Changing from Sotalol to Bisoprolol ?

[Jasperpete]

I am taking Sotalol 40mg am and 40mg pm. Because I find the side effects intolerable the Hospital suggested to my doctor "stop Sotalol and change to Bisoprolol 2,5mg. Picked up the new tabs but no instruction on how to change over. How long should I stop the Sotalol before starting the Bisoprolol. No help from my doctor or the hospital, just cannot contact them. So just wanted to know what other members have experienced before I manage to talk to my doctor or hospital. I know that I have to get official info from the medics, it would be interesting if others had a similar problem.

[baba]

Try the pharmacy who supplied the medicine.

[jeanjeannie50 in reply to baba]

Good idea.

[Jasperpete in reply to baba]

Thank you. The head man there said it will be ok to take the 6pm Sotalol and in the morning at say 6am if awake take the new tablet. But when I look up the Sotalol on the NHS website it says that the Sotalol stays in the body for about 3 days. That would mean that I would have 2 drugs working around my body. All a bit confusing really because I might feel over medicated.

[mav7 in reply to Jasperpete]

Personally, would wait until you can contact your doctor even if you have to endure the side effects.

[Jasperpete in reply to mav7]

Yes I am Inclined to agree. Thank you

[AussieHeart]

Hope you got an answer already. I experienced same, couldn’t tolerate Sotalol at all. Couldn’t even stand on it! So was switched to Bisoprolol. I dropped Sotalol to 40mg nights only x 3 days, then halved it 20mg x 2-3 days, stopped altogether x 1 day and went onto 1.25mg Bisoprolol mornings but then took it at night as fatigue was immense even on smallest dose. Told my aFIB paroxysmal so eventually weaned off it altogether and now take Bisoprolol as a pill in pocket!

[Jasperpete in reply to AussieHeart]

Thank you very much for your answer. Were you told how to drop the Sotalol before you changed medication or was that you're decision?

[AussieHeart in reply to Jasperpete]

GP not EP told me to step it down before switching.

[Jasperpete in reply to AussieHeart]

Thank you, understood

[AussieHeart in reply to Jasperpete]

Like you the EP isn't much interested or too busy to bother. It is left to my GP to pick up the pieces. They are not happy I weaned off Bisoprosolol but the EP said I could try it for two weeks. After two weeks I was ok so stayed off it and will report my findings (tracking my symptoms) until I see him again in April. I only get a six-month to annual visit on my request! I got off it as there was debate "high constipation" was behind my odd symptoms. My thought was while they investigate that I better be off all meds otherwise they'll blame the meds. You just go round and round in circles trying to understand triggers/cause etc

[Jasperpete in reply to AussieHeart]

Well I can understand your concern. It's a complete learning curve for me. I'm waiting until I can see a cardiologist so that I can discuss it in detail. What I don't know is why they put me on Sotalol to start with and why that when I stop using it my pulse went into AF about 135 BPM.

[AussieHeart in reply to Jasperpete]

Sotalol is known to be “brutal” and most people shouldn’t be put on 80mg or higher straight away from what my GP explained to me. I’m new to aFIB (past year) and the EP has explained nothing much. If you like answers like me you’re in for a rough ride as I think majority believe aFIB isn’t worthy of their time. Until you have a stroke or heart failure that is. My GP was furious with the EP. Sadly their handling of it has pretty much caused me to walk away. My pharmacist is more helpful!

[Morzine]

Just an idea could you stop solitol and just wait a couple of days then begin bisoprolol? Must solve your worry?Or the pharmacy may have an answer?

With the bisoprolol you must give it time to settle in your body, it does make you feel rather heavy and out of condition. I found 2.5 too much and 1.25 made a huge diference with feeling more me. So give it time and if it’s too tiring ask to go down a notch. It may be fine with you though. I reckon it took three weeks to a month to get used to so don’t be phased by it and give up the first week .

Sue

[Jasperpete in reply to Morzine]

Hi Sue, thanks for your input. The interesting thing about your idea is that after my heart operation to replace a valve I had a review 3 months after with the surgeon. (No body told me why I was given Sotalol when I was recovering in hospital. I can only assume that I went into AF). After a complete check up i.e. ECG, ex-ray and physical examination the surgeon said that I could stop the Sotalol. I suppose that he felt that I did not need it. A bad decision because within a few days I went into AF which was very frightening as I had never experienced anything like this before the operation. I immediately went back to full dose of Sotalol and eventually managed to contact my doctor who suggested a slow taper like cutting out the morning dose for a week to see if that was managing the situation. Again after three days I got out of bed to visit the bathroom and I could feel my heart racing. I measured it with my FitBit and it was 136bpm. So again went back on full dose of Sotalol 40mg am 40pm. Managed to talk to Cardiologist secretary who gave the info to the Cardiologist who then wrote to my Doctor to change Sotalol to Bisoprolol 2,5mg one daily in the morning. No instructions on how to come off the Sotalol. It feels as if I am living in a third world country. I am still trying to get an appointment with the Cardiologist who put me forward for the heart valve replacement. Getting more depressed each day.Best wishes

Pete

[Morzine in reply to Jasperpete]

It’s sounds awful to be left so uninformed. Of course you will feel bereft and depressed, as it’s our hearts and we worry about them . Can the doc find out fir you?

[Jasperpete in reply to Morzine]

I think that the doctor is trying to get an appointment with Royal Papworth at long last, but the hospital say it should be the doctor who should sort it out. It's like batting a ball back and forth, and a dreadfully slow process. Thanks for your input Moraine.

[graemeparsons]

Good luck with Bisoprol, i suffered it for 3 years at a high dose. Saw a new cardiologist who changed me on to Nadolol, what a difference it made. Fact is though everybody is different how they cope with meds. All the very best to you.

[Burdd in reply to graemeparsons]

The manufacturer of nadolol (Corgard®) has confirmed that this product has been discontinued. The product has been discontinued for commercial reasons. Nadolol, a beta blocker, is licensed for use in hypertension, angina, arrhythmias, migraine prophylaxis and adjunctive treatment of thyrotoxicosis.13 Apr 2016

[graemeparsons in reply to Burdd]

Are you in the US? it is still licensed in the UK.

[Burdd in reply to graemeparsons]

I’m in the UK and on Bisoprolol for the past 18 months. So just had to look the above up. I find it hard what with amiodarone as well … I’ve been told that the tiredness and I will call it twitching is not a wonderful way to live but better than the 17 cardioversions I’ve had for AF. Have to say that my ablation has lessend the pain.

[graemeparsons in reply to Burdd]

My cardiologist told me it was only the US you could not get it. On Nadolol I no longer have the fuzzy head sensation and fatigue like I had with Bisoprol. All the very best to you.

[Burdd in reply to graemeparsons]

Thank you take care.

[Jasperpete in reply to graemeparsons]

Thanks for the info.

[MJZaw]

I've been taking Sotalol 120 twice a day for a year now and have not noticed any discernible side effects. If you don't mind me asking, what were the intolerable side effects?

[Lavelle1 in reply to MJZaw]

Me to Jasper. On Sotalol now for 4 years plus.

[Karendeena in reply to MJZaw]

MjZaw I was going to ask the same question as I am ok on Sotalol but couldn't tolerate bisoprolol

[Jasperpete in reply to Karendeena]

Oh no this is getting complicated. Maybe I will not tolerate any beta blocker.

[mav7 in reply to Jasperpete]

Seems best to see your doctor soonest to be placed on proper medication.

Because of your valve replacement, your medications may be different. Also, keep in mind all medications can have side effects. But sometimes we have to compare and manage the side effects to the result it is giving for our heart health.

I hope you are able to find a trusted doctor and are successful.

[Jasperpete in reply to mav7]

Thank you mav7, my thoughts exactly. Waiting for an appointment with a cardiologist at Papworth Hospital. At time of writing , nothing yet but they have taken a 24hr ECG.

[Jasperpete in reply to MJZaw]

Hi MJZaw

Can feel my heart beating very slowly about 60bpm when resting.

Lightheadedness, especially in the morning.

Chronic fatigue, comes on fairly suddenly within a few minutes and have to stop what I am doing and lay down for a while.

Anxiety.

Excessive sweating.

Dry eyes. But given eye drops which help.

Cramp like pains in buttocks. But still make sure I go out for exorcise like walking at least a mile every other day, whether permitting.

Feel dreadful as if I have been poisoned.

Some of the above might be due to the heart operation, but I felt fine before the op, only shortness of breath from a warn out heart valve.

[MJZaw]

Wow… No wonder you want to get away from sotalol. Hope you’re feeling better and thank you for your reply

[Jasperpete in reply to MJZaw]

Thank for your interest MJZaw, that's more than my doctor has. No guidance what so ever. I might as well as the man in the street what to do. I am still waiting for Royal Papworth to give me an appointment so that I can discuss my options, and also what went adrift shortly after my heart valve replacement because I never experienced AF before the op. I haven't started the Bisoprolol 2.5mg yet because I want guidance from the cardiologist, of a doctor who know what he/she is talking about. I don't trust what the pharmacist has recommended i.e. just miss out one dose of Sotalol and take the new drug Bisoprolol. NHS website says Sotalol takes about 3 days to get out of the body, or words to that effect.