Reducing bisoprolol

[trixie100]

My heartbeat is so low I'm thinking of halving my 1 25 bisoprolol would this be ok or is it better to take it every other day instead?

[pottypete1]

Bisoprolol is a Betablocker and does regulate your heart rate.

I was told to stop taking it because I had a slow heart rate.

However yo should only adjust your dose with the guidance of you doctors.

Pete

[Teresa156]

Hi Trixie,

As Pete has said, you should discuss with your GP…though GPs do tend to think it’s easy to reduce, though in my experience, it can be hard.

How long have you been taking it?

How low does your HR go and what was it roughly before the bisop?

Do you take it for Afib and do you take it with anything else?

If Afib, has it stopped your attacks?

Teresa

[trixie100 in reply to Teresa156]

My heart rate goes as low as in the early 40s and I've been taking it for ad in for two and a half years

[Teresa156 in reply to trixie100]

Hi Trixie,

It is probably worth discussing with your GP, though they don’t always realise how difficult it can be to reduce the dosage in the best way that won’t actually ‘shock’ the system. Your body has got accustomed to this over the time you’ve taken it and if you were to reduce, I would say to do it extremely slowly.

Some people are fine with a quick reduction of it, but I know that a lot aren’t, I’m unfortunately one of them, so I speak from bitter experience. If you try and jump to half suddenly, or take it every other day, you might find you get a ‘reaction’ ( increased HR, increased anxiety) - or you may not. It’s difficult to predict. I’d be cautious.

Pill cutters are ok, but it’s unlikely you will cut the pills exactly in half and the tiniest weights make a difference. You can buy jewellery scales and weigh the pills and reduce by a small amount, week by week, which is what I’ve done, it’s extreme and a faff, but my body hasn’t really noticed the change, not like it has previously. This is just my own personal experience and we are all different of course.

Teresa

[javo123j]

I'm on 1.25 and my HR is around 45 but my cardiologist wants to up it to 2.5. All my afib episodes come from slow heart rate! I don't get it

[JudiHalf in reply to javo123j]

That seems crazy! My heart rate goes very low sometimes and I have been told not to take it, also it makes me pass out, so it’s definitely not for me.

[Ppiman]

The question is only whether it will retain its efficacy at the lower dose. It's not something to try without your doctor's approval, as your heart will be used to the current level of medication, and beta blockers are strong drugs.

I was told by my arrhythmia nurse when I had a bad bout of tachycardia and AF after my ablation for flutter that this is a common predicament and one that an implanted pacemaker is often used to cure. It's one that I foresee coming to myself eventually, although, currently, I only need bisoprolol on an as need basis. When I had to take it regularly, my heart rate at times was in the low 40s.

Steve

[Nerja2012]

Trixie. I have a naturaly low heart rate and diastolic both in the mid 50s but also have PAF. 1.25 bisoprolol brought it down even further so I halved it and it actually works HR and BP dont go much lower but it keeps the rhythm steady. Consultant was ok with that. Ask your GP or Consultant for advice. You can only go by your own Body. I found it works for me but no harm in asking. M

[stoneyrosed]

I too was getting a low heart rate of around 45 bpm so I emailed cardio nurse for advice, he said if it is not causing you any worrying symptoms to just carry on. Hope that helps Trixie.

[Auriculaire]

When I was on Bisoprolol I reduced the dose to .65mg . Itnink it is better to do that than take it every other day. Less chance of forgetting it algogether. You might find it will lead to anincrease in afib though.

[JOY2THEWORLD49]

How low? Avge day and night?

I take 2.5 at night and it does not bring down my night avge of 47. H/R.

cheri Joy. 73 yrs. NZ

How can you half a 1.25?

[DevonHubby1]

My wife had similar low HR on 3.75 so GP cut it immediately to 1.25 and that caused a significant increase in AF episodes. She's now on 2.5 which appears for her to be the balance between number of episodes and HR.

[Redders]

Hi Trish, I was prescribed 1.25 bisoprolol but it made my BP go to low and as I’m prone to fainting I haven’t taken them. I’m in af most of the time now so perhaps I’ll try to take half. Let us know how you get on Trish

[Ronnieboy]

I was on bisolprolol 2.5 even up to 3.75, with a hr of low 40s.i gradually went down to 0 over a period and feel a lot better for it,my hr is edging up a bit and I don't suffer any palpitations ,in fact I'm doubting whether I've actually ever had AF in the first place.

[2learn]

talk to your Doc. My experience was low heart rate was caused by leaky valves which have been fixed, but still low heart rate and pacemaker inserted to stop it going below 60. My experience is if you are over age 60 docs are more worried about low heart rate being an indicator of something else wrong. Have you had a scan?

[Magson]

You don't mention the consequences of a low HR? Does this increase or cause AF? If it doesn't , why do you want to change?

[PleasantPink]

I agree with the others who advised you work with your doctor in order to reduce your dose safely. I was on Bisoprolol 2.5 mg for 4months due to frequent PVC's and Hx. of PAF. I was so tired and foggy I could hardly function at work. The EP cardio allowed me to wean off and use it as the PIP ( pill in the pocket, which means as needed basically ) . Well the weaning was apparently too fast or my system too sensitive, I ended up with a rebound hypertension ( normally I have a normal to low BP ) and the anxiety was off the scale. I had to end up going to the medical cardio to get the BP stable because the EP wanted me to use another beta blocker Metoprolol. Anyway...it took another 2 months on Lisinopril 2.5 mg daily and Slow Mag 2 tabs twice a day to stop the excessive PVC's and now my BP is too low so I am weaning off that too. All that to say , work with your doctor and listen to your body.

[Coco51 in reply to PleasantPink]

Sorry to hear of your troubles. As a matter of interest how long did it take for the rebound hypertension and anxiety to start? I'm thinking of halving my BP tabs and wonder what to look out for.

[PleasantPink in reply to Coco51]

I am at work so I will double check this evening. Best I recall I was told to wean off every other day times 4 doses and then stop. I think it was around 5 days after that BP was climbing and the anxiety was increasing both because of the med change and my worrying about the BP. Always best to work with your doctor if you are adjusting a BP med. What are you taking and what dose ? Is it specifically for your BP or something else ?

[Coco51 in reply to PleasantPink]

Thank you. I am taking indapamide 2.5mg one a day and Lisinopril 20mg 2xdaily and have been for years. But a few things have happened. I'm now on Bisoprolol for AF and I have lost a stone so my BP has dropped and in the heat I feel a bit hypotensive at times. I feel a bit better halving the diuretic in hot weather which the GP has agreed. Just wondering about rebound if I did it for longer!

[PleasantPink in reply to Coco51]

I did check my notes and I started getting headaches around day 3 after weaning the Bisoprolol 2.5mg every other day times 4 doses, so basically that took a week. By day 5 my BP was rebounding and the anxiety increasing. I should emphasize I was not on it for my BP but to control the frequent PVC's. I was diagnosed with Paroxysmal Afib in 2019 after 2 hospitalizations it was controlled with Multaq & Ranexa. I had no further episodes and went to the Pill in the Pocket method with both those until 2021. I had no further events but started with multiple PVC's , SVT and PAC's. Went on the Bisoprolol as I mentioned for 4 months but could not function well at work with the fatigue and brain fog. And that's how the weaning came about. From your history, and btw, congratulations on the weight loss...that's AMAZING ; but you have a more complicated picture with the BP and if you are starting with weaning the diuretic first your response would most likely not be as intense as mine. You have other BP meds covering you. The meds in the Beta Blocker category are the ones I see some people have the rebound issue with, not so much the diuretic. With lowering that I would specifically watch for weight changes ( more than 2 lbs 2 days in a row is a rule of thumb to notify the doctor ) and signs of swelling. Hope this helps.

[Coco51 in reply to PleasantPink]

It's so kind of you to go to the trouble of writing such a detailed reply. I really appreciate it. I think you are right I don't plan to cut the Bisoprolol so halving the diuretic should be ok. BP seems to be ok at the moment and I have no swelling or weight gain so far. Day 5 tomorrow. So fingers crossed. Thanks again😊

[PleasantPink in reply to Coco51]

You're very welcome...Good Luck !

[Coco51]

As you're on the smallest dose maybe halving it would mean youre taking an ineffective dose? But it is a strong medication. My heartrate resting went from 48 to 43 when I started Bisoprolol. No one seemed particularly concerned till I had a procedure followed by a certain amount of blood loss. Then the HR went to 29 and it was thought I had had a heart attack! Many tests later they decided I hadn't had one, it had been caused by the effect of the blood loss. However I now have a pacemaker set to 50 bpm, it seems a bit like overkill to have a PM to offset the effects of medication but c'est la vie. At least it seems to work.

[Hidden]

Definitely would not want to every other day it - would be better to halve due to half life of the medication, there likely won’t be any in your system at some point if you did every other day. Regardless, always best to ask doctor first.