I’m currently on Bisoprolol 1.25 once a day . When I started the drug a few months ago it reduced the AFIB episodes significantly and also reduced my palpitations/ ectopics. However, the AFIB episodes are now back to where they were every 11/12 days.
The cardiac nurse has suggested taking another dose at night . Can’t understand how that would help . My resting HR is around 55 BPM. I’m concerned I might have a problem.
1.25mg is a very low dose even with another 1.25mg at night will still be considered a low dose
Many thanks. My total dose would be 2.5 mg
I’ve been on 2.5mg of Bisoprolol for two years following a mitral valve repair which left me with AF. The 2.5mg controlled the AF however the side effects were getting worse so my clinician suggested reducing the dose to 1.25mg. I started getting AF episodes almost immediately so went back up to 2.5 mg and just put up with the side effects. Bisoprolol is a powerful drug and minor changes in dosage can have quite dramatic effects. My resting heart rate on 1.5mg was around 50bpm but dropped to 40bpm on 2.5mg
Many thanks
Getting the dose right is a juggling act. The effective dose profile looks a bit like an inverted bath tube, it goes up slowly at first then accelerates to a peak then decreases slightly for the next 24 hours before it reduces sharply (unless you take another to top it up). Some Docs will be good at predicting what is right for you and some not so good. The main problem you will have is ensuring your resting HR remains high enough, if its now just 55 then taking another 1.25 (as its just a very small dose) may not affect it that much, however if your heart rate went lower by taking an additional dose then you would need to speak to your Doc. In some a lower HR can cause ectopics and these in turn can cause other arrhythmia.
Thanks
I'm not an expert but rom this forum ive seen one of the many possible side effects of Bisoprolol is tiredness. By having the extra dose in the evening you will hopefully push the AF away and any additional tiredness will be hidden by your nightly sleep.
In my wifes case she was put on 2.5mg initially and she felt her heart was struggling to beat. Her GP reduced it to 1.25 which helped along with blood pressure tablets that the cardiologist suggested would reduce one of the AF triggers. That worked for 6 months but then AF returned and became more persistent. She eventually was put up to a single daily 3.75mg of Bisoprolol and has had 12 uneventful months. Resting BPM is low, mid forties, but she does not feel her heart is struggling. We went on a 4 mile walk yesterday and the dog looked more knackered than her 
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I'm on 2.5mg bisoprolol, been 10 days and side effects are not good. Made my tinnitus worse and I can hear my voice in my head when I talk. Feel tired,nausea and sick. Looking to come off. Anybody had these side effects? Thanks.
I’ve been on Bisoprolol for five years gradually going up from 2.5 to 10mg which I’ve been on for over a year taking it in the morning. While in hospital in Sept for ablation number three I stayed in for two nights being monitored closely in CCU. They noticed that my heart was racing during the night and it kept setting off the alarm. The next day a consultant suggested changing to 5mg morning and 5mg evening, he said my 10mg might be wearing of by the night time.. There has been an amazing change in my quality of sleep since, I sleep much better not waking five or six times a night as I did before.
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