Bisoprolol with Flecinaide?

[heartface]

Hi all, this is my first post as I generally find all my answers by reading other posts. This site apart from medication has been so helpful and inspiring. Please could anyone tell me if I can use Bisoprolol as a pill-in-pocket if my heart starts racing even though I am taking Flecinaide and have been symptom free for 4 months now.

[wilsond]

Yes I do,use flecanide as pip in most cases and bisoprolol as pip if heart races in afib...doesnt always for me..works well for me xx

[Finvola]

Hello heartface and welcome to the forum.

I asked my EP this exact question as Bisoprolol was causing me breathing problems but he told me it would be too dangerous as tachycardia would be in place before the drug kicked in. I would stress that this was advice to me only and wouldn't necessarily apply to other people.

Flecainide causes me to have very short runs of AFlutter and he said the Bisoprolol was essential to keep my heart rate down during AFlutter. It stops 1:1 conduction of the AFlutter signals which can give a very high heart rate.

Happily, I was changed from the awful Bisoprolol to Nebivolol which does a better job for me, without the breathlessness and lethargy.

[ShimmeringLillyMae in reply to Finvola]

I notice you said the bisoprolol caused you breathlessness, did you feel like your chest was heavy and struggled for each breath? I have that same feeling but I'm on diltiazem (cardizem) are they the same type of drug?? I'm trying to figure out which drug I'm on that is doing this, I'm going to see an EP on Tuesday and praying he will change my medications 😔

[Finvola in reply to ShimmeringLillyMae]

My chest felt heavy and tight and the least exertion made it worse. I wouldn’t say I struggled to breathe but it was a nuisance as I couldn’t walk too far and I was taking only 1.25mg. Life is much better for me on 2.5mg Nebivolol.

I don’t know about Diltiazem but when you talk to your EP, tell him/her about the effects on your quality of life and ask if a change of meds would be the answer. It took me four years to figure out that I needed to personalise the effects of Bisoprolol and how, for example, I couldn’t do normal tasks. I was quite pushy and determined 😀

Best wishes

[Dangerousdriver in reply to Finvola]

Hi Finvola,

Can I ask what symptoms you were getting with Bisoprolol? I’m only on 1.25mg a day, or sometimes I take one morning and night depending on what my heart is doing. But I feel shattered constantly, and it’s getting me down. Thinking of going to the Dr and telling them I’m not tolerating the Bisoprolol well and could I switch to Nebivolol.

[Finvola in reply to Dangerousdriver]

I started with 2.5mg but was breathless, shaky-legged and felt like I was wading through deep mud. It was dreadful and I struggled to do simple tasks. The reduction in dose to 1.25mg when I started Flecainide improved things slightly but the symptoms were still there.

Nebivolol has certainly worked for me and my ectopics are less invasive - perhaps the higher dose has calmed them.

Best wishes with your doc - I planned my visit and speech with military care. 😄

[Dangerousdriver in reply to Finvola]

Thanks for that, I get lots of ectopics and definitely the lethargy. Some days I fall asleep so easily if I stop for 5 mins.

I’m only on 1.25mg and Dr’s all tell me it’s a homeopathic dose, which I don’t subscribe to at all. My HR definitely goes up when I don’t take my dose.

I did the same with my stains years ago, was on the standard issue statin (Simvastatin) and told a porky to get me switched to the more expensive Atorvstatin and I’ve had that now for years.

I just want to reduce my symptoms and get rid of this lethargy and nausea feeling.

[Finvola in reply to Dangerousdriver]

Yes, I was repeatedly told it was a low dose and was 'the drug of choice'. I assumed all beta blockers produced similar symptoms until I read about Nebivolol on this forum. If you research it, somewhere it is explained that Nebivolol is cardiac-specific and does not act on lung tissue - my cardiologist confirmed this (in medical language) - but that Bisoprolol does affect lung tissue. There are a lot of threads on Nebivolol if you search at the top right of the page.

[Dangerousdriver in reply to Finvola]

Ah ok, that’s very interesting! I was the same as you, in assuming that all beta blockers worked the same.

I had no idea that Nebivolol was cardiac specific!

I’m guessing the problem is when it comes to meds we all react differently, so what works for one doesn’t work for another. I have been taking Magnesium Taurate and found if anything it increases my ectopics, but others have found it a miracle worker.

So, I guess it’s trial and error. Well looks like I’ll be booking to see the GP and over exaggerating my symptoms on Bisoprolol to see if I can get switched onto Nebivolol.

[BobD Volunteer]

Listen to others experience by all means but please, we are not medically trained here so really must not give advice on medication. Each of us may have different needs and conditions and what may be right for one could be totally wrong for another. You really should discuss this with your medical team.

[pottypete1]

We are all different nor medically trained which is why we cannot offer such advice.

You need to talk to your EP for guidance.

Pete

[jwsonoma]

My doctor insists I take a small dose of Bisoprolo along with Flec. He said the Flec can cause dangerous tachycardia in response to an a-fib event with out a rate reducer(Bis) in your system. The Bis has to be working before the Flec. As a PIP that would suggest you take the Bis and an hour later take Flec.

I don't like the Bis but am taking 1.25mg/day. But as others say talk to your EP or chemist or both.

[heartface in reply to jwsonoma]

Thanks for that jwsonoma. All replys are gratefully recieved, and very helpful.

[Auriculaire in reply to jwsonoma]

You could ask to be changed to Nebivolol. Many people here ( despite not being medically trained) recommended it. I asked to change and found it much better than Bisoprolol.

[Jalia]

Bear in mind what Bob has said. However I have bisoprolol as a Pill in the Pocket to use when I go into fast AF or plain tachycardia. When I present at AE it is the first drug use to try and reduce heart rate. I do not take flecainide though ....it promotes arrhythmia for me.

[Dangerousdriver in reply to Jalia]

Snap! I did not get on well taking Flec daily Pre-ablation. If it was administered intravenously in A&E then it would be hit and miss as to whether it reverted me to SR, but as a daily pill I didn’t tolerate it well.

[jedimasterlincoln]

I have both on standby, but it may not be right for you. Check with GP or EP.

[heartface]

Thanks Jalia that is good to know they use it in A&E.

[bigbearatthecave]

I am on 1.25mg Biso and would say one year later have had no flutters - however I am convinced that it affects my joints and muscles, although I cannot find any connection

So for no flutters I would say stick with teh Biso - as for asking Doctors they find the worried well a pain to deal with, I am fortunate I have a couple of consultants as pals and they give me the right answers.

[Shcldavies]

No one knows, not even the Cardiologist or EP. The Docs will have the best risk adverse advice for your condition as they know your condition better than anyone and have experience in the drugs to use. As you are individual their advice is not 100% but far better than any other. A combination of Bisoprolol and Flecainide given by my EP appeared to work wonders for 3 months but then morphed my AT into very bad Aflutter which needed Cardioversion. On the positive side it did take me up the pecking order for an ablation (just 6 weeks later). In short only do what your Doc tells you but keep Doc aware of changes to your condition.

[songbird74]

When I took Flec without a beta blocker I ended up in A&E with heart rate of 200 plus bpm so now take nebivolol each day and Flec as pip