What is the difference between bisoprolol and verapamil?

[DizzyD]

Hi all, a week ago I finally got to see a cardiologist after many admissions to a+e spaced over 2 years. I informed him that I had stopped taking bisoprolol two weeks previously because it severely impacted my ability to exercise, which really got me down. While off the bisoprolol my exercise levels improved greatly....didn't feel like I was hitting a brick wall anymore with every step I took! Also my breathing was less restricted because exercise was easier and not a struggle.

Anyway he prescribed verapamil which I took after getting script in hospital pharmacy. The next morning I dosed with verapamil. Half hour later severe sharp pain across top of chest which was new for me, pain up left side of neck and all around the jawline. Totally weak, could barely walk or speak. Phoned 111 who sent for an ambulance. While waiting for ambulance which was delayed due to heavy traffic (grand national day) bit by bit I started to feel a better. Phew I was relieved and called emergency service and cancelled the ambulance. They turned up anyway and checked me out. ECG showed abnormality. Admitted to hospital (different hospital to where I am usually admitted) where I remained for four days while being monitored etc then discharged.

Discharge notes state that I had AFib along with RVR (rapid vernacular rate) which was never mentioned or detected during previous a+e admissions to a different a+e. On this occasion though, my trotopin (spelling error) levels were raised after second blood test in a+e

Is it possible that the new meds could have triggered this episode? What is the difference between bisoprolol and verapamil? Perhaps my usual hospital failed to determine RVR but they always mentioned trotopin high markers.

Sorry overdrawn out post...really would appreciate some feedback.

[Staffsgirl]

Sorry I can’t help, but I’m interested to read your experience. I had similar problems when on Bisoprolol, a Beta Blocker. Once I came off it I could function again. My GP recently prescribed Verapamil, which is a Calcium Channel Blocker. I could not tolerate it: hallucinations, difficulty breathing, limb pains and involuntary twitching.

[BobD Volunteer]

RVR just means that the fibrillating atrium is sending signals to cause the ventricle to contract quickly. In most cases this is normal for AF so not remarkable.

Bisoprolol is a beta blocker, Verapamil is a calcium chanel blocker. Both aim to slow the heart in AF. Troponin is released by the distressed heart muscle and depending on the levels can indicate a heart attack which your symptoms may also indicate. Note, some people suffer this kind of pain during AF events as well. Try to stay off the exercise for a while or at least LISTEN TO YOUR BODY.

[DizzyD in reply to BobD]

Hello Bob thank you for informative reply. It's interesting to read in your reply, "Both aim to slow the heart in AFib" I can understand the need for this medication while having a Afib flare up or if I had permanent AFib, so why take it on a daily basis when heart is in sinus rhythm? Surely, taking it on a daily basis (when Not needed) will interfere with normal heart rate and stop heart from doing it's job. Consequently heart rate goes too slow, then in order to kick start itself it's goes into AFib along with RVR. It's interesting to note: I never had AFib prior to taking bisoprolol. AFib popped up a few months after I was prescribed them by GP. Certainly going to run this cardiologist at my next appointment. Not sure if this makes sense to you but hey hoo.

[Hidden]

Hi,

You state ... "stopped taking bisoprolol two weeks previously because it severely impacted my ability to exercise".

You ask ....."Is it possible that the new meds could have triggered this episode? What is the difference between bisoprolol and verapamil?" Well, I'm not a medic or in anyway a healthcare professional .... so these are just observation .............

1) Why would you think verapamil would have taken effect in half an hour ? seems illogical to me as any medication particularly taken for the first time would need some time period to take effect ..... maybe you should consider something else was going on.

2) Bisoprolol ..... its a challenge this drug but again consider it from logic rather than science ..... its like this ( and I go along with BobD ) ..... Bisoprolol is designed to slow your heart ...... your mind set says ..... I gotta go get exercise. There you have it, any exercise will cause your heart rate to increase .......... you are scoffing Bisoprolol/ Verapamil and slowing your heart then you go out an exercise to speed your heart up ......... you have two forces in the known universe at work here, both diametrically opposed to each other ........ sooner or later there is gonna be a casualty !! Bisoprolol will win every time.

Why don't you just forget the exercise dynamics for a while .... you sound as though you could be an exercise junkie .... just give the meds the chance to do the job the chemists/scientists designed them to do ?

John

[DizzyD in reply to Hidden]

Thank you John when I say exercise (bisoprolol free) I mean basic walking, one hour 3 times a day with breaks inbetween walks, sometimes less than that, not workouts at gym. With bisoprolol I was lucky if I could walk 3 x 10 mins day before hitting a brick wall they had to go. There was no way I was going to become a couch potato, due to medication, which is detrimental to the body and heart, so I am not an exercise junkie, just someone who I trying to incorporate daily exercise in my life.Appreciate your imput.

[Desanthony]

Don’t know all the ins and out but Bisoprolol I’d a beta blocker and verapamil a calcium channel blocker. I think here mist start off on bisoprolol as I did and it made me more I’ll than the AF. I then tried verapamil and still felt bad. I think all in all I tried about 6 different medications it mixes of medications and in the end don’t take any of this type of medication just apixaban and thankfully can function normally.

[DizzyD in reply to Desanthony]

Hi Desanthony as I was reading your post, I realised initially I was not prescribed bisoprolol for AFib. They were prescribed by GP while awaiting cardiologist appointment which never came about cos covid arrived. Before taking bisoprolol I have never had an AFib attack, but I did have my first one a few months after taking them. Oh heck, is it possible that AFib popped up because of bisoprolol messing about with my heart rate? Furthermore, I worse off now on meds than I ever was. Having come to this realisation I have a choice, either carry on taking verapamil or not. Will continue with apixaban though.

Going to run all this by cardiologist at my next appointment.

Strange, I hardly ever been admitted to a+e before being put on bisoprolol. Since being put on meds I have been admitted far to many times. Last admission was on second day of dosing with verapamil....Is that just a coincidence?

This is my experience. I am not advocating that anyone does what i am doing. At end of the day I am an individual in my own right and I take risks in accordance with my experience. I AM NOT A MEDICAL PERSON BUT I DO KNOW MY OWN BODY

[Desanthony in reply to DizzyD]

All beta blockers, calcium channel blockers or rate control medication made my heart rate go down to around 40, I was breathless, dizzy and had a cough and felt better off without them. They tried lots of variations of dosage and mixes. I even let them try bisoprolol twice. Then, one Saturday morning during the second lot of bisoprolol I couldn’t even manage to walk downstairs ( just as well as I would never have been able to get back up 🤣). My wife rang the hospital and my cardio was on duty and he just said to come off them straight away.

Hope you manage to get yourself sorted

[KMRobbo]

RVR - rapid VENTRICULAR response, but in my mind your version would be a lot funnier!

Not medically trained but I think RVR = FAST AFIB.. I alway had typical 165bpm resting although it could bounce about .

Verapamil is a calcium channel blocker, bisoprolol is a beta blocker. They both control heart rate but in different ways. I could not tolerate beta blockers , even 1. 25mg slowed my hr from 70 to 45 ish. My max hr when trying to run was 117 ( from memory) I could only run 100yards before I was completely out of breath. Verapamil did not give me ANY side effects certainly not those you described. - I had 120mg modified/ extended release. It did not significantly affect/ slow my normal hr did not affect my running but when I went into AFib it did not really control my hr either. Still 165 ish resting. I think it did delay my launch into afib though. I did get a supply of 40mg normal release to be used like a PIP so if I saw a raised hr I took one just in case to reinforce the 120mg dose. However it takes a few hours to act so is not really any good as a PIP on its own. Bisoprol took 40 mins to act on me ( I know as it put me to sleep in that time!). Also - we are all different with sensitivity to medications. Some people love bisoprol I felt I only just survived on 1.25mg !

Another calcium channel blocker I tried is diltiazem hydrochloride. That was better for me in actual rate control whilst at 200mg mod/ extended release allowed me to run with max hr 137bpm. The good thing was post afib when I went into atrial flutter it rate controlled my heart to 140bpm which was really good. It could have been much higher than that! I should add that I thought that 200mg was too high a dose for me , and tried 120mg for a while which was better for running max I think was 144 from memory and other side effects reduced. But my local hospital switched me back to 200mg as I was very difficult to get me out of AFib when in it. ( long story).

Best wishes

[Snowgirl65]

The difference I saw between Bisoprolol and Verapamil, was that the first produced no discernible side effects; the latter made me feel absolutely horrible, like a spaced-out zombie.