Goodbye Bisoprolol - welcome Nebivolol

[Finvola]

After more than four years of putting up with the misery of breathlessness, I am now officially on Nebivolol 2.5mg daily.

Original thread here:

healthunlocked.com/afassoci...

After four weeks on Nebivolol, I’ve had no breathlessness, tight chest or wobbly legs at all. I’ve also been free of ectopics (whisper) and runs of tachycardia. I really cannot believe the difference in how I feel.

I asked my GP about the differences and why Bisop was so awful and widely used but all he would say was that it sometimes takes experimentation with different drugs. I was always told during my complaints about breathlessness to my cardiologist that all beta blockers were the same. Not so in my case, it seems.

Anyhow, I’m so grateful to the members of this forum who pointed me in the direction of Nebivolol and have been so supportive during the changeover. Thank you so much - my life is so improved. xxx

[BobD Volunteer]

Great news there. So happy for you. I never took any beta blocker after the first three or so months so never had that problem.

[Vonnieruth]

I'm on Bisoprolol 2.5mgI have my first cardio clinic appointment July Might I be best asking about this medication Just had my ramapril changed to losartan and feel better regarding breathing itch and cough

[Vonnieruth in reply to Vonnieruth]

Ohh sorry forgot to say I'm glad your feeling better also Hit the send too quick

[doodle68]

Hi Finvola I am so pleased Nebivolol is working well for you, it is bad enough having AF in the first place without having to cope with dreadful side effects from medication.

I am relieved that having asthma meant I went straight onto Nebivolol and never had to experience Bisoprolol. That said my older brother takes Bisoprolol for AF and doesn't seem to have any problems with it.

[P0rtnahapp1e]

Finvola , I don’t know where I’ve been but I’ve missed out on your transition from Bisoprolol to Nebivolol. I’m delighted that you are feeling so much better. Strange how medication can affect us differently. I’m on 12.5mg Bisoprolol which is apparently above the maximum dose for Heart Failure and don’t have side effects.

The only scary aspect is that I’m on maximum dosage for all my medication which means there’s nowhere else to go. Still, I’ll just keep on waving at you on the next mountain. 😀⛰

[Finvola in reply to P0rtnahapp1e]

Waves furiously from Benevenagh!! Aren’t the sunsets something else these days?

[SophieBella in reply to P0rtnahapp1e]

I found that I was constantly 'cold' on bisoprolol. I've been taken off that and that has improved enormously.

[jeanjeannie50]

Hi Finvola

Good to hear of something that improves life with AF for a change. Long may your better health continue.

[CDreamer]

Hi Finvola - so pleased you got that sorted. Very sad it took so long. I was very breathless on Bisoprolol but stopped taking it fairly early on in my journey and felt so much better.

Best wishes

[cassie46]

Hi Finvola - glad to hear that you are still improving on Nebivolol. As you know it is now three months since I changed at my request and I am so much better on it. Being persistent with medics proved worthwhile in the end.

Cassie

[JaneFinn]

Wonderful news! Sooooooooo pleased for you!!! 😊🎉

Thanks so much for letting us know xx

[Mike11]

I think I was one of several who suggested you try nebivolol as it worked well for me so I'm glad it worked for you as well. The argument that it is slightly more expensive (pennies nowadays) shouldn't stop it being prescribed. I assume you are on the 5mg tablets which you break in half as for some insane reason 2.5mg tablets are more expensive that 5mg tablets. If not suggest this to your pharmacy to save money. The tablets have an indent to make sure they break exactly.

You don't need to be a diagnosed asthmatic to have problems with bisoprolol as it seems even a slight hint of asthma as an underlying condition is enough for it to lay you flat. I was an extremely well controlled asthmatic (using Seritide - another underused wonder drug) but bisoprolol almost killed me whilst nebivolol has no side effects. Now you mention it I do recall a headache for a couple of days but since then it's been the perfect drug for me.

[Finvola in reply to Mike11]

Thanks Mike - I'm on 2.5mg but will mention the cheaper version of half of 5mg to the pharmacist. I cannot imagine what my breathing would have been like in the current heatwave.

[Mike11 in reply to Finvola]

Interesting point - would be interesting to see a chart of hospital admissions or even deaths for those still on bisoprolol. I do wonder if it peaks in cold winter and hot summer more than those on nebivolol. That would be just the proof needed to make nebivolol the first choice drug with bisoprolol as the backup. And of course then nebivolol would probably become the cheapest option as well.

[Buffafly in reply to Mike11]

I tentatively mentioned Nebivolol to my GP because she was not happy with my cardiologists suggestion of Bisoprolol but she said it was no different because it is a betablocker. If the suggestion of taking Bisoprolol as well as the Diltiazem I am on comes up again I think I might dig my little cloven hooves in.......

[Finvola in reply to Buffafly]

Buffafly - this article indicates that Nebivolol is different and it specifically mentions the lesser effect on the lungs.

medicinehow.com/how-does-ne...

Wikipedia also has an explanation of it and its contra-indications. It all helps with the homework to sharpen those little hooves.

[Buffafly in reply to Finvola]

😈

[Mike11 in reply to Buffafly]

This shows a horrifying lack of understanding of basic chemistry by your GP. Even an A level chemist (a prerequisite for a medical degree I believe) can see the actions of the bisoprolol and nebivolol molecules are quite different even if they have some similar end results !

Mind you I've had more serious discussions with junior cardiologists about the far more similar sotalol and dromedarone molecules. I really am disappointed about how little doctors seems to understand about how the drugs they prescribe function.

[Buffafly in reply to Mike11]

I don't think my GP had heard of it, looked it up in a book 😒 but at least she considered it.

[Mike11 in reply to Buffafly]

Sorry I hadn't read your first post correctly. As you are on a calcium blocker Diltiazem you shouldn't really be on any beta-blocker, be it bisoprolol or nebivolol without careful monitoring of BP and pulse rate. Do you take these at same time or 12 hours apart ?

[Buffafly in reply to Mike11]

My cardiologist suggested trying the minimum dose of Bisoprolol in spite of my asthma but added failing that we might try Diltiazem as well. I suspect he meant 'instead' (I don't think he is a native English speaker) but who knows? Anyway my GP took it as instead I think so that is what I am taking, minimum dose because the usual dose caused pauses. I am waiting for another full-blown episode of PAF to see if my HR is reduced to a tolerable level, if not back to square one. Snakes and Ladders anybody? Btw my GP has asked me to do random BP checks for two weeks as my BP was high when she checked it but at home it is low so they are being careful, thank you 😊

[icklebud99]

So glad to hear you have had your drug changed from Bisoprolol. I also had very bad reactions to Bisoprolol and am now on Atenolol and feel fabulous.

[Zezee]

Good news Finvola...I was at cardiologist EP on Monday I asked if I could change from bisoporlol to Nebivolol he says OK ...my breathlessness is on going ...hope I can get similar results when doctor prescribes for me after letter from EP gets to him ...Try it see if it makes breathing any better he said...I am trying to stay on medication ...option to have pacemaker for bradycardia...will try Nebivolol hope that helps ....all the best

[Finvola in reply to Zezee]

Thank you Zesee. It’s worth trying - hopefully you will find breathing easier without Bisoprolol. Please let us know how you get on with Nebivolol.

[MT51]

Great news. I've felt the same about Nebivolol. Yet my (young) doctor had never heard of it. Stay well.

[Fruitcake100]

I have had the same problem with Bisoprolol , very breathless and a terrible cough, don’t know if it is caused by the heart or the pills. Decided to talk to a very unimpressed GP who said ‘well what do you want to do?’ Mentioned going on Nebivolol as I had read about it here so that is now what is happening, the GP wasn’t keen and I am now petrified I have done the wrong thing. He said it was for blood pressure not heart specific like Bisoprolol . I need reassurance that it is ok, I was on Bisop for approx four years. Thankyou folks.

[Finvola in reply to Fruitcake100]

Hi Fruitcake - this is the link I posted for Buffafly regarding Nebivolol:

medicinehow.com/how-does-ne...

I’ve now been taking Nebivolol for nearly six weeks after four years on Bisoprolol and I feel great. My understanding - and I’m not a medic - is that all beta blockers work on the heart, blocking adrenaline receptors which slows the heart and lowers blood pressure.

Nebivolol’s difference is that it doesn’t affect lung tissue in the same way, hence its use for people with asthma or those like me who couldn’t cope with the breathlessness caused by Bisoprolol.

My GP was quite the opposite from yours - he felt Nebivolol would suit me better and it was actually his suggestion that we should try it. Do your research into the drugs - Mike11 has written some detailed posts above in this thread.

Regarding breathlessness caused by your heart itself, did your GP or cardiologist refer to that at all? Did your GP comment on why you are breathless and coughing? When I complained (a lot) to my cardiologist about breathlessness he did a BNP blood test to check for signs of heart failure. Came back very normal so I knew my heart was OK and Bisoprolol was my problem.

I hope this is of some help to you.

[doodle68 in reply to Fruitcake100]

Hi fruitcake I have been on nebivalol for over a year with no obvious Ill effects. It has brought down my blood pressure to excepable levels and during episodes of P-AF keeps my pulse rate down making them less severe. Try not to stress about the change, if it doesn’t suit you can always change back

[Gwersey]

Know it was 3 weeks ago Finvola when you put this post, but can I ask what dosage of Bisoprolol were you on before changing to Nebivolol and are you taking the same dose of it as you were Bisoprolol?

[Finvola in reply to Gwersey]

Hi Gwersey. I was taking 1.25mg Bisoprolol and was prescribed 2.5mg Nebivolol. I don’t know if the two are of similar strength or if I’m now taking a bigger dose of beta blocker. Whatever it is, it is working.

[Gwersey in reply to Finvola]

Thank you. And I'm glad you find it better.

[Glynne1]

nice to hear positive comments about nebivolol regarding breathing. My problem with Bisop is tiredness. I wonder if it would help with that?

[Finvola in reply to Glynne1]

Because I was so breathless on Bisop, any task made me so tired that I had to rest after about 20 minutes. I am still aware of being ‘dampened down’ with Nebivolol, but the awful fatigue is gone and I can do things without a major plan of action on how to tackle them.

The only way is to try it - that’s what my GP did - a month’s trial and evaluation, then two months and evaluation and now permanent repeat prescription.

[Glynne1 in reply to Finvola]

Worth a try 😉