My OH was recently diagnosed with AF after being taken to hospital with racing heart rate and chest pain.
He was put on bisoprolol and apixaban. He was like a zombie - could hardly walk a few steps, complete exhausted all of the time. They reduced his dose of bisoprolol down from 5 to 1.25 and this helped.
However, he started to get terrible itching all over his body which is driving him crazy. He was switched from apixaban to dabigatran, but if anything the itching got worse. He has now been told to stop the bisoprolol as sometimes this can cause itching and recommence the apixaban.
Has anyone else suffered this particular side effect - i.e. extreme itching?
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Twitchen
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I took Bisoprolol for four years - had no itching but was the zombie cousin of your OH. It is notorious for causing side effects such as gross fatigue and breathlessness in certain people. I now take Nebivolol which is fine for me.
I am surprised that they put him on this one as he already has compromised lung function and suffers from extreme breathlessness.
Anyway he has been told to ditch the beta-blocker for now but stay on the blood thinner.
This was his first episode of AF but they seem convinced that once you have experienced one, further episodes will follow.
Having seen the effects of the drugs he has been taking makes me wonder if it is actually worth staying on any of them on a permanent basis. His CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk is 1, which I thought was pretty good.
Yes, that would surprise me too as Bisoprolol is not prescribed for asthmatics as it interferes with lung function but Nebivolol is.
Unfortunately, it is usual that other AF episodes may follow but there are some people who have had one triggered by a one-off specific cause. We who have recurring AF (the vast majority) have a predisposition to the condition. There are lifestyle changes which can reduce the likelihood and/frequency of recurrence and a good source of reference is the main AFA website where there are downloadable leaflets and articles on all aspects of AF and it management.
A CHADs score of 1 is classified as low moderate risk of stroke which is there whether AF episodes occur or not. I started Apixaban with a score of 2 - (one point being for being female, which is the source of some difference of opinion). Stroke is a horror for me and, although I hated the idea of anticoagulants seven years ago when I started, they are now quite commonplace.
Has your partner been referred to a cardiologist, preferably an EP (electrophysiologist) who specialises in heart rhythm? That would evaluate all aspects of his health and condition and give him a treatment plan.
Two weeks after leaving hospital he was referred for follow up with a specialist clinical nurse at the hospital who deals purely with AF patients and he has proved to be very helpful and can be contacted by phone very easily to discuss any concerns.
So for the time being it is going to be just the Apixaban, so will have to see if that makes the itching worse. He is going four days without anything to try and clear his system of all the drugs to try and ascertain which one is the cause of the problem. Will restart Apixaban on Tuesday.
The first afib attack I had I went to hospital in an ambulance. After being taken off the drip which I think put me back in NSR I was started on a regime of anticoag injections and Préviscan - a vit K antagonist used here far more than Warfarin - and Bisoprolol 5mg. The nurse arrived with the pills and a preventative asthma inhaler- they knew I had asthma but were still putting me on Bisoprolol!
I took it for about 10 days and felt like a zombie. I went to my GP and told him if I had to take this for the rest of my life I did not wish to live! He reduced the dose immediately to 1.25mg and later my own cardiologist said I could stop it. After going back into afib after bowel surgery it was the same ( different hospital) -5mg Bisoprolol. But this time I ignored the cardiologist. As soon as I was back in NSR ( after 12 hours) I dropped the dose immediately to 1.25mg. Now I take Nebivolol. I do find that Bisoprolol brings my heart rate down faster during an attack of afib so I use it as a PIP.
I was put on Bisoprolol by a well-meaning hospital doctor when my heart rate went over 200bpm during keyhole surgery to remove my appendix. 7 weeks later I began to itch. It was Christmas Eve 3 years ago.
The first GP I saw told me that the medical centre had 800 patients on beta blockers and none had had that side effect, and that it must be something else.
A month later I saw the GP in the centre who had dermatology qualifications and she said immediately that it was likely to be the Bisoprolol. While being weened off it I had very bad asthma which came on when I was in a pharmacy. I spent two nights in hospital.
At first I was prescribed cetirizine hydrochloride, up to 40mg a day. It helped greatly. Unfortunately nearly 3 years later I still get the occasional rash, so take 10mg daily of cetirizine. I tend to buy it over the counter, pre Covid 19 times at Lidl, Aldi, or The Range, but now at a local pharmacy, as all shopping is done on line currently.
My normal ailments include both permanent AF and Asthma. Asthma is normally controlled by steroid inhalers.
As he has now been completely off the blood thinners for over a week, it has to be down to the Bisoprolol. He hasn't taken any of these since Thursday but is still itching, however, you say that it still causes you problems 3 years after stopping, which is very worrying.
I do have some cetrizine tablets so will get him to start taking one of these a day to see if it helps.
Were you put on an alternative beta blocker or did you stop taking them completely? Also, do you take a blood thinner as you suffer from AF? The doctor says it is imperative to take these even if the Bisoprolol is stopped.
My husband also suffers with breathing problems and has a steroid inhaler.
The itching now is nothing to what it was nearly three years ago. Yes I take Warfarin, which is my choice. I did take Rivaroxaban about six years ago but came off them after 12 days because of bad reactions.
I don't take any beta blockers. My GPs decided that I would have side effects from all beta blockers.
I've had AF for about twenty seven years, originally paroxysmal but now persistent / permanent, (but I can't feel it as you can with paroxysmal AF.)
My heart rate is just above normal, about 70 to 110 resting. I take no medication for AF, except the Warfarin. I have my own Coaguchek meter so I can check how the blood is doing whenever I want, but usually I check every six weeks and email my results to the arrythmia nurse.
I should have added that the beta blocker also caused rashes when I ate certain foods including grapes, oranges, bananas and tomatoes. I now eat tomatoes and grapes without getting any rashes.
Hi Twitchen that all sounds so familiar. They took me of Bisoprasol it caused hives put me onto Nabivolol same thing so put me on to Tildium the said I was allergic to beta blockers I’m sure they will find one that’s suitable
Yes, extreme itching that was so bad I could not sleep, caused by too high a dosage of Apixaban. Stopped as soon as I was put on the correct dosage for my age and weight.
He has to restart the blood thinner again on Tuesday. Says he is going back to the Apixaban rather than the Dabigatran, so hopefully they won't cause any additional problems.
My cardiologist wanted me to take bisoprolol but my GP was reluctant to prescribe it because of my asthma so I take an alternative which is a Calcium Channel Blocker - Diltiazem in my case. I take Apixaban without problems but I also take cetirizine (available cheaply from Morrison’s pharmacy) because of multiple allergies - it used to be prescribed but now I have to pay myself.
The itching got so much worse that we went back to the hospital yesterday to see the specialist AF nurse. He managed to get one of the cardio doctors to come and have a look at the rash (which is pretty much everywhere now) and he said that with a CHAD score of 1 my husband should stop taking both the Bisoprolol and the Apixaban.
So now I am just wondering how long it will take for the dreadful itching to subside. Doctor did say he should take an antihistamine for a couple of weeks, which he has already been doing but it didn't help.
How miserable for him. I hope the itching subsides and the anti-histamine might even work in the absence of irritation from the drugs. Fingers crossed . : :
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