Many times on here I have seen people recommend nebivalol over bisoprolol and people say there are far less side effects etc.
I have been putting up with bisoprolol for 6 months now and my cardiologist said if I wanted to change, he would be happy for me to switch to Nebivalol. Even though before bisoprolol I never considered I had a high heart rate ( mid/late 60s at rest) My paroxysmal AF seems to be controlled very well by the much lower rate HR that bisoprolol gives me at the moment and it’s all I take for Afib, ( apart from vitamins/minerals). I have reduced from 2.5 to 1.6 mg.
I feel I’m stuck between a rock and a hard place, in that I still want to maintain a low resting heart rate, but not too low and not too high. I notice my heart rate is quite sensitive to very minuscule changes now while I try and reduce further and it’s becoming a right faff getting the balance right. I just want to take one pill and be done with it, but I do not want to go back to 2.5mg bisoprolol. Also, I have been on bisoprolol from the same manufacturer ( Sandoz) for over 4 months now, but the weights of their 1.25 mg vary greatly which is annoying.
An EP told me that bisoprolol alone doesn’t control afib…but for some reason it seems to be controlling mine and it can only be the low heart rate. If it wasn’t such a palava in cutting tiny tablets/weighing and the inconsistencies, ( and the side effects) I’d probably stay on bisoprolol.
Please can I ask for those that switched from bisoprolol to Nebivalol, How did it affect you and your heart rate and was your HR exactly the same? Also did you switch to same dose equivalent ( as I know doses of both are like for like). Did you get any ill effects from the switch?
Thankyou,
Teresa
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Teresa156
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It’s interesting that your HR went quite a lot higher on the equivalent dose of nebivalol. My Cardiologist said my HR should stay around the same but with less side effects, but I’m always sceptical, which is why I thought I’d ask the question here. I was hoping the HR would be similar on both medications and in your case it’s quite vastly different.
I don’t want it to go too much higher as I think the lower rate is preventing my attacks- but I don’t want it too high either ( perhaps I’m just being fussy lol)
If I took 5 mg bisop I think, like you, my HR would also be in 30s or even lower when asleep 😳
When I used the term ‘at rest’ I’m probably using it wrong, as I think of it when say, sitting in front of TV, not sure if that’s right or not. On 1.6 mg bisop it can go to 55 watching TV, sometimes it can go to 52. Ideally the lowest I’d want it to go is 57/58 watching TV. The higher my ‘resting’ HR goes, the higher it goes on exercise or exertion and the higher it goes is when I worry more about Afib?
It sounds like I won’t know until I actually try it.
Interesting that you get cold hands, feet and nose and you still get that on nebivalol. I don’t get those effects - from bisop, but I do if I take propanolol.
For me, other side effects, are poor sleep, bad dreams, tinnitus and hair thinning.
Cardiologist said there were no side effects from nebivalol 😳 again, I am sceptical and your answer shows there are, but I know not everyone gets them.
I feel the cold and I only take 1.25, was on 2.5 but HR went down low at night waking me up. I’ve been on that dose for a long time and now its lowering my HR again to the low 50’s at night. I’ve started taking it every other day to see what happens. I’m also on 100mg of Flecainide. So, it looks like hit or miss with different meds 🤷🏼♀️
Hi LaceyLady,I never thought about HR going so low being the reason for waking me up 😳 you’ve made me think now. I just thought it was something in the bisoprolol. I don’t wear my applewatch at night because it might might make me worry more if I know. I wake up twice every night.
Good luck with taking it every other day though, how long have you been trying that? When I tried to come off it last year, I found it pretty much left my system in 24 hrs, but I’d only been on it 8 weeks at that time.
Teresa
X
Hiya,
Back in the day, when I first started my AF journey 2010/2011 when I was first put on Bisoprolol I went through the experience of coldness of extremities. Also random and inexplicable nose bleeds. In those days I was prescribed it at daytime (usually breakfast) at 5mg.
In the end I went back to my GP and she checked up in her book of Magic Potions and Brews and said take it at night .... I did so, and continue to do so, and all my problems have disappeared. About a year ago my GP increased my dose to 7.5mg.
My belief is that in terms of medication Ramipril and Felodopine control my BP and Bisoprolol controls my HR. This combination, along with diet changes have kept me mostly AF free. I'm now 77 my BP is around 132/77 and HR around 64 to 67 during the day ( a bit higher when at work driving buses - 72 to 77 ) and around 52 to 55 when asleep at night.
Hi Carneuny,Thankyou and sounds like you have found your magic cocktail that suits you 😊 glad you manage to work and also have your Afib under control, which is great too. Long may it continue.
It’s impossible for anyone to “ recommend “ which medication to take as we all react differently. All we can do is to say how it effected us. I’ve been on both drugs in the past to help control AFIB ( prior to ablation) . What I found is that both drugs worked for awhile but eventually the effect was reduced . It really was a matter of trying them to see what happened to me.
Don’t make any decision based on forum responses. Do your research and speak to your medics.
Thanks for coming back. I’m really not asking for recommendations at all, I am asking if anyone found their HR was very different when they switched to Nebivalol and what side effects they had, if any. I tend to take some of what my cardiologist says to me with a pinch of salt as I have been told in the past to ‘just stop taking Bisoprolol’ - I can’t or ‘ it’s easy to come off Bisoprolol’ - it isn’t. I was also told that nebivalol will give me the same HR as Bisoprolol, which is what I am aiming for roughly and that there are little or no side effects. I would love this to be the case as my Afib seems to react well to rate control.
I am just trying to find out how others found the switch. This is the only way I think I can feasibly do my research as there’s not a lot on this, in the web for nebivalol.
If I research other beta blockers that are left for Afib, I am put off by the side effects.
I can only take a beta blocker as I can’t take a calcium channel blocker and my cardiologist doesn’t want me to either. I’ve tried atenolol and propanolol, neither suited me and now they’re open to me telling them which one I want to switch to.
I am just interested in how others found the switch and will ultimately make my own decision 😊
I've been on Sotalol, now regarded as rather ancient and no longer recommended, for around 20 years and I have just been told to switch to Nebilolol without really being told why, when I am reasonably controlled by the former. I would also like to hear what responses people have had to the drug as I still wonder if the 'devil you know ' is better than something unknown which might make me feel iller again. I will be interested if you decide to make the switch and it works for you. Good luck.
Thankyou, yes, it’s interesting to know isn’t it? It would just help to gauge whether it’s worth taking the jump.
Sounds like both of us don’t want to ‘upset the apple cart’
If my HR was unaffected, but my sleep and tinnitus was improved, I think I’d be a happy bunny, but if my HR jumped up significantly and my sleep and tinnitus stayed the same or worse, I’d be gutted.
I think my pulse rate was too low on Bisoprolol as my cardiologist likes it to be in the 60's. TBH I think a low dose of Nebivolol increased my heart rate to a level that suited me. I've not had any side effects at all.
I am not sure if my Afib is rhythm or rate to be honest, now I have heard that bisop has a rhythm effect too….something is stopping my Afib break through at the moment in the bisop, which is why I want to tread carefully.
I never used to have a high heart rate naturally, in fact it was usually in 60s, low 70s generally.
Please can I just ask ( sorry) when you say it’s in the 60s, would that be say sitting and reading? Watching TV etc? Then when walking upstairs say, late 70s, perhaps touching 80 etc.?
Just tying to gauge 😊
I do know we are all different, it just helps to know.
No worries, happy to help if possible. I must admit I no longer monitor my heart rate as it seems to be pretty stable in the low 60's. I would expect it to I crease on exertion but that never really been an issue. I tend to have issues with low BP rather than low pulse rate. My Afib seems to be well controlled as I've not had an issue for over 2 years now.
Glad you are stable, I think I am again a bit similar to you, my BP is also low, it was 99/54 last week ( taken at hospital too for a different appointment) and it’s usually around that, when I take it at home. I’m hoping that might go up a little bit more as I sometimes feel dizzy and lightheaded and I think it’s that. I always had low/normal BP pre-beta blockers, so I’m probably not the best candidate for them.
The two beta blockers are, I was told, very similar in action and side effects, although people do metabolise drugs slightly differently, so might feel differences. In the end, I decided my side effects were not down to the bisoprolol but the condition itself.
It seems that most people around the world are given either bisoprolol or metoprolol, with far fewer taking nebivolol, but that does seem popular in one or two countries. I think there are fewer overall complaints about bisoprolol than it might seem, considering the number who must be taking it, and it seems as good a choice as any for doctors to try first. The manufacture of the tablet will be very carefully standardised, for certain, with a very tiny allowed variance in active material quantity; any difference in tablet weight will be in the tablet coating process which is of no consequence whatsoever to the delivery of the active drug.
Bisoprolol has been shown to have a slight rhythm effect, but it works in AF by preventing the adrenergic response which can set off many people's arrhythmia, I gather. I was told by the doctor I saw that the problem with beta-blockers, generally, is that, as AF becomes more persistent, they tend to create bradycardia at therapeutic doses. That's why pacemakers are used when this occurs - to speed up the heart yet still allow for sufficient beta blockade.
Thanks so much in taking the time to come back to me and you’ve really given me a lot of food for thought. I saw an EP privately last month ( I’d never get to see one on NHS) who told me that a beta blocker like Bisoprolol alone doesn’t stop Afib. He wasn’t really that helpful for me, but that’s another story.
If it has a slight rhythm effect to it and stops adrenegic responses, then that probably explains a lot and why I’m able to get by on it alone at the moment.
I hear such a lot of bad press about Bisoprolol and it does influence me, I must admit. I did think that there should be a standard amount in each 1.25 mg pill and my husband thought it would be the fillers that might be altering the weight very slightly. It could be that when I cut it into quarters I’m getting slightly more in one quarter than another and that might be the issue. I didn’t realise how sensitive I was to such tiny amounts. I’m scared to go straight to 1.25 from 1.5 ish right now ( I normally woukd take the leap) as I’m going through some stressful medical things at the moment for the next two or three weeks and it is helping me. I’d only worry that my HR was all over the place otherwise.
Adrenaline was one of the causes of my Afib definitely when I started having attacks every three weeks, last Summer. It all makes sense really.
I shall see what happens when I eventually get to 1 tablet of 1.25.
Your HR sounds very similar to mine, though I know we can still be all very different. On 2.5 mg bisop my HR would fall regularly to 52 and I’d rarely get it over mid 60s walking around the house.
My GP months ago was going to try me on nebivalol but prescribed me 1.25mg which we can’t get in UK and as it was a weekend and I had no beta blockers apart from bisop, I had no choice but to go back on bisop. He said it was ‘like for like’ but it doesn’t sound like it is. It’s probably a lot of trial and error.
It sounds like 1.25 nebivalol would not be ok for me at all.
Cardiolist said less side effects 😊 I don’t know why I later said no side effects I am sorry, I can see it’s confusing ….I did say initially in my post less side effects then I changed it for some reason to no, but I think I just got carried away 😳 I know there isn’t such a thing as no side effects….wouldn’t it be a marvellous thing?
He most definitely said less though….especially my sleep pattern and no bad dreams? He said Bisoprolol is known to give bad dreams….
I would say that for me Nebivolol has had less side effects at an equivalent dose. Especially asthma wise. At the moment I only take .65 mg. I break my 5mg tablets into 4. They are scored as they are meant to be broken but even so the resulting pieces are not always quite the same size. I then cut the quarter in two and here I never get two equal pieces! As I never bother measuring my heartrate unless I am actually in afib I can't say what effect the change had in that respect. But Nebivolol does not reduce my heartrate as well when I take extra during an attack.
I heard about nebivalol being able to be cut into four. I never get equal pieces of bisop, even with a really sharp pill cutter 😳 I wish I could not monitor my heart rate so much, I am really trying not to look at my watch. I actually bought a ‘normal’ watch, but it is still in its case, as I can’t bring myself to not have my applewatch on.
Good to know about the less side effects. I did wonder about it as a pip - I do have fleconaide as well, but have only had to take a large dose of that once.
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