Does it make a difference to you whether you take Biso in the morning or before bed?

[torwell]

Hello - I`m new to these boards but have lurked about and appreciate the information and support shared here.

My situation is I was diagnosed with SVT with VT abberant or NSVT (cardiologist says its benign as runs are infrequent and short - so we haven`t done further investigation yet) last Christmas.

Treatment is bisprolol 1.25 mg daily. My symptoms were mainly feeling very lightheaded, at least one time to the point of almost passing out - which took me to ER, who said nothing was wrong. I followed up with GP and Cardiologist and got diagnosis. I`m not sure I really had many palpitations at the time-- but I certainly do now. (I wonder if this is due to beta blocker?)

I get symptoms now and then - every couple of weeks I`ll have a short blast of tachycardia that rights itself quickly.

This past week, I`ve had short runs if tachycardia and what I think are palpitations or PVS or PACs (the feeling of a quick `drop` in your heart) almost daily.

The only thing that has changed, has been that I started taking my bisoprolol in the morning 4 weeks ago (wondering if it would be better that way) after taking it in the evening for 8 months.

I wonder what your experience is? I know this is the AFib board, but people here are so experienced and helpful, I thought I would ask.

Does it make a difference whether you take biso in the am or pm? Is one better for you? Why?

Thanks!!

[torwell]

I meant PVCs or PACs (palpitations) in post above...

[BobD Volunteer]

Never taken the stuff myself but many here report feeling better taking it in the evening as any symptoms are then mainly over night when asleep. It may also be true that beta blockers can increase ectopics due to slowing the heart rate but that is not scientific. Some people do report that the drugs they are on make things worse.

[jedimasterlincoln]

I've tried both. 5 years ago it was prescribed in a morning and I always took it at that time. But when I was on 10mg I started to really feel ropey on it in a morning, I couldn't do anything of note for a good couple of hours after taking it.

So I swapped to the evening. I was already on Amytriptaline which has a mild sedative/relaxant effect so I figured already feeling tired at night wouldn't matter that much.

I found when swapping that it was even harder to get out of bed in a morning, and logically the bisoprolol was covering the most inactive period of the day whilst I was asleep. As a result when awake during the day, I was some 10-12 hours away from my last dose when I started to get up and do things.

I think for me personally taking it in the morning is the way to go, and not leaping straight into activity when I have taken it. A good 10-15 minutes to just chill before I go out after taking the bisoprolol appears to have had the better result.

[mavisrich in reply to jedimasterlincoln]

totally agree with you Jed it takes me quite a while to come to in the morning but I too take amitryptiline at night and that causes enough problems on its own so I stick to taking bisoprolol in the morning.

[kyoom in reply to jedimasterlincoln]

I totally agree with your reasoning.

It is best to take a Beta blocker in the AM in order to give your heart a rest when you are most active.

[CaroleF]

I don't take bisoprolol any more, but when I did was taking a dose of 2.5mg per day. Initially I took it in the morning and experienced unwelcome side effects (no energy, legs like lead, freezing cold hands - to name the worst). After about a month I consulted the pharmacist who suggested taking the whole dose at bedtime. I did that and there was a little improvement, but not much. I went back to the pharmacist who then suggested buying a pill-splitter and taking half in the morning and half at bedtime. I did that too. That was a bit better, but not enough to make a real difference to my quality of life (QOL). As far as I can remember whatever I did seemed to have no significant effect on whether I experienced an AF episode or not. I tend to be asymptomatic though so it's not always easy to know what's going on - unless I have an exceptionally high heart rate when I feel like death.

I suspect that the answers you get will only demonstrate that taking the medication at different times of day has different results for different people and that all you can do is experiment and see if anything mentioned here actually works for you.

Why not have a chat with your pharmacist to see what they say? They are the experts on medication and in my experience know much more than your average GP about this sort of thing.

[Hidden]

I was prescribed 5mg daily in morning. This didn't work and so my GP changed it to be taken at night. No problems since doing that.

[Hidden]

Apparently Bisoprolol levels peak in 2-4 hours and the half life is 10-12 hours.

Perhaps it follows that taking it in the morning is better if episodes occur during the day, and vice versa.

I can see the logic of taking it at night if side effects are troublesome but equally, reducing the dose might be as effective, subject to GP’s advice.

[torwell]

Bisoprolol doesn`t cause ectopics, or does it? Sometimes I wonder... I honestly don`t think I ever felt these droppy, `heart in the wrong gear` sort of beats before I was on it --- but then, I wasn`t hyper aware of my heart all the time then, either.

[momist in reply to torwell]

Same here. I'm only taking 1.25mg (in the mornings) but I too have become aware of ectopics most days. Is this just me being aware of my heart's activity, or is it the Bisoprolol? Not a placebo effect, I never thought it might be the drug. Now I'm wondering.

[opal11uk]

I take mine in the morning and no problems

[Bmwpaul1971]

I have done everything possible. Morning, Evening, Afternoon, Split tablet strategy etc. I just don't get on with it. I was getting too slow a heart rate during the heart when taking it in the evening. I have switched back to Morning. Better but does not control my ectopics

[jwsonoma]

Maybe ask your Doc about a rhythm control drug. That had a huge effect on my SVT

[Hidden]

I used to take bisop at night, as taking it in the morning i was a zombie (was on 12.5mg at one point!)

about 12 months post ablation I stopped taking it, and my SVT went away, I also have a lot fewer palpitations

[DK81]

I take 1.25 mg in the morning, but the purpose of the drug is partly to prevent my heart from going too fast, a point that no-one else has mentioned. I suppose a speeding heart is more likely during the day than the night because of the effect of exercise. Side effects are difficult to identify, and have never been a consideration.

[Tapanac]

My husband takes his bisoprolol at night, but he is one of the lucky ones in whatever tablet he takes thank goodness he is fine. I take mine in the morning because my heart rate is so slow now after my ablation that I feel that if I take it at night as it is between 39-45 during the day it might drop to ?? much lower during the night and I have enough problems with palpitations and dropped (or ectopic) beats as it is. I also have very cold hands and feet and like john6 also a cold nose. I'm sure you will settle down once your body gets used to the tablets, alternatively if you have a pharmacist like ours who is very good and understanding perhaps you could ask him or her. All the best to you.

[Rosamoyesii]

Hello torwell. I had bad side effects on bisoprolol fumarate, 1.25mg for a year until recently. I complained to the GP that I was unable to walk for more than 100 yards without having to sit down and the symptoms were getting worse daily. Posture was all bent over and legs felt weighted down. The GP halved the dose recently to 1.25mg taken at night. Had a few mild ectopics at bedtime after that but persevered for a fortnight. Returned to GP who said stop the bisop altogether since I had only had one Afib event last year. After two weeks returned to GP as heart had begun to have small racing events. As I was sitting in the GP waiting room I had coincidentally another small racing event. I was called into the consulting toom, told the GP what was occurring and on examination she was amazed that my heartbeat was so steady and exclaimed, this is sinus tachycardia! The point of all the above is that she stopped the bisop completely and has put me on Propanolol 20mg daily - 10mg at breakfast and 20mg in evening. She said I still had been originally diagnosed with the Afib, but that the propanolol would treat both.

The difference is like chalk to cheese. I can walk again. Hope the above will be helpful to some degree. As you say, this is a really helpful site where people can speak their minds.

Best regards and keep well.

Rosamoyesii.