Reducing Bisoprolol when in normal sinus rhythm

[MartinoH]

Was just wondering whether anyone reduces their bisoprolol dose when returning to normal sinus rhythm ?I’m aware that we can’t advise on doses and that we are all individual cases, I was just curious. I had a successful cardioversion a month ago but am still on 5mg bisoprolol ( raised from 2.5 when I went into AF a few months ago.)

[Hidden]

For the reasons you have indicated Martin, it’s best to get proper advice before changing doses of prescribed medication. Have they arranged to review your cardioversion as this will be the best time to discuss.

What you have asked could be subject to mis-interpretation for example, someone with paroxysmal AF only taking a higher dose when in AF.

In my case, prior to my CV I was taking 3.75 mg Bisoprolol and 120mg Diltiazem. At the review it was suggested I could stop one so I opted to stop the Bisoprolol.

[MartinoH in reply to Hidden]

Yes absolutely, totally agree. Not planning on doing anything without the agreement of my EP, was just interested to hear how others have fared. I have an appointment in a few weeks time. Thanks for your advice.

[Hidden]

Just musing while having a pain ridden night ............ so, why would you want to stop it ? I was prescribed it at the beginning in January 2010 (5mg) , am still on it although the dose is now a tad higher at 7.5mg.

Are you saying because you don't have AF you don't need it. How do you know what your heart rate is doing 24/7. How do you know you aren't AF asymptomatic.

Somebody posted on here recently the following link ............. drugs.com ...... then go into the search box and go for Bisoprolol. The link may assist you.

Whatever you decide - good luck.

John

[MartinoH in reply to Hidden]

Sorry I probably wasn’t clear, just want to reduce my dose to my pre AF level, not stop it completely. Not planning to do anything until I speak to my GP, was just keen to hear what others have done in a similar situation.

[Hidden in reply to MartinoH]

Aaaah, I see. Thanks. Just a thought that may interest you .......... after I returned to work having been diagnosed with AF and put on Bisoprolol I experienced massive, full flow, random nose bleeds. The hospital cardiac team who put me on it prescribed it to be taken in the morning.

I returned to my GP, back in the day, and complained. She looked it up and told me to take my 5.0 mg of Bisop (as it was in those days) at night along with my other night time meds. I did her bidding and amazingly, I have never had a noise bleed since - nor any other side effect. It really is a tricky little number and impacts on us all in different ways.

John

[MartinoH in reply to Hidden]

Thanks, I’ll give that a go !

[momist]

Since we are advised to never just halt bisoprolol suddenly, but needs must taper down the dose gradually, I don't think what you are suggesting would be acceptable to the medics. When I first started taking the drug, I was severely impacted by it with a slow down of my energy levels, exercise tolerance, and weird vivid dreams. It took about four months for all that to settle down, and I now tolerate it well. I would assume that reducing or increasing the dose would all have such effects, and would have to be done carefully.

[javo123j]

I asked a cardiology nurse the same question recently and was told not to stop taking it as it can take 2 to 6 weeks to get fully working.

[Visitingcat]

I asked my gp if I could lower my dose from 7.5 back to the 5mg I was on before my afib episode that had to be cardioverted.I cannot tolerate 10 mg and said that if I get stuck in afib again 7.5 left me

no way to increase.

I went to see her because I was getting so breathless trying to walk around supermarkets and when I went for my booster at a stadium (still in normal rhythm ) I went up six flights of stairs and ended up nearly on my knees! There was a lift but I thought I’d be ok as I’d managed fine last time I went for a jab.

She agreed straight away but sent me for another echo as it had been awhile which then showed my valve leaks had become worse which was causing a lot of the breathlessness.

Have a chat with your gp about it, hope you get sorted.

[Belle11 in reply to Visitingcat]

I'm on 10mg Biso too, and get short of breath with any exercise. A different cardiologist from the one I've seen before has agreed to let me try a lower dose. Have your breathing symptoms improved since your dose was lowered?

[Visitingcat in reply to Belle11]

They have improved but I feel much better in myself overall, from Nov to march I felt dreadful. Chest ache just doing housework, bra too tight feelings. The echo showed severe regurgitation in Jan yet a TOE and angiogram end of may showed only moderate and arteries clear. I find it hard to understand.

10 mg of bisoprolol was awful for me, I couldn’t walk anywhere like as far, like wading through treacle and a couple of other weird symptoms that eased off after I went to 7.5 down to 5.

10 is a really high dose, was your rate very high?

[Belle11 in reply to Visitingcat]

10mg is the dose I was prescribed over 3 years ago when I suddenly went into rapid AF, and it was what was needed at that stage to get my heart rate below 100. But since a cardioversion 2 1/2 years ago, my heart's stayed in normal rhythm, and my heart rate has been mostly 44 to lower 50s, occasionally as low as 39. I've recurrently complained of being short of breath on exercise, but this is the first doctor who has offered to reduce my dose. So my fingers are crossed that it will help!

[Visitingcat in reply to Belle11]

That’s a big dose to stay on, I first started on 1.25 and was gradually increased as it wasn’t enough I bet you will feel much better when it’s been lowered.

[Belle11 in reply to Visitingcat]

I do hope so! I think some doctors like to keep the heart rate low as they think it makes a recurrence of AF less likely. It would be lovely to walk more than a 100 yards without starting to get short of breath.

This group is so good for learning what's worked for other people, and sharing experience.

[Visitingcat in reply to Belle11]

It really is great isn’t it? I’ve learned way more here and what questions to ask when seeing doctors.

I’ve also been very reassured about procedures. I was scared stiff of cardioversion when I found this forum, by the time I went in for it I’d read so much that I was just slightly nervous. Like my mind was calm and accepting but my heart rate was still up 😀.Hope you are feeling great soon.

[Belle11 in reply to Visitingcat]

That's good to hear. I didn't find the forum until soon after my cardioversion, but it's really helped since. Thanks for your good wishes - my fingers are crossed for more breath!

.

[2learn]

I've had 3 cardioversions and after each one I stopped bisoprolol, with GP guidance, as 5mg would take my heart rate down to 40-45 and I'd feel faint. Same after 2 ablations, but now after 3rd ablation I'm kept on bisoprolol 5mg and my pacemaker stops my heart rate going below 60.

[Paul0208]

All that c**p about getting medical advice didn't help me after my AF. They put me on blood thinners for life (I came off them after a few days after working out for myself that there was no need for me to be on them (48 male no previous heart or stroke issues)) and after being prescribed 10mg of bisoprolol to take for ever more (even though I have a resting heartrate of 55) I came off that because I felt rubbish and like a living dead on it and now feel wonderful. Not advice to you, just reliving my experience.

[Keano99 in reply to Paul0208]

so how is your AF now?

[MartinoH in reply to Keano99]

All good thanks, still in NSR after three months! Have stayed on 5mg bisoprolol and am also taking 100mg flecainide. Thanks for asking 👍🤞

[MartinoH]

Thanks for your comments everyone, all really helpful. I’ll ask my EP if I can reduce to 2.5mg and hopefully I’ll start feeling human again !

[Visitingcat]

Hope they get you sorted and you are feeling better soon MartinBest wishes

V Cat

[Hidden]

Hi,

I was on 2.5mg of Bisoprolol when I was in persistent AF, after a cardioversion which brought me back into NSR my cardiologist said I could halve the dose to 1.25 mg.

I did that for about 2 weeks but found it was causing my heart rate to drop down to the low 40’s therefore my cardiologist told me to stop it all together.

I remained in NSR for about 7 weeks and then reverted back to AF as many people do.

You do not mention in your post what your heart rate is or was which is the pertinent issue.

If your heart rate is in the ‘normal’ range in NSR whilst on 5mg of Bisoprolol it would suggest that the dose is right, If your heart rate is now on the low side then that would suggest the dose is to high.

Ask your cardiologist or doctor, although doctors tend to work on the premise of giving the highest dose of Bisoprolol that a patient can tolerate. You’ll probably get the best view from your cardiologist.

Hope the above helps.