Hi everyone who gave me their wisdom in recent response to my ” Bisoprolol beats me at last”. Thank you. Apologies for my delay in getting back to you, had a road trip to do to spend a few days with my sister and very poorly brother in law ( with vascular dementia) up in Surrey. Am home now and preparing to do battle with my GP, the bloody surgery and any other medical/ healthcare practitioner who gets in my way.
I had already made up my mind to ‘zap’ Bisoprolol - not totally stop it but to reduce it to a level that worked for me in the past. From 7.5 mg back down to 5 mg. I posted because I wanted to read the considered opinion of those with other experiences of Bisoprolol. So, again my thanks. Tonight I’ll start the reduction process which I’ll spread over several weeks. Fortunately I have a wrist watch which also is a health tracker ..... specifically it monitors HR. Having sync’d it to the Dashboard on my laptop I have been able to more accurately plot how often my HR dropped below 60 bpm. Groan !
Must say having spent quite some time reading up on Bisoprolol I am becoming increasingly disillusioned it was sold to me back in Jan 2010 as a heart rate control medication. Nowadays - regardless of what I read, it is being promoted as a blood pressure control, with very little mention of HR control. Hmmmmm ! For goodness sake ... I’m already on Ramipril and Felodopine for BP control. Maybe time to review all my meds with the view to substituting Bisoprolol with something else specifically aimed at HR.
Good idea John, nebivolol seems to be well tolerated so may be worth discussing with your unfriendly surgery! Sorry to hear about your family problems, getting old ain’t much fun for many!
in reply to
Hiya FJ,
Thanks for that. What I find so amazing is how once I got above 5.0mg of Bisop is that it has taken so long before I started to not tolerate it.
All my experiences since the beginning of the year (2022) seem to be building up and up and now its a disaster - I certainly can't go on with readings almost daily between 41 and 58 like this, not with a body like mine ...... I mean, 15 stone and almost 6 ft. tall is a bit big to cope with a HR of low to mid 40's on a regular basis
John, I don't know why but a few weeks ago after looking at my ECG the cardiologist I saw said Nebivolol wasn't suitable for me. I'd asked for a copy of the ECG which showed I was in flutter with variable AV block and premature ventricular of aberrantly conducted complexes etc. Most means nothing to me and I feel ok. He said he thought Flec was the cause and said to stop it. I have and also upped my Metoprolol to 25mg. All been ok for the last few days, but just to make you aware Nebivolol isn't for everyone. I thought I just had to ask and would get it.
Thanks for that information .... I'll bear that in mind. I shall do some more research on it. The thing is (as I've written on here at times) I have dollops of AF each year, maybe 3 to 5 times a year, all with varying degrees of intensity. Until earlier this year HR has been well controlled with 7.5 mgs of Bisoprolol. These days its beyond tolerance and I'm no longer prepared to accommodate HR that are regularly between 41 bpm and 58 bpm. In this range those numbers totally derange my brain and I have a shedload of other more meaningful Bisoprolol symptoms into the bargain.
So, I shall try and talk to my GP ( she has a great life - works 4 days a week) and see if between us we can reach an agreement on a replacement for Bisoprolol.
If your afib episodes are so infrequent why on earth are you on such a high dose of Bisoprolol? Seems like a hammer to kill a fly. Why did they put you up from 5mg to 7.5mg?
When it all started, back in Jan 2010, and I was admitted to hospital ( with a HR of 156 bpm from which point AF was diagnosed) the Cardio Consultant put me on 5mg Bisoprolol taken in the morning. Following unexplained random, full flow nose bleeds my GP ( back in Surrey) changed it to evening - where its been ever since. Also never had a nose bleed since !
It was my local GP (down here in Cornwall) that upped the dose to 7.5mg as she felt that my blood pressure needed more assistance to bring it down. She and I have never discussed my AF because there has been no need to - it doesn't bother me - it knows its place in my world (!) yeah sure 3 to 5 times a year there are blips and the worst only lasts a few hours. The last real humdinger was in April 2018 when it went ballistic for around 15 hours and once before that when we were away and it took me out for the weekend away. I have never ever since we've been in Cornwall sought out a Cardio Cons. for AF treatment.
The other thing that bothers me about Bisop is that in the beginning it was 'sold to me' as a " rate control" drug. I was put on it by the Cardio Consultant. Today you never hear of it being referred to as a rate control drug - its being peddalled in and around the medical fraternity as a blood pressure drug. In my simple mind - it cannot possibly - and effectively do both. That in itself for me is enough to firstly, reduce my dose down to 5mg where I know it did its rate control job very well. Then after that get off the bloody stuff as soon as I can - hopefully with the cooperation of my GP.
It would seem that the NHS are having 2 bob each way ......... Bisoprolol - the ultimate multi purpose AF weapon of choice. I don't think so. I pity the poor person on 10 mg or higher. I do have to say though its done nothing for my blood pressure at all, and I am already on Ramipril and Felodopine for BP control ...........
It seems odd to me. I understood that Bisoprolol was considered outdated for BP control and more modern solutions like Losartan were used. My husband has blood pressure meds and he takes Exforge - a combo of Amlodipine and Valsartan. But that was an expensive branded drug that has only recently gone generic. His last scrip changed to the generic. Bisoprolol does control rate for me - it works much better than the Nebivolol to bring down my afib when an attack comes . But yours seem so infrequent that surely PIP would be better. I would be very cautious about weaning off though after being on it for so long especially when you get below 5mg.
I find Biso works to reduce my heart rate within a very short time. When I was diagnosed with AF by chance, but not surprising as my whole family has it, and I had no symptoms. The cardiologist I was sent to removed my existing BP meds because he considered my BP too low and placed me on 2,5 mg Biso, which I hated , after taking it for a couple of weeks it went to my GP when I discovered my BP had risen to dramatic levels. After phoning the cardiologist my BP med was reinstated part of which included 120mg. Verapamil and the rest Lisoprilil (wrong spelling but a common BP drug,) and it settled again, but still the hated Biso continued. I then committed the mortal sin of halving the dose and was much better, much to the horror of the locum GP I saw for renewal of my prescription. I am now seeing a different cardio (we have no EPs where I am) and he agrees that I carry on with my tried and tested BP meds and take 1,25mg of Biso, if my HR seems to rise ( I am happiest in the late 60s and 70s) but I take the Biso if I go to 110BPM) if there is arrhythmia, I find a glass of iced water very effective in dealing with that.
My cardiologist just kept putting my Bisoprolol dosage up until I was talking 15mg per day. It destroyed my quality of life and was preparing to give up work until I joined up here. Going with a lot of others on here and how Bisoprolol affected them I demanded a change of medication and got changed to verapamil. Big difference immediately . Some consultants seem to think Bisoprolol is a miracle drug for all... and don't listen to their patients concerns.
Hiya Cam ....... my goodness ....... 15mg ......... I would really be out of it at that dose . Thats twice what I'm on now, and right now is bad enough. Goodnes me ! glad you are on top of things now.
I was on Bisoprolol for about 7 years, starting at 1.25mg daily and increased to 2.5mg twice a day. The higher dose was ok for quite a while, but then the fatigue and breathlessness set in. After reading on here I asked my cardiologist to change me to Nebivolol. He wasn’t keen but reluctantly agreed. That was 3 years ago and I have never looked back.
On Bisoprolol I was getting a lot of AF starting during the night. I believe that my heart rate was too low causing this.
I do keep some Bisoprolol to use to slow my heart rate if I get AF, as Nebivolol doesn’t seem to help.
My resting heart rate is between 65 and 72 which is pretty good.
It seems that Bisoprolol builds up and eventually causes you to become intolerant to it.
As for your GP’s great life working 4 days a week. These days that is classed as full time for a GP and they still moan. 🤣
I just commented to Auriculaire about my adventures with Bisoprolol which you may find interesting. I must say for 10 years 5 mg of the stuff kept me in a happy place ......... the same as your resting heart rate. OMG ! wish I could be there now, closer to 72 if truth be told.
Before I start going head to head with my GP I'll be doing a fair bit of research as to what might be suitable for an old git at his stage in his AF journey. Nebivolol could be a good start point.
Must say dealing with the coldness is one thing - the tiredness is beyond belief. For goodness sake I feel as if I have just flown direct from Heathrow to Sydney (21 hours) without sleep. My eyes are so sore, like the proverbial sandman has come along and scattered fine dusty sand into my eyes. Can hardly keep them open. Can hardly function. Brain fog doesn't even begin to describe it.
I did a CoVid test today as well ......... one of the features I've noticed is that there are a goodly number of Bisoprolol side effects that run a very close parallel to CoVid symptoms. Almost as if they are mimicking each other. Negative - yet again.
Actually, you made an interesting comment about the build up of Bisoprolol in the body and becoming intolerant to it. I've wondered about that in the past.
Anyway Val, onward and upward. I'll post more about weaning off Bisop as things unfold.
I would insist on a thyroid test as well. Feeling cold in summer can definitely be a sign of hypothyroidism. My sister has had this for years and only recently been diagnosed as "borderline" hypo. Not enough to treat it of course . Can't have her feeling better and stop piling on the pounds.
My experience of just being on 2.5mg bisoprolol was terrible. My medication was changed from 200mg Diltiazem to 90mg diltiazem and 2.5mg bisoprolol. The adverse side efffects were immediate - drop in heart rate from mid50s to 35-45bpm, lightheadedness, extreme fatigue, unable to breath properly, to name just a few. I phoned my consultant’s secretary who passed on my concerns - then told to take 1 x 2.5mg every other day but I still felt the same. Consultant advise to just take diltiazem. So this week I have resumed to only taking 200mg diltiazem and off Bisoprolol completely.
Your excellent post took me to read up a bit more on beta blockers as I take bisoprolol as needed for AF, ectopics and mild tachycardia. It seems that they are licensed for use in AF when heart failure results from the condition (presumably as a direct result of the AF or the tachycardia it can induce). They aren't called "rate control" in the NHS pages I read.
Well I don't think a lot of docs take any notice of this . I have been put on 5mg Bisoproplol daily by 2 different hospital cardiologists. The first time I was bluelighted to hospital and kept there for several days. I had blood tests which determined that my TSH was below range ( they said this was the cause of the afib) and an echo which showed a perfectly normal heart. So no sign of heart failure . The second time was after major bowel surgery when not only was I dehydrated having come off the drip (but unable to drink enough due to the bloating caused by keyhole ) , I had also overdone the Ventoline due to the post intubation phlegm. Again no sign of heart failure and all circumstances known triggers for afib. Luckily my own cardiologist is not such a fan of Bisoprolol and was quite happy with a drastic reduction of dose then a weaning off. After the second time he switched me to Nebivolol when I asked .
You’ve been through the mill a bit in your time. Bad luck. I was thinking that “heart failure” in this respect must refer to the “temporary” reduction in output caused by an arrhythmia, rather than, say CHF and similar. It does seem odd that in the approved indications for beta-blockers, “rate control” never gets a mention.
I was prescribed 2.5mg Bisoprolol to try and bring down heart rate (no afib).It didn’t make any difference so was increased to 5mg. I felt awful - as though I was dragging myself around, my legs were like lead weights and breathlessness worsened. Tolerated it for 10 days to give it a chance but didn’t get any better. Now on 120mg Diltiazem twice a day and heart rate slowly coming down and I have a bit more energy at last. Bisoprolol is one of the few meds that has a bad effect on me so it’s definitely not for everyone.
Well, much like a lot of the comments, I felt like a tired breathless zombie on Bisoprolol. I suddenly received a random unexpected phone call check up from a consultant to see how I was doing (those were the days when someone cared)! He said stop taking it immediately and suggested Sotalol. I'm so much better on that. I get the odd AF episode once every 4 to 8 weeks but feel almost normal inbetween. Hope you find something that suits you soon.
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