How long for beta blockers to settle in?

[celticlady]

Sorry to pester but my bisoprolol prescription is up for renewal next week...been on them 3 weeks on Sunday and struggling with fatigue/s o.b,/low mood/sleep issues/light headed Ness. Should I ask for neviprolol or am I being impatient. Any anecdotal reports welcome. Got cardio phone appt Saturday so will check with him as well maybe even a total change of meds. Undiagnosed as yet so it's not straight forward but if all BBs are going to cause sleep problems it's going to be difficult for me. Palpitations have stopped BP down and HR ok. Those are the positives. I'm on 1.25 Biso but I have high intolerance if even some vitamin supplements. My confidence has taken a knock and feel very anxious . Many thanks.

[Hidden]

You are not pestering but you are asking a question that in my opinion, is impossible to offer a meaningful answer. If you get six replies you are likely to get six different opinions based on six people’s own personal experiences and the next six are likely to be different again. In truth, I think you are being a bit impatient. You are taking the lowest available dose of quite a powerful drug and it’s commonly known it takes time for the body to adapt so medics may resist any attempt to change so soon after they have been prescribed. When you see your Specialist, you can of course express your concerns and seek his advice on what you should do if your situation doesn’t improve in say, a couple of months. It’s Nebivolol I think you are referring to which does get fairly good reports but you need to think about how best to keep him “on side”. Sometimes asking if it would be OK for you to contact his secretary or a named Arrhythmia Nurse if you still have problems a bit later on.

You also need to bear in mind that most of us get the eebeegeebees when we read the information leaflet which accompanies medication. Quite a few probably here on the forum won’t agree with me but often the vast array of side effects published may only affect a small number of people, but it can create a mindset which causes us almost to seek out side effects. One things for sure, every drug used to help manage AF (including Nebivolol) will have a list of possible side effects that will make your eyes water so it may take some time to get the balance right.

In my case, when I was first diagnosed with AF back in 2014, before my cardioversion and two ablations I was taking 3.75mg Bisoprolol, 180mg Diltiazem with Digoxin and warfarin and it felt like I was walking in treacle. Now I just take Diltiazem and life is so much better…….

[celticlady in reply to Hidden]

Thank you for this information. Feeling reassurance having just had chat with cardiologist who positively encouraged making a change if symptoms persist, even taking meds alternate days. Ultrasound next then holter so should have a confirmed diagnosis which will help. Good to hear you're feeling better... there's light at the end of the tunnel!

[mav7]

In truth, I think you are being a bit impatient. You are taking the lowest available dose of quite a powerful drug and it’s commonly known it takes time for the body to adapt

This from Flapjack's post.

Give it more time. Many face/have faced the same adapting.

The key is your HR and BP are down. That is the goal and most important.

[BobD Volunteer]

I think Flapjack has said most of what I would but there are a couple of points.

I make a point of never reading any of the leaflets which come in pills and to the best of my knowledge have never had any side effects. Wouldn't know really as I don't know what they are supposed to be.

Regarding the much vaunted Nebivolol I was prescribed 5mg twice a day by my EP for atrial tachycardia but it just knocked me out completely and made me feel very unwell. I persevered and experimented over a few weeks at much reduced dose and now take just 1/4 of a tablet once a day in the late evening. By my calculations that is 1.25mg. I'm not suggesting for one moment that you experiment with drug doses but my EP whi I have known for 17 years trusts me to find my own level so long as it isn't upwards.

My point is that we are all different so be careful what you wish for.

[Threecats]

Hi celticlady, I’m sorry to hear that you’re struggling with Bisoprolol. I am on 1..25mg as well and started ( reluctantly as I also seem to react to everything ) about 5 weeks ago. I am also an anxious type. To start with I experienced, sob, dizziness, exceptionally dry mouth and weird dreams but those have gradually settled and the benefit, in terms of calming my heart, has been worth it. Obviously your cardiologist will advise you today and I know there are a lot of folk who cannot tolerate Bisoprolol at all - I must confess I thought I was one of them to start with but , as I say, things have gradually settled for me. I hope you get some answers today and things improve for you soon.

[celticlady in reply to Threecats]

Thank you ... cardio reassured me it's ok to change a reply on here from a lady whose cardiac nurse said Biso cheapest neviprolol 5 times more expensive...side effects known to be difficult. Have stopped the palps, lowered BP so that's a positive. My confidence has taken a knock as had s panic in supermarket queue and now can't go so my partner does the shopping . Hopefully things will settle to some kind of normal. The advice and support I've had on this forum have helped massively. Best wishes, Moira.

[Threecats in reply to celticlady]

I’m pleased to hear your cardiologist was helpful. Interesting about the cost difference between the two drugs.

I am so sorry to hear about your panic attack in the supermarket, how horrible for you. I can sympathise with that, too. I’ve always been an anxious animal but not suffered with panic attacks until, that is, I had a very bad bout of ‘flu a couple of months before Covid kicked off. After two weeks completely laid out I gathered myself together enough to venture down the road for some shopping. Driving down the bypass I had a panic attack- I thought I was going to die! I managed to get back home but, of course, that set up a link in my mind so every time I thought about going out, off I would go into full panic mode! I hope things will improve for you if you decide to change your medication but if you’re still being bothered by the anxiety about having another panic attack, as I was, I have found a couple of books : Dare by Barry McDonagh and Self Help for your Nerves by Dr Claire Weekes have helped me a great deal with this issue, so might be worth looking into.

Apologies for going off the AF topic but thought it worth a mention. All good wishes to you, TC

[celticlady in reply to Threecats]

Thank you so much for your kind words. My panic probs have been sporadic over the years and really bad after being put on thyroid meds. Dose too high so dropped to virtually starter dose but being sensitive to all meds it was perfect for me. I'd just got over all that and felt more in control then wham- palps etc. Long story short I bought Claire Weeks book many years ago when in stressful job ....it was fab and still going strong today. The light headed sob stuff is fore runner to a full on panic episode so that's the cause of recent probs but I'm working on myself so will get there. So good to compare notes on this and your experience driving is quite a common scenario for attacks. All this heart stuff has exacerbated the panic and I feel that I want to just be at home safe in case another episode occurs. Will challenge myself to get out and about more. Thank you again for sharing your experience. Take care,Moira.

[Threecats in reply to celticlady]

Yes, that seems to be the way of it, these bodies of ours like to give us challenges!🙄 I was just getting a handle on the panic attack malarky when I had my first AF episode and ended up in A&E. Talk about ramping up the anxiety levels!! As you say, the desire just to stay home is a strong one but I had to start going out again as the cats were getting fed up with me disturbing their daytime snoozing regime 😹Glad you find the Dr Weekes book good. I reckon we’ll crack this one eventually! Good luck to you, TC

[Ppiman]

Even 1.25mg of bisoprolol is quite a potent dose. I take this amount on an as needed basis, and it reduces my heart rate quite significantly for well over a day and a half.

Unfortunately, there aren't many options and betablockers are all pretty similar. They are by far the safest option, too, I gather, and do lots of things that help the heart function well.

I would take the advice from others here and stick with the bisoprolol for, say, a month, to see if you don't get used to it. I remember having a similar conversation with my GP about nebivolol but he basically said what I have written above.

Anxiety and a low mood are not easy or pleasant things to deal with, and can, in themselves magnify all kinds of feelings. You have my sympathy with that to deal with.

Steve

[celticlady in reply to Ppiman]

Thank you Steve. Just spoken to cardiologist, very nice man, who said to swap if symptoms didn't improve and that they're interchangeable , could even take alternate days. Got ultrasound in a few weeks then ECG holter so will hopefully have a diagnosis soon. Best wishes.

[Ppiman in reply to celticlady]

That will be helpful and likely it will reassure that you’re doing okay! Anxiety and this condition go hand in hand.

Steve

[Auriculaire]

I changed to Nebivolol and found it better than Bisoprolol on a daily basis . But it does not do as good a job of reducing my heartrate when actually having an afib attack. If you are undiagnosed why have you been prescribed it?

[celticlady in reply to Auriculaire]

Had palpitations dizziness short of breath tachycardia incidents high BP.... prescribed to help with palps ...got ultrasound in a few weeks, but ended up in a&E few times. Suspected electric s rather than structural.

[Auriculaire in reply to celticlady]

When do you take the tablet? Some people here have found less side effects by taking the dose in the evening rather than morning.

[celticlady in reply to Auriculaire]

Evening. About 5,30 , was tempted to scissor off part of the tab. Had a more settled day today so will persevere.