Dosage too high?

[Clivecsw]

Hi all, been on 2.5mg bisoprolol for three months now but noticed my heartbeat has recently fallen to under 40bpm, I'm constantly knackered and my extremities are very cold- asked the doc about dropping to 1.25m but he seems to have left the decision to me! Anyone out there with a similar experience?

[montgomery]

Clivecsw I was exactly the same .... When taking Bisoprolol my Heart Rate dropped.

I had a Pacemaker implanted and set at 60 bpm, Following ,I was able to take higher doses of medication.

We are all different.... I am sure your Doctor will monitor you very carefully and suggest the correct treatment?

[Clivecsw in reply to montgomery]

Ok, thanks for that montgomery, I guess I'm still a bit new to this atfib business!

[Hidden]

Yeah, back in the day, when initially on Bisoprolol I was like that. So bad my HR would drop to 46 BPM, my hands, fingers, feet would freeze. I'd go to bed with socks and gloves on, hot water bottle and an electric blanket too. I'd drink a mug of sweet coffee, sleep for about 4 or 5 hours wake up and be normal again. Hardly ever happens now, but then after nearly 10 years I've got used to the Bisoprolol.

John

[Clivecsw in reply to Hidden]

Cheers John, guess I'll get the hang of eventually!

[LaceyLady]

I was on 2.5mg Bisoprolol and 50mg of Flecainaide x 2 day. HR went as low as 48, and got too many active dreams! Cardiologist said to try 1.25mg Of Bisoprolol. Still dreaming but not as bad and not so bad morning headache. HR doesn’t seem to go as low.

Had a partial knee replacement 3 weeks ago and they put me on anticoagulant and an opiate pain killers, 😳 HR went looow, felt lightheaded and couldn’t work out if was anaesthetic or the pills 😳

[Hidden in reply to LaceyLady]

How r u goin' after your knee job. I had one 4 years ago ....one of the best things I have ever done ....got my life back 😂😂😂😂😂

[LaceyLady in reply to Hidden]

Coming along ok, not rested it up enough today, so blinkin sore 😳 My other knees protesting, was before op, so hoping that’ll settle as the knee gets better. I know there’s only a bit of wear on the good knee

[Gowers]

When I was taking Bisop my hr dropped to 45ish, my cardiologist said I could halve the dose or take 1.25 twice a day. But, you need to ask your GP or cardiologist that its still ok to do this

[1Heart]

I wonder why it’s recently fallen below 40bpm after three months of taking the drug. I’m taking 2.5mg and felt the decrease in bpm straight away. It really alarmed me when my bpm dropped to 36 but I’ve got used to it now.

[cuore]

Interesting. how high did your blood pressure go? Mine seems to be all over the place with this AF. Until AF, I was on low dosage for BP. When in AF, my blood pressure goes low enough; back to sinus, the blood pressure goes high. After third ablation and in sinus , my blood pressure is totally high so i do wonder if the anti-arrhythmic pill propafenone 300 x 2 daily contributes to this.

[Mikededent]

I was just like you and felt like I was dragging a weight around. I saw my cardiologist privately because of a long wait and he advised me to halve the dosage and if necessary stop the bisoprolol which I did but to carry it as a PIP, (pill in pocket). This I've done and felt so much better with a resting heart beat of 60-70. He assured me the bisoprolol would be absorbed within 30 mins if needed. Reassuring!

[DevonHubby1]

My wife was initially put on 2.5mg of Bisoprolol when diagnosed with PAF. She also had a low BPM and felt her heart was struggling. Clinical pharmacist attached to GP cut the dosage in half which improved symptoms.

6 months down the line AF episodes were on increase and Bisoprolol was increased back to 2.5mg with none of the original symptoms. AF episodes are now less frequent and of a short duration.

[Nick1957]

I've just spoken with my arrythmia nurse who consulted the cardiac specialist about my recent successful cv - my hr dropped to 46 bpm. from time to time and my index fingers were very numb with the cold. They suggested I stay on 5mg of bisoprolol because they don't want to risk going back into AF. We're all different so keep listening to your specialists advice.

[Ppiman]

From what I’ve read, the dose response to bisoprolol is far from linear, so don’t imagine 2.5mg is “low” necessarily. After I had a very debilitating bout of PAF following my flutter ablation, having stopped my bisoprolol too soon, I was restarted in 5mg. Within an hour, NSR returned and I was slowly reduced to 1.25mg and then to zero as my heart rate was like yours - too slow and I was empty of energy So far - six months on and touching wood - all is still well.

Steve

[JanettePearson]

I was on 2.5 also and kept getting dizzy spells. Got my blood pressure checked and it was so low the doctor halved the dose to 1.25. I take it at night now ad that suits me better. But you should definitely get checked as you shouldn't be feeling so cold. I get very tired but also get very warm so the opposite. I know blood thinners can make you feel cold but I'm not yet on them. Good luck.

[Polski]

Your symptoms sound typical of too much Bisoprolol. We all react differently to it. If I were you I would try reducing to 1.25mg as your doctor sees no problem with it. It may take a few days for your body to adjust, so be patient if your heart jumps around a bit for a week or two, then you should feel a lot better. That was certainly my experience.

Why suffer bad side effects if you don't need to? The Bisoprolol is there to keep your heart rate down when you are in AF, but the doctors seem to consider between about 60 and a 100 is satisfactory. When you are not in AF then you want to be able to live! Below 50 is uncomfortable, and below 40 very unpleasant, as you are discovering!

[Melbuckton in reply to Polski]

Very interesting. Am in permanent af.

Had holter last week.

Rate between 66 and 128 avg 90.

Cardiologist upped bisoprolol from 7.5 to 10mg as still too high.

[Polski in reply to Melbuckton]

Permanent AF, when it is that high, is probably a different issue. In PAF the heart will only be beating that high when it actually happens, which, for many people, is not much of the time. For you it is all the time, so for you they would be looking to get it permanently lower.

How are you feeling on 10grm Bisoprolol?

[Melbuckton in reply to Polski]

I have 500 entropics a day according to my cardiologist. Not sure if that has any significance.

Due to obstinate high pulse rate went from 2.5 to 5 to 7.5 to 10mg bisopropol in 10 days.

Been on 10 for 6 days am ok just hope it's working can't tell from pulse myself.

[Polski in reply to Melbuckton]

Many people find taking magnesium helps to decrease the ectopics, and may calm your heart rate as well. Research on here - there are lots of previous posts about taking magnesium (But don't buy magnesium oxide - any of the other kinds are good)

The doctor may say magnesium won't help, because they can only check your levels with a blood test, and our bodies always try to make sure there is enough in the blood. It is the body's magnesium stores you are trying to build up. It is used in over 300 processes in the body so is very important, but check with your GP that there isn't any particular reason for you personally not to take it, as there are one or two important counter-indications, but for most of us it is really helpful. The first thing my GP (not in the UK) told me about AF was that 'everyone with AF is short in magnesium!'

Six days on 10mg isn't long. Your heart is probably still adjusting to it, so be patient!

[Melbuckton in reply to Polski]

Thanks. Recently started on Tesco magnesium tablets after reading that they are good for you as you say.

I checked my one-a-day multivitamins and minerals and was very annoyed to find that they only give you a quarter of a days supply of magnesium. I guess it's expensive but that's not really on because people rely on these sorts of tablets.

Had

[Polski in reply to Melbuckton]

Well Done. But if they give you diarrhea take less, or change to a different variety, as that will cause you to lose electrolytes which will make the AF worse. Magnesium oxide is notorious for this, and citrate sometimes causes problems at first, but it is usually fine if one starts with a small amount and then gradually increases.

[Melbuckton in reply to Polski]

That's

[Melbuckton in reply to Melbuckton]

That's very interesting are you saying that the recommended daily allowance, which is the Tesco tablets are, of magnesium can give you diarrhoea?

[Polski in reply to Melbuckton]

I would buy any supplement from a health food shop; they sell the best types. Tesco is likely to sell you the cheapest, which, in this case, is likely to be magnesium oxide - see my note above! (So go to a health food shop and spend a bit more on another variety of magnesium, and start on a low dose so your body can adjust to having more of it available, and you shouldn't have any bathroom problems)

Also the 'recommended daily allowance' is the minimum amount that is recommended on the grounds that if you consume less than that of it each day you will suffer from a shortage and the consequences of not having enough! This says nothing about how much your body actually needs each day.

'Taking supplements' in order to improve our health, is about taking as much or more than one needs, on the grounds that the body will get rid of what it doesn't use eg through the kidneys. (So beware of taking supplements if you have kidney problems). By taking extra you are building up your body's stores, which means it can then use more, and you will start to feel better as a result.

[Melbuckton in reply to Polski]

Damn got loads of the Tesco ones as we're 3 for 2. No indication on them of side effects. Am trying half dose but not easy to break tablets into equal halves!

Considering some brands have the side effects how do I know which type to get from the health shop?

Thanks for your very useful information!

[Polski in reply to Melbuckton]

Just read the packet and avoid any containing magnesium oxide. If you're not sure ask the assistant to check for you. Any other variety should be fine, but start on the minimum dose for a week or two, to give your body time to adjust to having more magnesium available. Never take more than the packet says, and then you can be confident that you are not taking too much.

A chemist (or the health food shop) may be able to sell you a 'tablet cutter' for a small amount. I have a very useful one, but can't remember where I bought it!

[Melbuckton in reply to Polski]

Just a quick research survey you are quite right it's quite a nasty little drug. I'm surprised they're allowed to sell it not much of the magnesium gets into the body.

Now for the amusing bit they've just opened a huge Lidl a few minutes walk away from me and I've been buying all the special offers of chocolates etc. Guess what I put a couple of rounds of diarrhea down to? Certainly not the just started magnesium supplements!

So thank you very much indeed for your advice you may well have saved me from getting ill.

[goldey]

my story is exactly the same. When I dropped to 1.25 I felt better all around. Also, I used to have like a minute of breathlessness when I laid back in my recliner before the dosage reduction, that went away immediately after the reduction to 1.25. I have to say that I do have a pacemaker which kicks in when my beat goes too slow -- but on the 2.5 Bis, I felt weaker and more tired. the reduction in dose worked very well for me. You can always raise it again if you have a problem with the reduction

[Staffsgirl]

My own experience with Bisoprolol hasn’t been good. Was on it for around eighteen months, lowering the dose after six months or so to 1.25. Since I came off it I have been liberated from the excruciating overnight leg/feet pains, alongside numbness and extreme cold. (I’d had existing neuropathy, and never been happy to be taking Bisoprolol. )I have also had less breathlessness, and more energy. Dr suggests I use as PIP. Haven’t used it that way yet.

Clearly everyone is different, but I feel I’ve been given a new lease of life.

[56-er]

Yeah .....Pacemaker required because Bisoprolol depresses hearthrate too low....

I had a pacemaker put-in, eventually I realized that Bisoprolol was the culprit . Now I am off of it. My hearth rate is steady 72.

[Colin1314]

I was the same, couldnt put one foot infront of another at times. My heart rate went to same as you . Dr put me on 1.25mg cause it was far to low. Been on it since march and feel a lot better. Go back to dr say u arnt happy . Pulse rate now a constant 60 to 65.