons, but he did not really answer me looked at his book of drugs and prescribed me Carvedilol. This is totally unacceptable for someone with breathing problems. I was lucky when I next spoke to my GP I told her and she just said that's fine I will prescribe them. My reason for asking for the change was because there had been a few posts on here suggesting that it might be better than biso if you have breathing problems, so I can thank the forum for this. Regarding cost, I did have a look on line to compare costs and although it is more expensive it was not by very much.

Cassie

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Thank you for that information, Cassie. I’m assuming that my GP was covering all angles regarding palpitations as he mentioned my Kardia and was unconcerned but careful (as he always is).

Regarding cost of Nebivolol to the NHS, there is an interesting post from Mike11 further down.

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So glad for you Finvola! Must be a bit relief.Best wishes

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Hi I'm off to doctors in next few weeks so I will mention this to him as I'm pretty much the same Words are getting mixed up sometimes when chatting

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Oh, that happens to me - and I forget the most obvious, simple word occasionally. In my case, I don’t think I can put all the blame on the drugs ☹️ Old age is definitely kicking in too!! Hope you get some advice.

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Deffo old age with me and not working I'm become stale

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so glad these meds are working for you. Could you tell me, are they a rate control drug ? I’ve just been put back on digoxin as my heart rate went up to 155 but this drug dous’nt agree with me. Last time I was on it I had a really bad stomach all the time. I’m still in permanent AF though.

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My earlier reply seems to have vanished!!

Thank you Redders - yes Nebivolol is a rate control drug and has lowered my heart rate slightly more than Bisoprolol did. Not sure how the doses compare though.

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Well I went to my gp this morning and asked about putting me on nebivolol but he said no as it was a beta blocker which dous’nt agree with me. Back to the drawing board.

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That’s disappointing and I hope you can find something which suits you, Redders. Best wishes.

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Hi Redders - do you find you have swollen ankles/feet with your permanent AF? My pulse has been in 130s for weeks, but just recently had problems with swelling and edema.

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Hi Inezelsie, no I don’t seem to have swollen ankles/feet. Your pulse is very high have you seen your gp about it ? When my pulse was 140 they kept me in hospital overnight and put me on digoxin. I’ve had a date for my cardioversion at Plymouth hospital on the 20th July but not holding out much hope as my other cardioversions hav’nt worked. Hope you’re feeling ok now. Val

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My GP put me on furosemide for the edema, but it's a sulfonamide and I'm allergic to sulfa. I can only take it every other day, and it often makes me short of breath at that low dose. I try mostly to keep my sodium intake low, and drink a lot of water. Fortunately I feel good most of the time.

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Glad to say that I'm having the same results after two weeks on Nebivolol, prescribed by cardiologist. I am much less breathless and I feel much more alert. Felt terrible on Bisoprol, Corvedilol and Atenolol. After six months of fatigue and lethargy, life feels worth living again.

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Good news MT, especially after trying three other beta blockers - must have felt like nothing would help. Long may things continue in the better vein.

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Absolutely, Finvola. My GP hadn't heard of Nebivolol so i'll be reporting back to him this afternoon.

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I changed to nebivolol after 3 days on bisoprolol as it almost killed me. Anybody with even well controlled (or unknown) asthmatic symptoms should not take bisoprolol. Why they can't just make nebivolol the default beta blocker is beyond me as the price difference is now small and with higher volume would become the same price.

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Thank you for that, Mike. I too wonder why Bisoprolol is so beloved, especially as so many of us report breathing problems with it. I plan to ask . . .

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Bisoprolol did use to be a lot cheaper and the 2.5mg nebivolol tablets are still expensive for some reason. But the 5mg nebivolol tablets are much cheaper and come with a notch so you can break them in half easily.

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Hmmmm, interesting - presumably 2.5mg is a common dose - sounds very crafty on the manufacturer’s part.

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For some reason, at times I have had difficulty obtaining Nebivolol so for anyone with a repeat prescription I would advise ordering early.

I belong to a large doctors practice with its own pharmacy and have been told I am the only patient taking Nebivolol.

A couple of times during the year I have been taking Nebivolol I have ordered a repeat prescription allowing 2 working days only to find on going to collect it the prescription wasn't there. The first time this happened I was really worried because of running out over the weekend so I asked to take away the prescription. I had to telephone 4 chemists before I found one stocking Nebivolol, a large Boots in a nearby town.

I assumed from this that it must be expensive so wasn't kept in stock.

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Thanks for the heads up doodle - I’ll bear that in mind.

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How wonderful to hear that you are doing so much better. It seems that we all have different reactions to certain drugs and it's good to hear that the change is working.

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Thank you - I can’t quite believe the difference in two similar drugs!

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Thank you so much for this!

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This gives me heart Finvola because after two years on a 10mg of Bisoprolol I really feel I have aged 10 years! I am seeing my Cardiologist next week and I am definitely going to ask for a change to try Nebriovol Fingers crossed 😉

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Best wishes Kineton - I hope you can get some improvement too.

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Hi Finvola :-) can I ask how you are getting on with Nebivolol now you have been taking it for a few days. Does it suit you better?

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Hi doodle - thank you for asking. I’m coming up to the end of the fourth week on 2.5mg Nebivolol and it is like going back to being ‘normal’ again. The breathlessness, tight throat and heavy chest have gone. I can walk uphill much more easily as well as walk and talk at the same time. I’ve had very few ectopics but those I have had seem to be blunted - that could be wishful thinking, of course. 🙂

I have noticed two things which I need to discuss with my GP at my review on Tuesday next - heart rate is lower at rest from low 70’s to low 60’s and my normally lowish blood pressure is down overall, sometimes sitting at low 80’s over low 50’s for most of the day. I wonder if 2.5mg Nebivolol is double the dose of 1.25mg Bisoprolol and if 1.25mg Nebivolol would do the job without the BP drop which is a nuisance.

Overall, i’m feeling very positive about the change and can do normal tasks consecutively without the need to rest in between. I’ll know more after I see the GP and will post a short note on the changeover from my perspective.

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Hi Finvola :-) it's good to know things have improved for you on Nebivalol.

I also take 2.5 mg a day and I have quite a slow heart rate , resting rate between 48-58 which was worrying me a little but I was told at a recent review at the arrhythmia clinic that it was ok as long as I have no adverse symptoms (and I don't) but I must never increase the dose without supervision. Also on the plus side I now have a good blood pressure reading .

I found Dr Guptas video on the subject of a low heart rate very reassuring, he says 'it's not about the number but how you feel ' .

I am really grateful to be on a BB that doesn't seem to have the side effects many here experience and if the trade off is a heart rate that is a bit on the slow side at times I will happily settle for that.

I do keep an eye on it though and also for any symptoms.

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I know it’s a few months old now. But wonder how it’s going finvola or anyone who made the change over. I’ve tried a ace inhibitor and also a arb. Have been stuck on bisoprolol for 8 weeks now. With the cramps etc eventually improving slightly. However the breathlessness, walked up stairs did a small job and literally felt like I had smoked 50 a day , jitters and also the weak dead leg feelings. At some points I’ve had to literally pick my legs up to move them.

I’m also sure it’s made me more anxious

I worried about asking for this as drugs.com has many bad reviews.

I take it for high bp. (Wednesday appointment at docotors 140/92 on bisoprolol)

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Hi Mjltazz - I’ve been taking Nebivolol for some months now and I feel like a different person. I can walk uphill, am not breathless and have much more energy than when I took Bisoprolol. I know the dead leg feeling which you describe - I called it empty legs - and that has gone too.

I hope you can find something which works for you - my GP felt that it is very much trial and error to get the drugs and their combinations right.

Best wishes

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