Bisoprolol at night: Hi I see many... - Atrial Fibrillati...

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Bisoprolol at night

Lilypocket profile image
30 Replies

Hi

I see many posts about this and was just wondering if taking Bisoprolol or other beta-blockers at night doesn't make your heart beat too slowly ( especially as HR drops during sleep naturally) which can provoke Afib I think? I would be interested in hearing your views/experience.

Take care

Lily

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Lilypocket profile image
Lilypocket
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30 Replies
CDreamer profile image
CDreamer

Short answer - it could but it may not. Very individual. I wear a smart watch and know my Pacemaker kicks in at night more than at any other time and I don’t take any heart rate meds.

Monitoring is the only real way to know.

Lilypocket profile image
Lilypocket in reply toCDreamer

Thanks for your reply!Take care

Lily

bantam12 profile image
bantam12

I take it at night, I do have a pacemaker but the data doesn’t show it kicking in so presumably the Bisoprolol isn’t making my rate low enough for it to be needed.

Lilypocket profile image
Lilypocket in reply tobantam12

Thanks for your reply. I take mine in the morning but I see some people are taking 7 - 10 mg a day at night to help avoid side effects during the day. I was wondering how it affected them. Take care

Lily

in reply toLilypocket

Hiya Lilypocket,

Originally put on 5mg when diagnosed with paroxysmal AF in Jan 2010. After a while once back at work, I developed random nosebleeds. Full flow ! I was also put on Warfarin at the same time.

Went back to my then GP and she said forget Warfarin, take the Bisoprolol at night ..... so I did and haven't had a nosebleed since. Job done.

My original 5mg was increased to 7.5mg in January 2021 ... still take it at night. No problems. Average resting HR during the day around 62 to 67 bpm ....with a bit of stress from say motoring near misses etc. might hit and stick around 73 to 77 bpm but nothing sinister.

At night when asleep, even though I have a tendency to shoulder pain when asleep my tracker reliably informs me my HR is around 51 to 58 bpm.

John

jeanjeannie50 profile image
jeanjeannie50 in reply to

John, are you saying you now don't take an anticoagulant? A year or so ago I spent a few days in hospital, with a huge bung up my nose that made my face swell because of a severe nose bleed.

Jean

in reply tojeanjeannie50

Hiya Jean,No ....what I meant was forget the warfarin as a cause of nose bleeds. Warfarin was not to blame. It was taking the Bisoprolol in the morning that caused the problems. As soon as I took Bisoprolol at night the nosebleeds stopped and I've never had them since. I would NEVER EVER ditch my anticoagulants ....ever. 😱😱😱😱

My GP has tried to persuade me to switch to the NOAC'S but I just smile and say - if it ain't broke, don't fix it. Warfarin and the opportunity to self test means I can lead a normal life. But I am fortunate that I can tolerate Warfarin.😃

John

jeanjeannie50 profile image
jeanjeannie50 in reply to

Pleased to hear that John.

Jean

mrhappydays profile image
mrhappydays in reply toLilypocket

I'm 5mg bisopropol am; 7.5mg in eve. Heart rate stable at 117 throughout the day (been elevated for 9 weeks; I'm seeing Cardio in 2 weeks), although did notice I was irregular beat for a couple of hours in the morning, last week, when HR varied between 63 and 120.One good thing (!) about elevated HR; I don't struggle to keep the top number of blood pressure below 130 (as specialist wants)

mav7 profile image
mav7

nhs.uk/medicines/bisoprolol...

Check link above and also consult with your doctor.

If it has been awhile or you have no other device, may want to ask to wear a heart monitor which will provide accurate heart rate while sleeping.

Lilypocket profile image
Lilypocket in reply tomav7

Thank you for replying 🙂

marvaldebaran profile image
marvaldebaran

I too take bisoprolol, 5 mg, right before going to bed. I rarely have AF episodes, but they tend to occur in the middle of the night (even before I began taking bisoprolol.) So that's one reason why I take it at that time: as a preventative. I've never had my heart rate drop much below 50 in the night, and it's usually between 50 and 62 during the day.

Jajarunner profile image
Jajarunner

I was prescribed bisoprolol after last emergency cardioversion. When I emailed EP he immediately took me straight back off it. He said the dose of 1.25 was too small to do.much for the Afib but enough to make me tired and breathless. My Afib always come on with sleeping so I did also mention that too him though he never confirmed or denied that.Sorry,not very helpful reply!

Racquet profile image
Racquet

Yes, and yes again. I had more AF episodes while on bisoprolol than off it because it was perfunctorily prescribed even though my lifetime BP and resting HR has always been in a normal range. I stopped taking it one evening when it was time for my evening 5mg dose and my pulse was already 48 and BP was 90/60 from the morning dose. I thought it was madness to take another one. A couple of GPs at church the next morning totally agreed with my decision. I will only take a bisoprolol PIP along with Flecainide PIP if I am having an episode.

jeanjeannie50 profile image
jeanjeannie50

What an interesting post Lily. I usually take a slightly bigger bit of my Metoprolol at night thinking it will help me sleep better. I divide a 50mg pill into quarters and they never end up equal.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply tojeanjeannie50

HiMetoprolol has been banned a year ago. Breathless and not controlling my dai rate 185 avge day! On Bisoprolol 156 avge.

BUT

on Diltiazem 93 avge day 48 night.

Take 2.5 Bisoprolol at night away from 120mg CCB Diltiazem at A.m

CONTROLLED AT LAST.

cheri. JOY

2 wks ago now Dr said no irregularity!

2 things new CCB introduced December2021 and TVT mesh removal swith all inflammation too. 2 March 2022.

jeanjeannie50 profile image
jeanjeannie50 in reply toJOY2THEWORLD49

Are you saying Metoprolol has been banned where you live?

Lilypocket profile image
Lilypocket in reply tojeanjeannie50

Sounds reasonable! In the end we are prescribed drugs and then we juggle them according to their effects on us. I can't take my anti coagulant at the same time as my other meds that are followed by breakfast . It upsets my stomach. I take my Pradaxa at about 11 am with live yoghurt and the second dose late in the evening ( about 11pm) again with yoghurt. X

ATSF profile image
ATSF

A few weeks ago I had mine changed to 1 twice a day. A week later told it was slowing my heart to much and revert back to 1 a day, best early in the day after food.

Belle11 profile image
Belle11

I take 10mg bisoprolol in the evening, as I hoped it might help reduce daytime side effects. My heart rate is low day and night - upper 40s to mid 50s usually, and it doesn't seem to have triggered me back into AF. As far as I know I've been in NSR since a cardioversion 2yrs 4months ago. But despite taking it at night, I do still get breathless on walking, and am planning to discuss again with my GP.

Lilypocket profile image
Lilypocket in reply toBelle11

Hello Belle , thanks for or your reply. I take 3.75 mg in the morning which slows me a little during the day ( tiredness) and sometimes makes mme breathless with effort. But it does reduce my rhythm cardiac so it made me wonder how it is for people who take a bigger dose at night.If you don't mind me asking why do you take 10mg which is quite a high dose if you have been in NSR for more than 2 years. Or do you take it for other reasons?

Take care x

Belle11 profile image
Belle11 in reply toLilypocket

It's the dose I was put on when I suddenly went into rapid AF in 2019, because nothing less slowed it down to below 100 bpm. People do seem to be given very different doses. I think I've been kept on it because of high blood pressure, but that's something else to ask my GP about.

Lilypocket profile image
Lilypocket in reply toBelle11

Yes that may the reason. Do you also see a cardiologist?

Belle11 profile image
Belle11 in reply toLilypocket

I'm months overdue for a follow up with the cardiologist - if my GP can't sort my breathlessness, hopefully they can speed up a hospital appt for me. Going on with a higher dose of bisoprolol is also supposed to help me to stay out of AF.

Lilypocket profile image
Lilypocket in reply toBelle11

I feel that in my case Bisoprolol makes me a bit exercise intolerant - my heart doesn't rise to the occasion so to speak 🙂I take an anti arrythmic drug ( Flecainide - but doesn't really work for me,) and Bisoprolol for rate control. After 12 years of Paroxysmal Afib the drugs don't work very well anymore so I have booked an ablation just to hopefully reduce or come off the meds eventually which don' t agree with me.

Belle11 profile image
Belle11 in reply toLilypocket

A lot of people seem to do well after an ablation - good luck with yours! x

Lilypocket profile image
Lilypocket in reply toBelle11

Well I'm hoping. But Electrophysiologists make me chuckle because the Dr that is doing my RF ablation said that as I had PAfib It would be 90% success rate. Well everything I have read about it cites about 70% success rate. But I suppose you have to be optimistic 😉 and he does about 600 a year so we shall see. My Afib is just plain silly - I was leaning over to stretch my back this morning and I went into Afib ( for 4 hours). Now I know we all try and cut out triggers but bending would be a bit hard to cut out of my life😂.Take care x

Belle11 profile image
Belle11 in reply toLilypocket

Sorry, I missed your reply last week. Hope your ablation is 100% successful. Perhaps your EPs have higher than average success rates? Before my cardioversion I read all the statistics, and that it was likely it was I'd be back in AF within days, weeks or a year, but I'm still in normal rhythm 2 1/2 years later. I suppose we have to be prepared either way, but to hope for the best.

It's certainly a nuisance to be triggered by bending!

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toBelle11

HiCould be your anticoagulant.

cheri. JOY

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiLilyPocket

I take my CCB Calcium Channel Blocker 120mg Diltiazem at a.m

My Bisoprolol 2.5 at pm

Balanced now my avge day heart rate is 93

My night avge always been losw is 48.

GREAT. The introduction of CCB was the best thing ever.

Now 2 weeks ago Dr says no irregularity. Tests are bdeing organised.

HAPPY JOY if it is true

NO Bisoprolol only maintains the low night factor.

cheri. JOY

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