Are you taking BISOPROLOL for Heart Rate co... - AF Association

AF Association

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Are you taking BISOPROLOL for Heart Rate control? What are your experiences with the Pulse Rates on this drug.


Hello friends.

Since diagnosed with AF 8 months ago, I have been on 2.5mg of Bisoprolol and Apixaban daily . My heart rate has been in the 40-65 BPM since then. Four days ago I had my second episode triggered I suspect by a pain killer that I have been taking for years. Since coming out from this my normal blood pressure crashed for 2 days to 84 over 55. It has since come back to normal levels. But my resting Heart rate has remained in the 80-90 range. I am more breathless and quite tired. Isn't the Bisoprolol supposed to keep it well below this range.

Keeping in mind that resting heart rates for adults are 60-100 BPM without drugs.

Because of Covid getting a hold of these doctors is not easy unless you go to the Hospital Emerg, and you want to avoid that if possible.

Thank you in advance for your kind assistance.

27 Replies


I was diagnosed with AF in Jan 2010. My consultant at the time prescribed 5 mg Bisoprolol ( amongst other meds) to be taken in the morning. After a while I began to suffer from violent and very random nose bleeds. I returned to my GP and she told me to take the Bisoprolol at night ...... I have done this ever since and never ever had a nose bleed since.

I am still on the prescribed amount after all these years, i.e. 5mg. and have had no problems until recently - which I'll come back to. The 5mg dose holds my HR between 62 and 67 bpm, however, every now and then for reasons unknown it occasions, at random, drops to around 46 bpm which wipes me out, but, I never bothered to pursue it as an issue as it only happens around 3 times a year, if that.

Before AF mugged me back in the day my HR was around 88 to 92 bpm .... constantly. That was my norm and is at the very high end of the normal scale and certainly was a contributing factor to my AF in the beginning. My personal belief is that anything regularly averaging over 75 bpm is way too high !

Now, back to recently my heart chucked a 'wobbly' and I was able to record it on my handheld ECG device. My GP has since prescribed another 2.5mg of Bisoprolol to be taken as a PIP ( while still maintaining the regular daily 5 mg dose) as and when needed should I get more of these occasional hits. She has also ordered me for a Holter monitor and an ECHO.

I understand that some people are prescribed Bisoprolol for blood pressure control so I assume it has some properties that suit it for both HR and BP control. When I was first diagnosed back in the day, my average BP was around 136/80 with medication, nowadays it is around 130/70. The day AF hit me my BP dropped during the day from the 136/80 down to 76/50 ........ at which point I saw my GP who then sent me to hospital immediately.

You mention your BP was 84/55 for 2 days. I wonder how often this happens and in normal circumstances what your BP is regularly ?

Hope this helps.


Mrhermyl in reply to carneuny

Thank you John. My BP is in the 115-130 / 70-90 with Telmisartan meds.

Yesterday I saw an article saying that Bisoprolol and Telmisartan should not be mixed !!

Yet the doctors say it's fine. We are never told the real truth just like HydroxyChloroquine .

CDreamer in reply to Mrhermyl

Pharmacist can always check interactions & they are always far more knowledgeable.

Mrhermyl in reply to CDreamer

I wish I could agree with you. In general you are right but such is not always the case.

They are hiring pharmacists that are recent arrivals and recent graduates, not to mention those that graduated years ago and hardly look at the manuals.

I know this because I was a Pharmaceutical rep and called on these people . If only the public knew what goes on.

CDreamer in reply to Mrhermyl

Oh dear, My pharmacist is brilliant with a private consult room & any new meds or if I ask about supplements we go into the private room & he says when he doesn’t know & checks on a professional site for me.

Mrhermyl in reply to CDreamer

I check the meds myself.

Are you still in AFIB?

Mrhermyl in reply to KMRobbo

I'm in an out of it at some level. But not very noticeable at all right now. This am, yes.

KMRobbo in reply to Mrhermyl

So could the AF itself be responsible fore the higb heart rate? When i was in A Fib I was 160 to 195 resting hr every time , occasionally lower depending which rate control.tablet I was taking.

Mrhermyl in reply to KMRobbo

The Bisoprolol either has stopped working or something is wrong. Increasing the doses is sending me from 38 to 95 and anywhere in between .

No idea anymore.

Mrhermyl in reply to KMRobbo

Wow !

Many people suffer many side effects from Bisoprolol, my experiences with this drug ere horrific and I can’t tolerate it so I now have a Red Alert on my file to never be prescribed it. Some need Pacemaker in order to take it because their HR drops too low at times when they are not in AF.

Resting rate of 40-65 is tolerable for some people but may be low for others and it’s not good when your systolic BP drops below 90 and stays there for any length of time. If your usual rate is 40-65 a HR 80-90 may feel high to you however I used to find that my heart took quite a while to come down after AF episodes so I don’t think that is unusual, as is feeling tired and breathless. Those after AF episode symptoms clear for some quicker than for others so just take it slowly and pace yourself, plenty of fluids and rest.

Are you able to monitor your O2 levels? I know when combined high HR and low BP my sats caould fall into low 90’s and even the 80’s and that caused extreme fatigue and breathlessness.

I tried taking Biso at night but was told by my Doctor that wasn’t a good idea as my HR & BP would dip during the night and that was probably the cause for my nocturnal AF and it didn’t control the HR during the day when I needed it. I think you do need doctor’s advice on this before taking action.

The other point on taking BP - was your reading an average of 3 in quick succession? Both my husband and I were told when in AF you should take the average of 3 readings as your BP when in AF bounces up and down along with your HR. Just a pointer. Dr Gupta has a explanatory video on YouTube on this subject.

If your pain med was a NSAID then it is a known AF antagonist so things like Ibuprofen must be avoided.

I know it can be difficult in these times but persevere and get hold of a Doctor for a consultation and review of your meds. You don’t need to have a face to face, telephone conversation may suffice. In your position I would ask why you are taking Bisoprolol and for what purpose? Is it absolutely necessary? Are there alternatives? Could you take a lower dose - if your Dr insists?

Hope that helps.

PS - Keep daily journal record of your resting HR and BP and if you have the ability to do that electronically, then a graph that you can send to your Dr can be helpful, I know our GP and cardiologist both appreciate the data which can assist their recommendations.

Mrhermyl in reply to CDreamer

Thank you CDreamer for a fine response. Yes I do take 3 BP reading automatically.

Yes I do keep records including my OXImeter, 96-99%.

The pain killer which I have been on for years due to cancer surgery is Percocet. This is the second time it has triggered an event. The first was very minor. This AM I called my doctors again and all I can get is voice mail. Amazing ! A large multi doctor Cardio office and no one around. My Family doctor is also working only 2 -1/2 days due to Covid. This is today's Canadian medicine . I have been trying to get my Blood and Urine test results for a week. Getting my results from the huge Lab directly is like trying to enter the White House in Chinese fatigues .

I guess we need patience and more patience. This Covid has changed things dramatically !

CDreamer in reply to Mrhermyl

Oh my goodness, that doesn’t sound at all good. We have reduced services but so far have been able to continue with normal bloods & can speak to our GP’s by phone, many of them are working from home. Everything is triaged & the fall back is 111 which is not an emergency service but one that provides a service of advice & referral.

Mrhermyl in reply to CDreamer

My Cardiologist will not give me my blood and urine results until I see him in 3 weeks. Crazy! Meanwhile I found out in the media that our section of the city has the highest COVID cases in Canada. They attribute it to "the people in wealthy areas travel more !!!! " It is made up of Chinese, Italians, Iranians and Germans.

Frankly I'm concerned about going to the clinics and getting into elevators .

CDreamer in reply to Mrhermyl

Very worrying & madness! I can look up & see every test I’ve had for the last 5 years on a secure site & get a notification when they’re in.

The only thing for us that’s changed is face to face appointments & we can’t book our own appointments through the app & have to go through reception and triage.

I too was on these , the drug made me dizzy almost faint so doctor took me off them.

it depends on how much bisoprolol your heart needs to get the rate down. When I was in fast AF my HR was 195+, with 12.5mg bisoprolol they managed to get it down to 130 bpm (yes twelve point five mg, 2.5mg above the recommended maximum)

Following my ablation after the initial raised HR, on 2.5 mg daily my hr was 30 bpm.

Since dropping the bisoprolol (thank goodness) my HR is now 50- 65 at rest

Mrhermyl in reply to Mikee69

Pleased it worked out for you.

I've been on 10mg, split between morning and night, due to some tachycardia episodes found on a 48hr holter. My HR is around mid 40's most of the time, was mid 60's -70's before.It has dipped into the 30's a few times which was a worry but doctor seems fine with this. Been like this for a year after a hypertensive crisis.

No really bad side effects thankfully, I seem tolerate it very well. Only downside is doing higher exertion exercise is no longer possible as my HR seems to top out at 90 now. But walking and light exertion is fine.

Still suffer PVC/PAC now and again as well but have always had these.

Would rather not be on it but if it keeps me turf side up for the long run up I'm happy.

I'm on 10mg Bisoprolol / 300 Flecainide / Rivaroxiban.

BP generally around 130 over 75 / BPM around 45 - occasionally dipping into the low 40s. I've been told that if it drops below 40 to go to A&E immediately.

Generally, don't feel tired. I take daily light exercise, walking 2+ miles.

Big benefit is that my AFib is quite well controlled. I count that as a major blessing pending ablation - even if the medication doses are high.

Mrhermyl in reply to Challiefan

Good for you.

Just to add...I, too, had terrible side effects with this drug. Hadn’t realised quite how the Bisoprolol had been affecting me until I came off it. Such a relief!

My wife is on 3.75mg Bisoprolol which she takes once a day. Her resting BPM is in the high forties.


I am on Bisoprolol 2.5mg 1 x daily and Apixiban 2 x daily

Am waiting for my second ablation and find my heart rate like yours is between 80/100. BP has been low and at times normal 130/90

I play golf 3 times per week and find i can do 18 holes but at the end i am shattered

Other symptoms can be breathless at times especially going up inclines

Will be pleased when/if I can leave Bisoprolol behind, but they do the job required

Mrhermyl in reply to Golfer60UK

Good for you, wish all the best. These drugs are needed and they are a major pain in butt.

Lol they are too, but much better than the alternative

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