AF and asthma

[rcburton]

Does anyone have experience of Bisoprolol impacting on asthma, suggestions for other suitable medication would be good, however not calcium channel blockers which I've tried and were disastrous

[BobD Volunteer]

Beta blockers such as bisoprolol are ill advised if a patient has asthma and likely to exacerbate it. Maybe time to consider rhythm control drugs or ablation.

[rcburton in reply to BobD]

Thanks Bob, I'm seeing my consultant at the end of June so hopefully will have some more options at that point. I don't think I fancy the ablation route yet, just hoping that we can find the right medication to keep it under control and allow me to exercise as I would normally do.

[BobD Volunteer in reply to rcburton]

Just interested why not? When first offered it I was not keen but within 6 months I was begging for one. Don't leave it too long.

[Buffafly]

Bisoprolol shouldn’t be prescribed for people with asthma. What was wrong with calcium channel blockers?

[rcburton in reply to Buffafly]

They made me feel dizzy and unable to think, ended up with in a night in hospital because I felt so terrible. The nurse insisted I take one in the morning and within 10 mins all the symptoms returned.

[Buffafly in reply to rcburton]

😬

[Ducky2003]

Bisoprolol left me horrendously breathless and I dont have asthma. My local pharmacist explained that it's supposed to be cardiac specific but it does also attach to receptors in the lungs. I was put on Diltiazem (calcium channel blocker) with no problems and also currently take Amiodarone.

Not sure what other meds options are available to you now, other than rhythm control. Hope you get it sorted.

[frazeej in reply to Ducky2003]

While all “beta blockers” are designed to be cardio specific, acting on the adrenaline receptors in the heart (Beta-1 receptors). Blocking the adrenaline action on the heart is what we want (slows rate, decreases contractive force). Unfortunately, all have some (small to significant) activity at the Beta-2 receptors, which are found in the airways and smooth muscle of the veins and arteries. Blocking these receptors is an unwanted side effect, preventing the airways and arteries from properly dilating during exercise/stress-which leaves us all “out of breath” to varying degrees.

Thus it’s pretty much a “roll the dice” process to find the drug with the best desired response with the most tolerable “side effects”.

[Ducky2003 in reply to frazeej]

I was told that some BBs are more cardiac specific than others and if I was having trouble with Bisoprolol, chances were I'd have trouble with any others. Pharmacist suggested talking to the cardiologist about Diltiazem which I did and luckily no issues with that.Like you say, a bit of lottery with it all.😊.

[pusillanimous in reply to Ducky2003]

When I was diagnosed by chance with AF, and rushed off my the GP to the cardiologist as she was concerned about a dissection. I had been taking 120mg verapamil and 10mg lisprilol (not sure of spelling) for BP - this kept my BP under control but it was a tricky one to know exactly how it was behaving because I suffer from severe 'white coat syndrome' and sometimes in the doctor's rooms, the systolic could be in the forties, and I was never given a Holter device to wear. Anyhow, I was kept in the cardiac hospital for the weekend and just lying in bed my BP was 114/70 (I did not have my BP meds with me) and the Cardio took me off them and put me on 250mg Biso only. After a couple of weeks my BP had shot up to 199/100 so I saw my GP who phoned the Cardio and the Verap and Liso were reinstated and my BP normalised. I was still on the Biso. I then went to see him for a check and I was in AF, so he did a cardioversion then. I then changed to another Cardio as the original one moved , asked him if I could have something instead of the Biso, and he said no, it was Cardiac specific and would not affect my lungs. I changed Cardio again and the latest has agreed that I can take 125mg Biso if I feel I need it (I seldom take it only if my BP goes above 110bpm, which is rare). But the point is, some Cardios don't seem to worry about the effect of the lungs, even though the Cardio who originally prescribed it knew I have ACOS!

[rcburton in reply to frazeej]

Thanks for the reply, interesting to hear the mechanism that's affecting my asthma and therefore breathing , thanks

[Silvasava]

Im asthmatic, very well controlled. Bisoprolol made me breathless to. Cardiologist changed me to Nebivolol, my breathing improved considerably. My understanding is that this is preferred for asthma sufferers. HTH

[rcburton in reply to Silvasava]

Thanks for the reply, that's certainly a route I will be suggesting when I see the cardiologist, very helpful.

[cassie46]

I have lung problems and eventually I was able to get changed to Nebivolol from Biso. Breathing much improved and generally felt more alert. I asked to be changed to Nebivolol at three of my cardiac checkups, explained why, but it fell on deaf ears. I eventually asked my GP to prescribe it and she did.

[rcburton in reply to cassie46]

Thanks for the reply, confirming the benefits mentioned by "silvsava"

[KMRobbo in reply to cassie46]

That's the way!

[Thomas45]

I've had AF for over 25years, now permanent but asymptomatic. I've been treated for asthma for 47 years. After my heart rate shot up to over 190 while under general anesthesia a well-meaning hospital doctor insisted prescribing a beta blocker despite knowing I was asthmatic. 7 weeks later I had the first of 2 side effects, urticaria, painful rashes which appeared anywhere apart from my face. I also couldn't eat certain foods because they gave me further rashes, especially grapes, banana, orange, and tomato. While being weaned off Bisoprolol I had the second side effect which was a very sudden exacerbation of asthma and chest pains. Fortunately I'd just entered a pharmacy. An ambulance was called and I spent two nights in hospital. My GPs took me off all beta blockers. I still take antihistamines to reduce the number and strength of the rashes.

[KMRobbo]

Which CCB did you try? I had several side effects with Diltiazem, but had none with Verapamil. HOWEVER as my AFib progressed the Verapamil was not keeping my high rate in check. But we are all different in response to drugs so it may well suit you.

[rcburton in reply to KMRobbo]

I was on Diltiazem but the side effects were horrible, dizzy, tired all the time and just generally unwell. I'm going to see my consultant at the end of June and going to ask about Nebivolol which a couple of the replies have indicated is much better for asthmatics

[Electricblue1]

Hello, I have asthma and am on bisoprolol, small dose and so far my asthma been ok.