15mg Bisoprolol

[NLGA]

I am in a dose of 15mg plus Amiodarine I have AF is comes amd goes my question is it seems a high dose as I have a thinner and calcium channel blockers

My general gear condition is mild Mitral regurgitation a mildly dilated left atrium amd my ejection fraction is 50

I’m told lots of different things one doctor in A and E told me I had heart failure another that oerformed a recent ECG told me I haven’t amd all is pretty normal for a 52 years old make that could be do with losing a couple of stone .

but going back to my question is this much beta blocker normal ?

[BobD Volunteer]

Most people would not be able to function on a dose of 15mg. Are you sure it isn't 1.5mg?

[NLGA in reply to BobD]

Yes 100 per cent sure it was 2 x 5mg morning and night and increased to 15mg

[Teresa156]

Hi NLGA,That is certainly a high dose of bisoprolol.

Was it a cardiologist who increased it? So do you now take 7.5 in the morning and 7.5 at night?

I have read on Google that 10mg is the highest dose but i’m sure there must be exceptions…please can I ask why they increased it?

It is supposed to last 24 hours with one dose, though I know there are some who split it and get on well that way. I can just about tolerate 1.25 so I cannot imagine 15mg.

[NLGA in reply to Teresa156]

Hi The cardi doctor put me in 12.5 then my Gp increased this to 15mg 2 morning 1 night due to increased AF

[NLGA in reply to Teresa156]

I feel good on it never had any tiredness pains etc

[NLGA]

20 mg is the most you can take

[NLGA]

In May I had a hb of 172 it sat at 140 and after the 5th day in hospital it reduced to 100 same again in June they are the only cardio doctors I have seen to this week when I was told stay on the medication but I don’t have permanent AF as first thought

[Teresa156]

Hi,It shows how the internet can give misleading info re: highest dose then. If you feel ok on it, that’s the main thing.

Your post was asking if this much beta blocker was normal, was that your concern? In answer to that, I don’t think there are many that are on a 15mg dose of bisoprolol and I don’t think it’s a ‘normal’ dose for many people ( though others may come along and say it is and I’m happy to be proven wrong) If you know you are on a high dose and you feel ok on it then I’m not sure what others can say about it?

[NLGA in reply to Teresa156]

I was asking as it seems high compared what I read on here ?

[Teresa156 in reply to NLGA]

Hi,Yes, I think it’s higher than most people have or could tolerate, but as you say, you are still not on the maximum.

You could have many people coming back on here saying the same as me, but I’m not sure how that would help you? I am sorry but perhaps I’m misunderstanding what it is you are asking as you wanted to know if it seemed a high dose - and it is quite high I think compared to what most would have.

You have to also bear in mind that none of of us are medically trained and not able to advise on doses of medication too.

[Teresa156]

I would add that I do think it’s unusual for a GP to prescribe upping medication for Afib however….they usually rely on advice from a cardiologist. They do not have the same knowledge as a cardiologist of Afib.

Do you have any further cardiology follow up appointments coming up? You may be best to voice your concerns with a cardiologist.

[NLGA in reply to Teresa156]

No I don’t imagine a GP would have the knowledge as a cardio doctor would have

[dizzielizzie1 in reply to Teresa156]

You are so right. My GP took my pulse and announced that it was 81BPM. He thought it would better if it was in the 60s, so he upped the bisoprolol from 5mg to 7.5mg. GP told me not to take more than 10mg a day, then added that he thought I could go up to 20mg if necessary. Definitely a case of think of a number and double it. When I did eventually get an appointment with a cardiologist, he said that there was nothing wrong with having a pulse rate of 81 and said he thought 7.5mg was 'rather aggressive.' My cardioversion was successful but I was told to stay on Bisop 2.5mg. alongside Amiodarone. When my pulse got down to 46/48 I decided to take only 1.25mg and GP agreed . BPM now at 54 . AFib is no joke!

[NLGA in reply to dizzielizzie1]

I have a call today with my GP to discuss this

[dizzielizzie1 in reply to NLGA]

Make sure you tell him/her about all your AFib concerns. I'm not medically trained, but I would say that 15mg of Bisoprolol is a high dose. On the other hand there may be good reason why you need it. Good luck

[Teresa156 in reply to dizzielizzie1]

I did think it didn’t sound right….glad I’m not going mad! I checked the NICE guidelines again ( which is supposed to be used by NHS) and yes, 10 mg is maximum dose of Bisoprolol…

[NLGA in reply to Teresa156]

No 20 is I spoke to the GP today

[Teresa156 in reply to NLGA]

Hi,

10 mg is on the NICE guidelines website, so I’m referring to that.

I really do still think you need to discuss this with a cardiologist, when you get the chance, but it’s entirely up to you. Good luck.

[NLGA in reply to Teresa156]

Sure when or if I get to see one , although the cardio doctored did put me on 10mg the GP increased it

[Ducky2003]

I was told 10mg was highest dose. I couldn't function on 5mg of it so when they put me up to 10mg I could barely climb the stairs or walk to the garden gate. After a couple of months of this I begged to be put on Diltiazem so I've been on that for a few years now.It's good that you're not experiencing any issues with Bisoprolol.

AF has caused my left atrium to enlarge and its pulled the annulus of my mitral valve apart so I'm now on a list for valve repair surgery.

[NLGA in reply to Ducky2003]

Can I ask what’s your EF mi e is only 50

[Ducky2003 in reply to NLGA]

I dont actually know. Its never been mentioned. I've had a TOE and a CT angiogram so presumably, one of those will have shown it. I'll ask the cardiac liaison nurse when I speak to her next week. No AF, that I'm aware of, since DCCV in April so I've feel really well and so I would hope it's not too bad.

[NLGA in reply to Ducky2003]

I am sure how important the Ejection fraction is but 50 ( which I am) seems the lowest point before we start dropping into HF although many people lower seem fine

[NLGA]

Yes my left atrium has Mld dilation and I have mild MR but the vakve and the structure are in good order so they are not looking to operate in that and informed me mild MR is pretty normal in people

[Ducky2003 in reply to NLGA]

Yes, most folk have mild MR. He thinks the valve and annulus are ok for repair rather than replacement. He will just tighten the annulus back to normal size. He's also going to do a Cox Maze IV whilst he's in there, which may hopefully get rid of the AF once and for all.Surgeon also mentioned tightening up the atrium as well.

[NLGA in reply to Ducky2003]

That sounds really positive I wish you all the best

[Ducky2003 in reply to NLGA]

Thanks. No date as yet but I'm not wanting to rush 🤣. I did ask if he could tighten up the stomach at the same time but he wasn't keen 😁.